Contraceptive use dynamics research needs post fertility transition

Curtis, Siân L.

doi:10.1590/s0102-30982012000100012

Cited by 8 publications

(11 citation statements)

References 9 publications

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“…Participants' ages ranged between 14 and 24 years old. This study will refer to its the participants which includes adolescents (aged 10-19) and youths (aged [15][16][17][18][19][20][21][22][23][24], as young women. The study setting was selected based on the three Brazilian health care facilities place-based Sentinel Sites Evaluation (SSE) activities established by the research study sites WHO Human Reproduction Program (HRP).…”

Section: Recruitment Of Participantsmentioning

confidence: 99%

“…Despite the increase in use of contraceptives in Brazil [23,24], the young women were unaware of how to use them effectivelyor even how to access these contraceptive methods. They reported having little trust in short acting contraceptive methods such as oral and injectable contraceptiveswhich are commonly offered by the Brazilian public health services and have the highest usage prevalence in Brazil [25].…”

Section: The Information Gap On Sexual and Reproductive Health Care Lmentioning

confidence: 99%

“…Data from the National Demographic and Health Survey (PNDS) from 2016 revealed that 19% of women in Brazil experienced an unwanted pregnancy on the day of the interview; in the Northeast of the country the region where the study was conductedthe proportion reached 22,5%. In Brazil, more than half of all births were reported as unwanted or mistimed [11,24,29].…”

Section: The Information Gap On Sexual and Reproductive Health Care Lmentioning

confidence: 99%

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Understanding sexual and reproductive health needs of young women living in Zika affected regions: a qualitative study in northeastern Brazil

Diniz¹,

Ali

Ambrogi

et al. 2020

Reprod Health

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Background: In 2016, the World Health Organization declared a Public Health Emergency of International Concern due to Zika's association with microcephaly and other neurological disorders. Brazil was the epicenter of this epidemic and the most affected region has the lowest Human Development Index and the highest rates of adolescent pregnancy. Despite the end of the epidemic, Brazil continues to be the epicenter of Zika illness. This study examined the barriers faced by young women who seek sexual and reproductive health (SRH) care services living in affected areas and their attitudes towards SRH needs and the available services. Methods: Individual semi-structured interviews were conducted with 22 young women, aged 14-24 years in three Zika affected municipalities in the Brazilian Northeast. This qualitative research used thematic analysis for data analysis. Results: Almost half (n = 10) of the participants had their first pregnancy during adolescence (from 12 to 19), all of which were unintended. Lack of information and barriers to access family planning were found to contribute to the unmet need for contraception. Participants reported knowledge gaps about contraception. Zika was not considered a health concern and participants were unaware of the possibility of Zika's sexual transmission. Conclusions: The young women's knowledge and attitudes towards their SRH needs highlight the barriers to access care. It also implies that comprehensive, biopsychosocial and political, understanding is necessary in order to adequately provide SRH to this population and meet their needs. The government should place women at the center of any public health response to an emergency affecting women of reproductive age and focus on improving access to information and family planning services in a culturally and age appropriate manner.

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Section: Recruitment Of Participantsmentioning

confidence: 99%

Section: The Information Gap On Sexual and Reproductive Health Care Lmentioning

confidence: 99%

Section: The Information Gap On Sexual and Reproductive Health Care Lmentioning

confidence: 99%

See 1 more Smart Citation

Understanding sexual and reproductive health needs of young women living in Zika affected regions: a qualitative study in northeastern Brazil

Diniz¹,

Ali

Ambrogi

et al. 2020

Reprod Health

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“…Furthermore, during the fertility transition, the rate of contraception has also increased 11. Despite increased contraception use, the cumulative rate of spontaneous and induced abortion changed very little between 1996 and 2006, for which population survey estimates are available 12,13.…”

Section: Introductionmentioning

confidence: 99%

The burden of unintended pregnancies in Brazil: a social and public health system cost analysis

