Grant: Project Grant

What will we do? In April 2023, prescription contraception became available for free in British Columbia (BC). This was the result of a new "universal, no-cost subsidy" implemented by the BC Ministry of Health. Manitoba (MB) just announced a similar subsidy will start in October 2024. We will study the effect of these subsidies on contraception use and access, pregnancy outcomes, and costs. How will we do it? We will use population-based health administrative data from 3 provinces (BC, MB, and AB). 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 compare trends in BC to trends in MB (until October 2024) and Alberta (AB) (no subsidy). 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 people with lived and living experience, policy makers, health system leaders, contraception service providers, and patient advocates. Why does this matter? Canadians have limited and inadequate access to contraception. 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. These contraception subsidies aim to improve access, health outcomes, and costs. Governments across Canada are looking to BC to understand how a similar subsidy would affect their residents and health system. We are ready to provide this much needed, time-sensitive evidence.