Grant: Project Grant - PA: Sex and Gender in Health Research (Bridge funding)

What will we do? In April 2023, prescription contraception became available free of charge in British Columbia (BC). This was the result of a new "universal, no-cost subsidy" implemented by the BC Ministry of Health. We will study the effect of this new subsidy on contraception use and access, pregnancy outcomes, and health system costs. How will we do it? We will use population-based health administrative data from 3 provinces (BC, AB, and MB). The study will include all females aged 15-49 and contraception-prescribing health care providers from 2018-2026. We will use a controlled interrupted time series design. This will allow us to examine trends in important outcomes over time. We will also compare trends in BC to trends in a two provinces that did not implement the new subsidy (Alberta and Manitoba). Our team includes experts in contraception, health policy evaluation, and population-based administrative data. We will ensure direct sharing of findings to inform current and future policy. Thus, our team also includes policy makers, health system leaders, contraception service providers, and patient advocates. Why does this matter? Access to contraception is limited and inadequate across Canada. Canada's provincial health systems do not include universal contraception coverage. Our provincial systems cover all pregnancy care (ex. miscarriage or birth), but not contraception. This limits people's abilities to time, space, and prevent pregnancies as they wish. Mistimed and unwanted pregnancies lead to poor reproductive health outcomes and health inequities. Marginalized and equity-deserving groups are disproportionately affected. BC's new contraception subsidy aims to improve access, health outcomes, and costs. Recently, the federal government of Canada announced a plan to implement a contraception subsidy across the country. As policymakers work on this plan, findings from our study may help with the specifics of how this policy rolls out.