Expanding access to the etonogestrel subdermal implant: potential for Primary Health Care
DOI:
https://doi.org/10.5712/rbmfc19(46)4225Keywords:
Primary Health Care, Long-Acting Reversible Contraception, Social vulnerability.Abstract
Introduction: According to the guidelines of the National Policy for Comprehensive Attention to Women's Health (PNAISM), the Unified Health System (SUS) must be able to promote comprehensive care for women's health, including guaranteeing access to planning adequate reproduction. In Brazil, more than 55% of pregnancies are unplanned or unintentional, especially in regions of greater vulnerability, resulting in losses in maternal and fetal health rates, high rates of miscarriage, prematurity, intrauterine fetal death and infant mortality. Primary Health Care (PHC) is the health equipment with the greatest insertion and contact with the population, especially the most vulnerable, contributing to improving the living and health conditions of the Brazilian population. It is the responsibility of the APS to prescribe and offer the chosen contraceptive method. In this context, there are long-acting reversible contraceptives, called LARC (Long Acting Reversible Contraceptive), with emphasis on the etonogestrel subdermal implant (IMPLANON NXT®) approved by the SUS for women in vulnerable situations and which stands out for its effectiveness, regardless of the user's motivation and adherence. Objective: To make readers aware of the potential of inserting IMPLANON NXT® in PHC in order to improve reproductive planning in the SUS. Methods: Qualitative analytical study based on the Maguerez Arch. The fifth stage of the method (application to reality) was not carried out. Results: It was identified that geographic proximity, the bond with the community, and the ability to be inserted in the necessary time are prominent elements of PHC's potential. It was also noticed that APS can help overcome barriers such as reducing transportation costs and facilitating device removal. Furthermore, the training of PHC professionals is also a tool for expanding the offer of the procedure. Conclusions: The findings of this study suggest that PHC, considering its specific practices and attributes, should be incorporated into the IMPLANON NXT® insertion protocols in the SUS, aiming to improve the country's reproductive planning and guarantee comprehensive health care for people who can become pregnant.
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