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Southern medical journal · Feb 2023
Women's Health Provider Perspectives on Reproductive Services Provision in the Veterans Health Administration.
- Lori M Gawron, Jeanette Young, Serena Yang, Patrick Galyean, Lisa S Callegari, Alexandra Gero, Rebecca G Simmons, Morgan M Millar, and Susan L Zickmund.
- From the Department of Obstetrics and Gynecology, Division of Family Planning, University of Utah, Salt Lake City.
- South. Med. J. 2023 Feb 1; 116 (2): 181187181-187.
ObjectivesWomen veterans are a fast-growing population in the Veterans Health Administration (VHA), and ensuring reproductive service availability is a VHA priority. As such, we sought to explore barriers and facilitators to VHA reproductive service provision across a catchment area from women's health providers' perspectives.MethodsWe performed a mixed-methods study, including semistructured, qualitative provider interviews with a quantitative survey on training, comfort, and knowledge of reproductive services. All women's health providers and their support staff from the Salt Lake City Veterans Affairs Medical Center and nine VHA community-based outpatient clinics were asked to participate. We conducted qualitative interviews and knowledge surveys with providers and staff to explore training, care processes, and improvement opportunities in reproductive service provision. We completed descriptive analyses of all of the quantitative data and used an open, iterative process to analyze provider interviews for emergent themes.ResultsWe interviewed 15 providers (7 advanced practice nurses, 4 registered nurses, and 4 physicians) across nine sites (50% response rate). The commonly identified barriers included provider training and staffing, scheduling/referral processes, inconsistent services/supplies, and lack of veteran awareness of reproductive services. Facilitators included prior non-VHA reproductive health experience among providers, invested support staff, and the integrated VHA health system.ConclusionsAddressing barriers to VHA reproductive healthcare provision may overcome reproductive service variations related to clinic location and improve reproductive health outcomes for women veterans.
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