Use of and access to oral and injectable contraceptives in Brazil

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, Utilização e Promoção 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 Farmácia 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 Relação 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.

Satisfaction with the use of contraceptive methods among women from primary health care services in the city of São Paulo, Brazil

“…20 In addition to this, it is easy to obtain injectable contraceptives and pills in drugstores, even without medical prescription. 21 Regarding the correlates of contraceptive method satisfaction, our results confirm that it is associated with the type of method used, as well as described in other studies. 7,8 Traditional and barrier method users were less likely to be satisfied with their contraceptives than tubal ligation and vasectomy users.…”

Estudo comparativo entre dispositivos intrauterinos inseridos em mulheres no puerpério sob diferentes técnicas e períodos / Comparative study between intrauterine devices inserted in women in the puerperium under different techniques and periods

“…Dentre os métodos anticoncepcionais usados anteriormente, destaca-se o anticoncepcional oral. Um estudo brasileiro, apresenta uma taxa de uso de anticoncepcionais orais em cerca de 37,5% (IC: 34,8 -40,2) nas mulheres da região Sul do Brasil (16) . Porém, é evidente que o método com maior taxa de continuidade é o DIU, utilizado por um total de 5 participantes, com uma média de uso de aproximadamente cinco anos e meio (68,1 meses).…”

Caracterização Socioeconômica, Epidemiológica E Laboral De Trabalhadores Terceirizados De Uma Universidade Pública

“…No que se refere ao uso de anticoncepcionais, os dados deste estudo se assemelham aos dados nacionais, cujos resultados mostram que nas áreas urbanas brasileiras, 32,7% das mulheres com idades entre 15 e 49 anos utilizam anticoncepcionais orais ou injetáveis (19) . O uso de anticoncepcionais neste estudo também pode ser justificado pelo fato de 54,4% dos trabalhadores entrevistados serem do sexo feminino.…”