Le¹,

Connolly²,

Bahamondes³

et al. 2014

IJWH

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BackgroundUnintended pregnancy (UP) is an unmet medical need with consequences worldwide. We evaluate the costs of UP based on pregnancies in Brazil from for the year 2010.MethodsThe consequences of UP were evaluated using decision analysis based on pregnancy rates and outcomes as miscarriage, induced abortion, and live birth, which were factored into the analysis. The model discriminated between maternal and child outcomes and accounted for costs (in Brazilian currency [Real$, R$]) within the Brazilian public health service attributed to preterm birth, neonatal admission, cerebral palsy, and neonatal and maternal mortality. Event probabilities were obtained from local resources.ResultsWe estimate that 1.8 million UPs resulted in 159,151 miscarriages, 48,769 induced abortions, 1.58 million live births, and 312 maternal deaths, including ten (3%) attributed to unsafe abortions. The total estimated costs attributed to UP are R$4.1 billion annually, including R$32 million (0.8%) and R$4.07 billion (99.2%) attributed to miscarriages and births and complications, respectively. Direct birth costs accounted for approximately R$1.22 billion (30.0%), with labor and delivery responsible for most costs (R$988 million; 24.3%) for the year 2010. The remainder of costs were for infant complications (R$2.84 billion; 72.3%) with hospital readmission during the first year accounting for approximately R$2.15 billion (52.9%). Based on the national cost, we estimate the cost per UP to be R$2,293.ConclusionDespite weaknesses in precise estimates in annual pregnancies and induced abortions, our estimates reflect the costs of UP for different pregnancy outcomes. The main costs associated with UP are in those carried to parturition. The health cost of abortion represents a small proportion of total costs as these are paid for outside of the public health system. Consequently, reductions in UP will generate not only cost savings, but reductions in woman and child morbidity and mortality.

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“…Over the same period, the use of contraceptives has increased. 7,8 Preventing unplanned pregnancies through publicly funded programs is a strategy that has proven to be effective in significantly cutting costs for health services. 9 In this editorial, we will discuss the current situation in Brazil, providing an insight into the inequalities that exist in the provision of contraceptive methods, particularly long-acting reversible contraceptive (LARC) methods, and highlighting the causes and consequences of unplanned pregnancies in Brazil, where fertility planning services are vastly different to those provided in developed countries, and where abortion legislation is restrictive.…”

mentioning

confidence: 99%

Barriers to Implementing and Consolidating a Family Planning Program that would meet Brazilian Needs

Bahamondes

Fernandes

Monteiro

2017

Rev Bras Ginecol Obstet

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Rev Bras Ginecol Obstet 2017;39:373-375.Around 50-55% of all births in Brazil are unplanned, and these figures include both unwanted and mistimed pregnancies. 1,2 The overall rate of induced abortion is estimated at 1.5%, with all induced abortions resulting from unplanned pregnancies culminating in an adjusted abortion rate of 2.7%. In many cases, unplanned pregnancies terminate in induced abortions and, since abortion in Brazil is restricted and only allowed under certain circumstances, many of these procedures are unsafe. Indeed, unsafe abortions are estimated to account for 13% of all maternal deaths. 3,4 The cost of unplanned pregnancies weighs not only on the healthcare system but also on society, and involves the cost of abortion care and of unplanned childbirth. When the pregnancy is unplanned, the likelihood of preterm births and low birthweight infants increases, and this scenario implies high costs associated with neonatal care and longterm disabilities. 5,6 The total fertility rate in Brazil has fallen significantly in recent decades, and today stands at 1.8 births per woman. Over the same period, the use of contraceptives has increased. 7,8 Preventing unplanned pregnancies through publicly funded programs is a strategy that has proven to be effective in significantly cutting costs for health services. 9 In this editorial, we will discuss the current situation in Brazil, providing an insight into the inequalities that exist in the provision of contraceptive methods, particularly long-acting reversible contraceptive (LARC) methods, and highlighting the causes and consequences of unplanned pregnancies in Brazil, where fertility planning services are vastly different to those provided in developed countries, and where abortion legislation is restrictive.The Brazilian National Healthcare Service (SUS, in the Portuguese acronym) covers the cost of around 70-75% of all procedures performed in the country, including those related to reproduction. An estimated 1.79 million unplanned pregnancies and 1.47 million planned pregnancies occur annually, with 351 maternal deaths, of which 49 (14%) are attributed to abortions, and 302 to complications resulting from miscarriages and childbirth. The number of infant deaths in the first year of life is estimated at 32,864. The model estimates the number of preterm deliveries attributed to unplanned pregnancies at 122,523. The estimated number of neonatal admissions associated with unplanned pregnancies was 224,631 for 2010, including all preterm deliveries and 7.6% of all term deliveries. 10 Consequently, the total annual costs attributed to unplanned pregnancies are estimated at R$4.1 billion or more, depending on the exchange rate. Approximately R$4.07 billion (99.2%) of that total amount is attributed to childbirth and its resulting complications. Based on national cost estimates and the number of unplanned pregnancies per year, the cost per unplanned pregnancy is calculated at R $4,439. However, this is based only on cases occurring within the public healthcare sys...

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Contraceptive use dynamics research needs post fertility transition

Cited by 8 publications

References 9 publications

Understanding sexual and reproductive health needs of young women living in Zika affected regions: a qualitative study in northeastern Brazil

Understanding sexual and reproductive health needs of young women living in Zika affected regions: a qualitative study in northeastern Brazil

The burden of unintended pregnancies in Brazil: a social and public health system cost analysis

Barriers to Implementing and Consolidating a Family Planning Program that would meet Brazilian Needs

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