Escolha de métodos contraceptivos entre usuárias do Sistema Único de Saúde no interior do nordeste brasileiro

Hemily dos Santos Rodrigues; Márcia Neves de Carvalho; Iris Tarciana de Freitas Cunha; Tássia Nayane Vieira dos Santos

doi:10.5712/rbmfc21(48)4701

Authors

Hemily dos Santos Rodrigues Universidade Federal de Sergipe – Lagarto (SE), Brasil https://orcid.org/0000-0001-5156-2052
Márcia Neves de Carvalho Universidade Federal de Sergipe – São Cristóvão (SE), Brasil https://orcid.org/0000-0002-4370-2788
Iris Tarciana de Freitas Cunha Universidade Federal de Sergipe – Lagarto (SE), Brasil
Tássia Nayane Vieira dos Santos Universidade Federal de Sergipe – Lagarto (SE), Brasil

DOI:

https://doi.org/10.5712/rbmfc21(48)4701

Keywords:

Family development planning, Contraception, Unified Health System

Abstract

Introduction: Although 80% of fertile and sexually active women in Brazil use contraceptive methods, 55% of pregnancies are unplanned. Law No. 9263/1996 and the National Family Planning Policy (2017) guarantee the free provision of contraceptive methods through the Unified Health System (SUS). However, the predominance of methods such as the pill and female sterilization, combined with the low uptake of long-acting methods, highlights challenges in access and reproductive education. Socioeconomic and demographic factors strongly influence these choices, making it relevant to investigate these variables in local contexts. Objective: To analyze the factors influencing the choice of contraceptive methods among SUS users in Lagarto (SE), considering the impact of socioeconomic and demographic profiles and knowledge about contraception. Methods: A quantitative study was conducted with 147 women assisted at the Humanized Center for Women and Children, a women’s health service integrated into SUS in Lagarto (SE). Women aged 18 to 50, residing in the municipality and users of SUS, who provided informed consent, were included. Data were collected through a structured questionnaire covering socioeconomic and demographic information, knowledge about contraception, and current contraceptive practices. Statistical analysis identified associations between these variables and the choice of contraceptive methods. Results: Oral contraceptive pills (43.7%) and male condoms (20.2%) were the most frequently chosen methods, followed by the IUD (12.6%). The choice of methods was significantly influenced by age and educational level, with older women and those with lower schooling tending to choose irreversible methods. Higher knowledge about contraception was found among women with more years of education and those living in urban areas. Pharmacies were the main source of contraceptive access. Conclusions: The choice of contraceptive methods in the studied region is influenced by socioeconomic inequalities and limited access to information. The local analysis reinforces the value of regional studies as essential tools to understand the determinants of contraceptive choices and to guide more effective and territory-based interventions within SUS.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Instituto Brasileiro de Geografia e Estatística. Pesquisa nacional de saúde 2019: ciclos de vida: Brasil [Internet]. Rio de

Janeiro: IBGE; 2021 [cited on Aug 16, 2023]. Available at: https://www.pns.icict.fiocruz.br/wp-content/uploads/2021/12/

liv101846.pdf

Wender MCO, Machado RB, Politano CA. Influência da utilização de métodos contraceptivos sobre as taxas de gestação não planejada em mulheres brasileiras. Femina. 2022;50(3):134-41.

Brasil. Presidência da República. Casa Civil. Subchefia para Assuntos Jurídicos. Lei no 9.263, de 12 de janeiro de 1996. Regula o § 7º do art. 226 da Constituição Federal, que trata do planejamento familiar, estabelece penalidades e dá outras providências [Internet]. Brasília: Diário Oficial da União; 1996 [cited on Aug 08, 2023]. Available at: https://www.planalto.gov.br/ccivil_03/leis/l9263.htm

Starbird E, Norton M, Marcus R. Investing in family planning: key to achieving the sustainable development goals. Glob Health Sci Pract. 2016;4(2):191-210. https://doi.org/10.9745/GHSP-D-15-00374 DOI: https://doi.org/10.9745/GHSP-D-15-00374

Espejo X, Tsunechiro MA, Osis MJD, Duarte GA, Bahamondese L, Sousa MH, et al. Adequação do conhecimento sobre métodos anticoncepcionais entre mulheres de Campinas, São Paulo. Rev Saúde Pública. 2003;37(5):600-6. https://doi.org/10.1590/S0034-89102003000500006 DOI: https://doi.org/10.1590/S0034-89102003000500006

Trussell J. Understanding contraceptive failure. Best Pract Res Clin Obstet Gynaecol. 2009;23(2):199-209. https://doi.org/10.1016/j.bpobgyn.2008.11.008 DOI: https://doi.org/10.1016/j.bpobgyn.2008.11.008

Gosavi A, Ma Y, Wong H, Singh K. Knowledge and factors determining choice of contraception among Singaporean women. Singapore Med J. 2016;57(11):610-5. https://doi.org/10.11622/smedj.2015181 DOI: https://doi.org/10.11622/smedj.2015181

Ferreira HLOC, Barbosa DFF, Aragão VM, Oliveira TMF, Castro RCMB, Aquino PS, et al. Social determinants of health and their influence on the choice of birth control methods. Rev Bras Enferm. 2019;72(4):1044-51. https://doi.org/10.1590/0034-7167-2017-0574 DOI: https://doi.org/10.1590/0034-7167-2017-0574

Ali MM, Cleland J, Shah IH. Causes and consequences of contraceptive discontinuation: evidence from 60 demographic and health surveys. Geneva: World Health Organization; 2012.

