Use of and access to oral and injectable contraceptives in Brazil

Authors

  • Mareni Rocha Farias Universidade Federal de Santa Catarina; Centro de Ciências da Saúde; Departamento de Ciências Farmacêuticas
  • Silvana Nair Leite Universidade Federal de Santa Catarina; Centro de Ciências da Saúde; Departamento de Ciências Farmacêuticas
  • Noemia Urruth Leão Tavares Universidade de Brasília; Faculdade de Ciências da Saúde; Departamento de Farmácia
  • Maria Auxiliadora Oliveira Fundação Oswaldo Cruz; Escola Nacional de Saúde Pública Sérgio Arouca
  • Paulo Sergio Dourado Arrais Universidade Federal do Ceará; Faculdade de Farmácia, Odontologia e Enfermagem; Departamento de Farmácia
  • Andréa Dâmaso Bertoldi Universidade Federal de Pelotas; Faculdade de Medicina; Departamento de Medicina Social
  • Tatiane da Silva Dal Pizzol Universidade Federal do Rio Grande do Sul; Faculdade de Farmácia; Departamento de Produção e Controle de Medicamentos
  • Vera Lucia Luiza Fundação Oswaldo Cruz; Escola Nacional de Saúde Pública Sérgio Arouca
  • Luiz Roberto Ramos Universidade Federal de São Paulo; Escola Paulista de Medicina
  • Sotero Serrate Mengue Universidade Federal do Rio Grande do Sul; Faculdade de Medicina

DOI:

https://doi.org/10.1590/s1518-8787.2016050006176

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.

Published

2016-01-01

How to Cite

Farias, M. R., Leite, S. N., Tavares, N. U. L., Oliveira, M. A., Arrais, P. S. D., Bertoldi, A. D., Pizzol, T. da S. D., Luiza, V. L., Ramos, L. R., & Mengue, S. S. (2016). Use of and access to oral and injectable contraceptives in Brazil . Revista De Saúde Pública, 50(supl2), 14s. https://doi.org/10.1590/s1518-8787.2016050006176

Issue

Section

Original Articles