Access to long-acting reversible contraception: A systematic review to improve competencies in primary care settings.

OBJECTIVE: The aim of this study was to identify and synthesise published literature on barriers and facilitators to equitable access to long-acting reversible contraception in New Zealand, with a particular focus on wāhine Māori. METHODS: A systematic review utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 tool was conducted on peer-reviewed journal articles and grey literature to identify barriers and facilitators to equitable access to long-acting reversible contraception. Thematic analysis was utilised to present and synthesise the results. RESULTS: Fifteen records were included in the study, from which five key themes emerged: (i) health literacy, (ii) access to care, (iii) clinical experience, (iv) cultural safety and (v) data. Each theme addressed concerns regarding workforce capacity and training gaps, service accessibility, inadequate data and accountability mechanisms and inconsistent funding structures. The findings highlight structural inequities that disproportionately affect wāhine Māori (Māori women). CONCLUSIONS: Wāhine Māori are less likely to have their contraceptive needs met, demonstrating the importance of culturally safe, high-quality care. Strengthening access to professional development for the primary care sexual health workforce is essential to addressing these disparities. IMPLICATIONS FOR PUBLIC HEALTH: The findings highlight the need to improve access, enhance the quality of care and reduce sexual and reproductive health inequities.