Use of and access to oral and injectable contraceptives in brazil

Use of and access to oral and injectable contraceptives in brazil

Title: Use of and access to oral and injectable contraceptives in brazil;
Utilização e acesso a contraceptivos orais e injetáveis no Brasil
Author Farias, Mareni Rocha Google Scholar
Leite, Silvana Nair Google Scholar
Leao Tavares, Noemia Urruth Google Scholar
Oliveira, Maria Auxiliadora Google Scholar
Dourado Arrais, Paulo Sergio Google Scholar
Bertoldi, Andrea Damaso Google Scholar
Dal Pizzol, Tatiane da Silva Google Scholar
Luiza, Vera Lucia Google Scholar
Ramos, Luiz Roberto Autor UNIFESP Google Scholar
Mengue, Sotero Serrate Google Scholar
Abstract OBJECTIVE: To analyze the prevalence of current use of oral and injectable contraceptives by Brazilian women, according to demographic and socioeconomic variables and issues related to access to those medicines. METHODS: A cross-sectional, population-based analytical study with probability sampling based on data from the Pesquisa Nacional sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), carried out between September 2013 and February 2014 in 20,404 Brazilian urban households. Prevalence was calculated based on reports from non-pregnant women aged 15-49 on the use of oral or injectable contraceptives. The independent variables were gender, age, level of education, socioeconomic class, Brazilian region and marital status. Also analyzed were access, means of payment, sources, and reported medicines. Statistical analyses considered 95% confidence intervals (95% CI) and Pearson Chi-square test to evaluate the statistical significance of differences between groups, considering a 5% significance level. RESULTS: Prevalence of use was 28.2% for oral contraceptives (OC) and 4.5% for injectable contraceptives (IC). The highest prevalence of oral contraceptives was in the South region (37.5%) and the lowest in the North region (15.7%). For injectable contraceptives there was no difference between regions. Access was higher for oral contraceptive users (90.7%) than injectable contraceptives users (81.2%), as was direct payment (OC 78.1%, IC 58.0%). Users who paid for contraceptives acquired them at retail pharmacies (OC 95.0% and IC 86.6%) and at Farmacia Popular (Popular Pharmacy Program) (OC 4.8% and IC 12.7%). Free of charge contraceptives were mostly obtained from the Brazilian Unified Health System - SUS (OC 86.7%

IC 96.0%). Free samples were reported by 10.4% of users who did not pay for oral contraceptives. Most of paying users did not try to obtain contraceptives from SUS. Monophasic combined oral contraceptives were the most frequently reported (71.6%) and low-level levonorgestrel + ethinylestradiol combination accounted for 38.7% of them. The most frequently reported medicines are included in the Relacao Nacional de Medicamentos Essenciais (RENAME - National List of Essential Medicines. CONCLUSIONS: Most women aged 15 to 49 who reported using contraceptives had access to the medicine and use monophasic combined oral contraceptives of appropriate efficiency and safety purchased by direct payment, mainly from retail pharmacies.
Keywords Developing-Countries
Language English
Sponsor Department for Pharmaceutical Services and Strategic Health Supplies (DAF) of the Secretariat of Science, Technology and Strategic Inputs of the Brazilian Ministry of Health (SCTIE/MS) [25000.111834/2]
Department of Science and Technology (DECIT) of the Secretariat of Science, Technology and Strategic Inputs of the Brazilian Ministry of Health (SCTIE/MS) [25000.111834/2]
Grant number SCTIE/MS: 25000.111834/2
Date 2016
Published in Revista De Saude Publica. Sao paulo, v. 50, n. 2, p. 14s, 2016.
ISSN 0034-8910 (Sherpa/Romeo, impact factor)
Publisher W W F Verlagsgesellschaft Gmbh
Extent 14s
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000391447400013
SciELO ID S0034-89102016000300301 (statistics in SciELO)

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