Building on the Work of Statewide Contraceptive Access Initiatives (SCAI)

By Jessica Danaux and Jamie Hart

Since the early 2000s, state health departments, philanthropic organizations, nonprofit and community organizations, health centers, and many other partners have come together to tackle contraceptive access barriers in their states—such as reducing cost, improving provider comfort and skill, and expanding availability of contraceptive methods. While early efforts often focused on increasing access to long-acting reversible contraceptives, SCAI have begun employing strategies to ensure that all methods are equitably available for people to choose what works best for them. This shift comes as more SCAI, ongoing and new, prioritize advancing individual autonomy and agency, reproductive justice, and sexual and reproductive health equity (SRHE).

These statewide initiatives don’t (and can’t) use a one-size-fits-all approach. They adopt, tailor, and create activities to fit their state and local context, which both establishes best practices and spurs innovation. SCAI are proving to be a unique and effective model for building workforce capacity, innovating clinic- and community-based strategies, and building a coalition of committed partners.

CECA believes great opportunity exists to move SCAI forward and improve future efforts with an eye toward SRHE. In collaboration with the Center for Reproductive Health Research in the Southeast (RISE) and SCAI leaders, CECA gathered and documented evidence and stakeholder insights to identify opportunities to advance these initiatives. Together, we developed a shared vision and recommendations intended to support SCAI implementers, evaluators, funders, and other stakeholders to build on lessons learned, advance strategies to expand access, and progress toward the vision for SCAI.

The recommendations report outlines four goals and priority actions that provide clear direction for how to advance SCAI and their vision:

  1. Center community voice in all aspects of SCAI.

  2. Create space and flexibility for SCAI to adapt best practices, respond to local needs, and pursue innovative approaches.

  3. Ensure values-driven goals align with measures and intended outcomes that provide a more complete story of people’s access to contraception and experiences.

  4. Explore various approaches to sustain efforts to improve contraception access.

The hope of this effort is that SCAI and partners will use these recommendations to continue to build the evidence, develop supportive resources, and facilitate continuous learning and knowledge sharing. More broadly, advocates, researchers, community organizations, policymakers, and other stakeholders can help to gain buy-in, identify and test equity-informed approaches, and amplify the unique efforts of SCAI – a model poised for ongoing evolution and meaningful impact.

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