Community Reactions to Reproductive Health Care at Three School‐Based Clinics in Louisiana

Under the direction of the Louisiana Office of Public Health focus groups at three schools were used to conduct a formal evaluation of the school-based health centers (SBHCs). Specifically researchers aimed to determine the actual educational and health-related benefits of the SBHCs. One high school was in a politically conservative small city in southern Louisiana. 60% of the students were African-American. More than 50% of girls became pregnant at least once during their high school years. The high pregnancy rate affected school attendance and drop-out rates. The second SBHC served elementary junior and senior high school students who lived in a conservative close-knit community. Most residents were White. 90% of students enrolled for SBHC services. The third SBHC was located in a high school in the inner city of a medium-sized city. Crime violence drug dealing drug use single-parent families and poverty were common. Most students were African Americans. Shared commonalities of the three SBHCs included: little controversy existed about provision of pregnancy and STD (sexually transmitted disease) testing or referral about contraceptive counseling and everyone was aware of the high pregnancy rates in their communities and that adolescent pregnancy is associated with absenteeism and high drop-out rates. Yet few people were ready to define adolescent pregnancy as a community concern or as a problem appropriately addressed by the SBHC. The willingness of a community to address reproductive health may reflect their concerns about keeping students in school. These findings suggest that SBHCs must develop and maintain strong support and commitment from students teachers parents and the greater community. Once the SBHC has gained their confidence it is free to develop services that meet the specific needs of the students. Successful launching of SBHCs depends on keeping the health care goals consistent with the communitys educational goals rather than social goals.