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School-based health clinics with reproductive health services

Health Factors: Sexual Activity Education
Decision Makers: Educators Healthcare Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 1-9% of WI's population
Impact on Disparities: Likely to decrease disparities

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School-based health clinics provide a variety of health care services to attending students. Most middle and high school-based clinics offer reproductive services, which generally include contraception, abstinence and contraception counseling, and pregnancy and STI testing (SBHA-Data 2011). Such clinics also sometimes offer prenatal care (Strunk 2008). Clinics are located in urban, rural, and suburban schools; in 2010-11, about 70% of students attending schools with clinics were racial or ethnic minorities. In that same year, about half of all school-based health clinics were prohibited from dispensing contraception, most often by district policy (SBHA-Data 2011).

Expected Beneficial Outcomes

Reduced low birthweight births
Improved student attendance
Increased high school graduation
Increased use of contraception
Increased reproductive health care
Reduced teen pregnancy
Increased preventive care

Evidence of Effectiveness

There is some evidence that school-based health clinics that provide reproductive health services reduce low birthweight births, absenteeism, and dropout rates among students who give birth (Strunk 2008). However, additional evidence is needed to confirm effects.

Clinics that offer contraception appear to increase contraception receipt among sexually active students more than clinics that offer health assessments or counseling only (Blank 2010). School-based clinics can increase contraception use (Keeton 2012) and receipt of reproductive health care among females (Ethier 2011) and may reduce birth rates (Ricketts 2006). A California-based study suggests such clinics may not affect contraception use among males (Ethier 2011).

Some school-based clinics may offer patients screening and advice about substance abuse, nutrition, physical or sexual abuse, mental health, and preventing repeat pregnancies more frequently than community clinics (Strunk 2008). Confidential services appear to serve as an incentive for teens to use clinic services (Keeton 2012).


United States

Many school-based health clinics offer reproductive health services, examples include clinics in Baltimore, Maryland; Multnomah County, Oregon; and St. Paul, Minnesota (AFY-SBHC).

Implementation Resources

CA SBHA - California School-Based Health Alliance. Putting health where kids are. Accessed on December 30, 2015
NYC SBHC - New York City Department of Education. School-Based Health Centers. Accessed on January 14, 2016
SBHA - School-Based Health Alliance. Redefining health for kids and teens. Accessed on December 15, 2015

Citations - Description

SBHA-Data 2011 - School-Based Health Alliance. National census of school-based health centers: 2010-2011. Accessed on December 22, 2015
Strunk 2008* - Strunk JA. The effect of school-based health clinics on teenage pregnancy and parenting outcomes: An integrated literature review. The Journal of School Nursing. 2008;24(1):13-20. Accessed on October 13, 2016

Citations - Evidence

Blank 2010* - Blank L, Baxter SK, Payne N, Guillaume LR, Pilgrim H. Systematic review and narrative synthesis of the effectiveness of contraceptive service interventions for young people, delivered in educational settings. Journal of Pediatric and Adolescent Gynecology. 2010;23(6):341–51. Accessed on February 2, 2016
Ethier 2011* - Ethier KA, Dittus PJ, DeRosa CJ, et al. School-based health center access, reproductive health care, and contraceptive use among sexually experienced high school students. Journal of Adolescent Health. 2011;48(6):562-5. Accessed on December 16, 2015
Keeton 2012* - Keeton V, Soleimanpour S, Brindis CD. School-based health centers in an era of health care reform: Building on history. Current Problems in Pediatric and Adolescent Health Care. 2012;42(6):132–156. Accessed on October 18, 2016
Ricketts 2006 - Ricketts SA, Guernsey BP. School-based health centers and the decline in black teen fertility during the 1990s in Denver, Colorado. American Journal of Public Health. 2006;96(9):1588-92. Accessed on December 15, 2015
Strunk 2008* - Strunk JA. The effect of school-based health clinics on teenage pregnancy and parenting outcomes: An integrated literature review. The Journal of School Nursing. 2008;24(1):13-20. Accessed on October 13, 2016

Citations - Implementation

AFY-SBHC - Contraceptive access at school-based health centers: Three case studies. Advocates for Youth. Accessed on January 14, 2016

Page Last Updated

June 11, 2015

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