To Örebro University

Objective: To compare contraceptive services provided by family planning clinics in Linkoping and Norrkoping in Ostergotland County, Sweden. The two cities are of similar size but have different socio-demographic profiles. The abortion rate in Link ping (15.3 per 1000) is substantially lower than in Norrkoping (21.1 per 1000).

Methods: The study was performed in two steps. First, the clinics providing contraceptive services in the two cities were studied using ten pre-defined quality indicators. Thereafter, 11 healthcare providers were interviewed: six in Linkoping and five in Norrkoping. The interviews were analysed using qualitative content analysis.

Results: No differences were found in the organisation of contraceptive care in the two cities. Neither city met the criteria for five of the ten quality indicators. The analysis of the interviews generated four themes: 'Guidelines and electronic record template', 'Criteria for good contraceptive counselling', 'Availability of contraception', and 'Sexual health'. The interviews revealed that the clinical leadership in Norrkoping was insuffincient.

Conclusion: Clinics in the two cities are organised in the same way so that differences in abortion rates cannot be related to differences in organisation. The reasons for the differences in abortion rates in the two cities have yet to be determined.