Profile of the free distribution of emergency contraception for adolescents in São Paulo's counties
DOI:
https://doi.org/10.7322/jhgd.20058Keywords:
health management, family planning, birth control, adolescent, contraceptives post-coital hormonal, emergency contraceptionAbstract
The position adopted by São Paulo's counties, which received amounts of emergency contraception from the Federal Health Department in 2005 and 2006, is described in relation to the distribution of these to adolescents. Using quantitative surveys carried out with semi-structured questionnaires sent by e-mail to the Municipal Health Offices: influxes, services and health care professionals and the criteria of dispensation were examined. Of the total, 91.0% answered to the research, demonstrating that 85.4% began to offer the method to adolescents less than 18 years old, especially at emergency rooms (69.1%). At public health care clinics traditional and public family health care clinics there was less integration, 65.3% and 37.6%, and in services specialized in adolescent care only 31.9% of the counties offer them (percentages not excludent). Usually, the distribution is carried out by doctors and/or nurses, but 30% of clinics sub-utilize the nursing potential. Cases of sexual violence are fundamentally attended to, but excluding these cases, there is a drop of 10 to 30 percentage points in the distribution of emergency contraceptive to adolescents in cases of the failure or non-use of the regular contraceptive. The conclusion is that there exists selectivity in the method's dispensation, very scarcely offered in Basic Adolescent Health Care Services, which makes it difficult for adolescents to have access to emergency birth control in situations where pregnancy is a risk. This selective behavior among health care professionals has become common practice and goes against the initial objectives of the Federal Health Department. This position is due in part to health care professionals not being up to date on the laws and federal norms concerning Sexual and Reproductive Health, and also to the lack of knowledge of the method's mechanism action (sometimes identified as dangerous or abortive), as well as the prejudice towards adolescent sexual practices-leading to the purchasing of emergency contraceptive in drugstores and its incorrect use.References
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