Government considers using implant to prevent teen pregnancy

The Brazilian government considers the possibility of offering to the public health system two long-term birth control methods in order to prevent pregnancy among adolescents. The first is a subcutaneous implant, put in the forearm to release etonogestrel, a hormone that prevents ovulation. The second is a type of intrauterine device (IUD) that releases small daily doses of the hormone levonorgestrel. Both methods are reversible and last, respectively, three and five years.

Two public consultations dealing with the issue were opened in December last year and are available for the community to make their contribution until February 2nd at the website of the National Committee for Health Technology Incorporation (CONITEC).

The request for including both methods in the Unified Public Healthcare System (SUS) has been submitted by the Brazilian Federation of Gynecology and Obstetrics (FEBRASGO). In an interview to Agência Brasil, Marta Finotti, president of Febrasgo's Birth Control Committee, said the number of unintended pregnancies in Brazil and in the world has increased, reaching, respectively, 52% and 49%.

"Teenage girls are a more vulnerable [part of the] population to have a planned pregnancy. They do not use birth control methods on a regular basis. Therefore, their efficiency is compromised," stated Marta Finotti. The physician pointed out that both subcutaneous implant and the hormonal IUD, after placed, do not dependent on any intervention of the patient to ensure the birth control methods' effectiveness.

Marta Finotti also noted that teenage pregnancy creates important impacts on the mother's and baby's health. According to her, pregnant women under 20 report double mortality rate, when compared with those above that age. Moreover, infant mortality is up to four times higher among children of adolescent mothers.

"From the social point of view, 75% of adolescents drop out school when they become pregnant and 57% do not study or work because they stay at home with the child. This perpetuates the poverty and inequality cycle in Brazil," she pointed out.

Also according to Marta Finotti, the World Health Organization suggests all IUDs to be part of the medicinal products offered by all governments around the world because they are the most effective [method]," noted the physician.

In a statement, the Health Ministry reported that they already offer eight birth control methods for adolescents and for people at other ages: monthly contraceptive injections, 3-monthly contraceptive injections; mini pills; combination pills; the diaphragm; the morning-after pill; the copper IUD; and condoms (male and female).

The ministry has also mentioned that to approve a new technology and propose its inclusion in the public health system, the CONITEC requires documents and studies providing concrete clinical evidence of their effectiveness, the medications' efficiency and cost-effectiveness or strategic inputs.

The CONITEC is formed by representatives of the medical and health federal committees, State Secretariat for Health, Municipal Secretariat for Health and national health and health surveillance agencies, in addition to the ministry itself.

Translated by Amarílis Anchieta