| Autor: |
Maceira D; Professor, Department of Economics; Universidad de Buenos Aires, and Independent Researcher, National Council of Scientific and Technical Research (CONICET), Buenos Aires, Argentina.; Senior Researcher, Center for the Study of State and Society (CEDES), Buenos Aires, Argentina.; Board Member and Chair for The Americas, Health Systems Global (HSG). Correspondence: danielmaceira@cedes.org., Oizerovich S; Professor, Faculty of Medical Sciences, Universidad Favaloro, Buenos Aires, Argentina.; President of the Ibero-American Network of Sexual and Reproductive Health Professionals, Buenos Aires, Argentina.; Member of the Scientific Committee of the Argentinian Pediatric and Adolescent Gynecology Society (SAGIJ) and Argentinian Medical Association for Contraception (AMAdA), Buenos Aires, Argentina., Perrotta G; Member of the Scientific Committee of the Argentinian Pediatric and Adolescent Gynecology Society (SAGIJ) and Argentinian Medical Association for Contraception (AMAdA), Buenos Aires, Argentina.; Professor, Faculty of Psychology, Universidad de Buenos Aires, Buenos Aires, Argentina., de León RGP; Sexual and Reproductive Health Regional Advisor at Pan-American Health Organization / World Health Organization (PAHO/WHO), Latin-American Center of Perinatology and Women's Health (PAHO/CLAP), Montevideo, Uruguay.; Adjunct Professor School of Public Health of the University of North Carolina, Chapel Hill, NC, USA., Karolinski A; Advisor, Family, Health Promotion and Life Course; Coordinator of Family, Gender and Life Course, Pan-American Health Organization/World Health Organization (PAHO/WHO), Brasilia, Brazil Representation., Suarez N; Professor, Universidad Nacional de Hurlingham, Community Health Institute, Buenos Aires, Argentina., Espinola N; Teaching Assistant Professor, Department of Economics, University of Buenos Aires, Buenos Aires, Argentina., Caffe S; Regional Advisor on Adolescent Health, Healthy Life Course Family, Health Promotion and Life Course PAHO/WHO, Washington, DC, USA., Chandra-Mouli V; Scientist, Adolescent Sexual and Reproductive Health, UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland. |
| Abstrakt: |
A new public policy was instituted in Argentina for free distribution of subdermal contraceptive implants to women aged 15-24 years old in the public healthcare system. The objective of this study is to determine the extent to which this population adhered to the implant, as well as predictors of continuation. The retrospective cohort study was based on a telephone survey of a random sample of 1101 Ministry of Health-registered implant users concerning the continuation of use, satisfaction with the method and side-effects, and reasons for removal. Descriptive statistics and multivariate regression analysis were used to explore the association between adherence and having received contraceptive counselling, satisfaction, and side effects. We found high levels of adherence (87%) and satisfaction (94%). Common reported side effects were amenorrhoea or infrequent bleeding, perceived weight gain, increased menstrual bleeding and headaches. Multivariate regression analysis indicates that, among adolescents, having received contraceptive counselling increased comfort, while frequent bleeding at six months hindered trust. Participants who had a history of a prior delivery or who had themselves primarily chosen the method were less likely to request the removal of the implant. Our results support the public policy of free implant distribution in the public health sector. This is a sustainable public policy that contributes to equity and access to effective contraception. It is appropriate for adolescents and young women and will also reduce unintended pregnancies. Our results suggest that counselling patients is key prior to insertion of the implant, as it improves acceptability and continuation. |
