Purpose:  As part of a needs assessment phase for the WELL project (Women Enjoying Life Longer) in eastern Baltimore County, Maryland, 20 in-depth interviews of 15 clients of 3 Family Planning Clinics and 5 comparable women from the community were conducted.  

Our intent was to document both pre- and peri-menopausal women’s attitudes and beliefs regarding women’s health issues, to assess potential barriers women experience when seeking medical care, and to identify possible solutions for overcoming barriers and optimizing health status. 

Results:  Although “health” was a stated priority, both financial barriers—including lack of or inadequate insurance—and time barriers impede access to medical care.  These barriers impede access to routine care external to reproductive health services such as acute care, dental care, and specialty care services. 

Primary recommendations were: decreasing the waiting time and improving the waiting area; increasing the number of staff—particularly those with authority to prescribe medication; making the clinic services more comprehensive, particularly in the areas of links to mental health, violence, drug/alcohol abuse, routine physicals, and dental and vision care services; letting the women in the community know what services already exist and creating a task force to build and strengthen partnerships in the community; and investigating the feasibility of offering self-help groups in the clinics. 

Additional implications for future program development will also be discussed. 

By the end of this session, the learner should be able to:  State four barriers to utilizing health care services among women in different life stages; articulate how these barriers influence both social and behavioral determinants of health; and describe potential interventions to improve access to and delivery of health care services.