Sexual and Reproductive Health in the South: Understanding Diverse Investments and Moving Forward Under Health Care Reform

Background:  The ongoing health inequities in the South are the result of a multitude of factors. Limited access to sexual and reproductive health (SRH) services compounds these inequities, resulting in poor outcomes such as high rates of unintended pregnancy and STDs, including HIV. While myriad family planning, STDs, and HIV/AIDS organizations have invested resources to improve specific health outcomes, this work is often done in silos.  Recognizing the need to better coordinate efforts, the National Coalition of STD Directors (NCSD), the National Family Planning & Reproductive Health Association (NFPRHA), and the New Morning Foundation hosted a meeting bringing together partners representing a broad spectrum of stakeholders focused on improving SRH outcomes in the South. The sponsors facilitated cross-sector conversations about coordination, integration, and resource-sharing. A successful pilot meeting occurred in September 2013 with representatives from Alabama, Georgia, Mississippi, North Carolina, and South Carolina. A second meeting was held in February 2014 with participants from Arkansas, Kentucky, Louisiana, Tennessee, Virginia, and West Virginia.

Methods:  Using qualitative research methods including semi-structured interviews, the hosts facilitated discussions between stakeholders to identify resources and priorities, opportunities and challenges, critical needs, and next steps. These discussions were first segmented by state with representatives from STD, family planning, and HIV/AIDs programs. Discussions were recorded and coded to identify key themes.  

Results:  Participants identified community partners, shared information about financial resources and strategies for responding to service delivery challenges (e.g. lack of 340B funding), and learned from similar programs in other states. Participants also identified challenges for policy and grant makers to consider addressing (e.g. planning for workforce changes, decline of grant revenue as the health care marketplace evolves etc.). 

Conclusions:  SRH stakeholders benefitted from engaging with colleagues across programs in a structured setting. Participants identified opportunities to improve coordination and SRH outcomes in the South.