Brasil. Ministério da Saúde. Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher – PNDS 2006: dimensões do processo reprodutivo e da saúde da criança [Internet]. Brasília: Ministério da Saúde; 2009 [cited on Aug 16, 2023]. Available at: https://bvsms.saude.gov.br/bvs/publicacoes/pnds_crianca_mulher.pdf

R Core Team. R: A language and environment for statistical computing [Internet]. Vienna: R Foundation for Statistical Computing; 2023 [cited on Oct 04, 2024]. Available at: https://www.R-project.org

The Jamovi Project. Jamovi [Internet]. 2023 [cite don Oct 04, 2024]. Available at: https://dev.jamovi.org/ Aldrighi JM, Sauerbronn AV, Petta CA. Introdução e classificação dos métodos contraceptivos. In: Aldrighi JM, Petta CA, eds. Anticoncepção: aspectos contemporâneos. São Paulo: Editora Atheneu; 2005. p. 1-12.

Trussell J. Contraceptive failure in the United States. Contraception. 2004;70(2):89-96. https://doi.org/10.1016/j.contraception.2004.03.009 DOI: https://doi.org/10.1016/j.contraception.2004.03.009

Ruivo ACO, Facchini LA, Tomasi E, Wachs LS, Fassa AG. Disponibilidade de insumos para o planejamento reprodutivo nos três ciclos do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica: 2012, 2014 e 2018. Cad Saúde Pública. 2021;37(6):e00123220. https://doi.org/10.1590/0102-311X00123220 DOI: https://doi.org/10.1590/0102-311x00123220

Santos NM, Batista PDC, Fiorentino EDV, Moreira RD, Martins CS. Residência de MFC e inserção de DIU (cobre) na APS em Lagarto/SE [Internet]. In: 17o Congresso Brasileiro de Medicina de Família e Comunidade; 2023 [cited on Sep 19, 2024]. Available at: https://www.youtube.com/watch?v=cYpB-8W-4Fw

Daniels K, Abma JC. Current contraceptive status among women aged 15-49: United States, 2017-2019. NCHS Data Brief. 2020;(388):1-8. PMID: 33151146.

Harris ML, Egan N, Forder PM, Bateson D, Loxton D. Patterns of contraceptive use through later reproductive years: a cohort study of Australian women with chronic disease. PLoS One. 2023;18(5):e0268872. https://doi.org/10.1371/journal.pone.026887 DOI: https://doi.org/10.1371/journal.pone.0268872

Perpétuo IHO, Wong LLR. Desigualdade socioeconômica na utilização de métodos anticoncepcionais no Brasil: uma análise comparativa com base nas PNDS 1996 e 2006. In: Brasil. Ministério da Saúde. Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher – PNDS 2006: dimensões do processo reprodutivo e da saúde da criança [Internet]. Brasília: Ministério da Saúde; 2009. p. 87-104 [cited on Sep 19, 2024]. Available at: https://bvsms.saude.gov.br/bvs/publicacoes/pnds_crianca_mulher.pdf

Di Bella ZIKJ, Bianchi AMHM, Araujo FF, Sartori MGF, Girão MJBC. Contraception and family planning at the extreme of reproductive life – climacteric. Rev Assoc Med Bras (1992). 2016;62(5):454-7. https://doi.org/10.1590/1806-9282.62.05.454 DOI: https://doi.org/10.1590/1806-9282.62.05.454

Odwe G, Wado YD, Obare F, Machiyama K, Cleland J. Method-specific beliefs and subsequent contraceptive method choice: Results from a longitudinal study in urban and rural Kenya. PLoS One. 2021;16(6):e0252977. https://doi.org/10.1371/journal.pone.025297 DOI: https://doi.org/10.1371/journal.pone.0252977

Claringbold L, Sanci L, Temple-Smith M. Factors influencing young women’s contraceptive choices. Aust J Gen Pract. 2019;48(6):389-94. https://doi.org/10.31128/AJGP-09-18-4710 DOI: https://doi.org/10.31128/AJGP-09-18-4710

Tomaszewski D, Aronson BD, Kading M, Morisky D. Relationship between self-efficacy and patient knowledge on adherence to oral contraceptives using the Morisky Medication Adherence Scale (MMAS-8). Reprod Health. 2017;14(1):110. https://doi.org/10.1186/s12978-017-0374-6 DOI: https://doi.org/10.1186/s12978-017-0374-6

Akwara E, Pinchoff J, Abularrage T, White C, Ngo TD. The urban environment and disparities in sexual and reproductive health outcomes in the global south: a scoping review. J Urban Health. 2023;100(3):525-61. https://doi.org/10.1007/s11524-023-00724-z DOI: https://doi.org/10.1007/s11524-023-00724-z