Family Practice Advance Access originally published online on September 21, 2009
Family Practice 2009 26(6):493-500; doi:10.1093/fampra/cmp058
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Young women and their reproductive health needs in a family practice setting: factors influencing care seeking in Vitoria, Brazil
a Medicina Social, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo 29040-091, Brazil
b Coordinating Office for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
c Programa de Saude da Familia, Prefeitura Municipal de Vitoria, Vitoria, Espirito Santo, Brazil
d Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94105, USA
Correspondence to Angelica Miranda, Medicina Social, Universidade Federal do Espírito Santo, Av. Marechal Campos, 1468 Maruipe, Vitoria, ES 29040-091, Brazil; E-mail: espinosa{at}ndi.ufes.br
Received 23 January 2009; Revised 19 August 2009; Accepted 24 August 2009.
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Abstract |
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Background. Young women often have diverse options for addressing their reproductive health and other health needs in urban settings. In Brazil, they may access care through the government-run Family Health Program (FHP). Understanding factors associated with service utilization can enhance access to and delivery of appropriate services.
Objectives. To describe demographic, behavioural and clinical characteristics of young women accessing services through FHP in Vitória, Brazil.
Methods. From March to December 2006, women aged 18–29 years were recruited into a population-based, household survey. Responses were analysed to assess previous 6 months utilization of FHP services in this population and characteristics associated with accessing care through this public family practice model.
Results. Of 1200 eligible women identified, 1029 enrolled (85.7%). Median age was 23 (interquartile range 20–26) years, 42.7% were married or cohabitating with a male partner. A majority (72%) accessed FHP services in the preceding 6 months, principally for routine and gynaecological visits. Factors independently associated with seeking FHP included: ever tested for human immunodeficiency virus, using anal sex as contraceptive method and reporting a current vaginal discharge. Prior commercial sex work, previous diagnosis with an sexually transmitted infection or using oral sex as a contraceptive method were associated with less use of FHP services.
Conclusions. A public option for delivery of FHP has attracted wide utilization across a cross-section of young women in Vitoria, Brazil. Greater sensitization to specific practices and needs of this population, especially around reproductive health, could further enhance the services provided by family practitioners.
Keywords. Access to health care, Family Health Program, health care, population-based study, reproductive health, young women.
Miranda AE, St Louis ME, Figueiredo NC, Milbratz I and Page K. Young women and their reproductive health needs in a family practice setting: factors influencing care seeking in Vitoria, Brazil. Family Practice 2009; 26: 493–500.