Paranaguá has taken another important step in public health. The municipality is the first on the coast to offer Implanon free of charge, a long-acting contraceptive method considered modern and effective in preventing pregnancy. The service began being offered this Wednesday, the 15th, at the Maria Vargas Batista Basic Health Unit (UBS), located in the Porto Seguro neighborhood, through the Paranaguá City Hall, via the Municipal Health Department (Semsa).
According to the Secretary of Health of Paranaguá, Daniel Fangueiro, the method is safe, effective for approximately three years, and reduces the risk of unwanted pregnancies. “This, in terms of public health, is very important. We know that the rate of pregnancies outside the so-called normal age range is high in Paranaguá, and we started this contraception method, initially with women in vulnerable situations. From the point of view of public management, we also reduce high-risk pregnancies and the expenses that would be foreseen from these high-risk pregnancies,” he stated.
“It’s a perspective that helps us, both from an economic and a social point of view, since these implants guarantee the effectiveness of the contraceptive method without the need for full adherence by the patient, that is, without the need to take the pill every day,” said Fangueiro.
Target Audience
Initially, 512 "Implanons" will be offered, serving, at this first stage, women in situations of social vulnerability. "This criterion will be directed to the Basic Health Units. Those citizens who wish to apply for the Implanon should go to the Basic Health Unit, and from this flow, the criteria for installing this contraceptive method will be organized," the secretary pointed out.
“We see women in vulnerable situations as a special group, since within this group we have situations involving homeless people. For example, a homeless woman may be in her ninth pregnancy, so often the surrounding environment does not provide a stable situation for the newborn. Therefore, all these considerations are taken into account, in addition to special needs patients with neurological disorders who require special attention regarding their menstrual cycle. We are taking all of this into consideration when prioritizing these needs,” emphasized Daniel Fangueiro.
According to the secretary, the primary health care units (UBSs) will be responsible for organizing the patient flow. Subsequently, through a central regulation system, patients will be called according to the established waiting list. “The first point of entry for this service is always the primary health care unit. It's an innovative contraceptive method, an innovative policy that opens up various possibilities for birth control, control of unwanted pregnancies, and especially providing more security to women in vulnerable situations. So, it's a first step, primarily serving this population, but certainly working to extend this policy to other women as well,” concluded Fangueiro.
Applying the contraceptive method is simple and takes around five minutes.
The family health strategy physician at the UBS (Basic Health Unit) in Porto Seguro, Carlos Alberto do Amaral, will be responsible for administering the method at the unit. He explains that Implanon is a subdermal contraceptive, comes with an applicator, and is virtually painless. “The patient will only feel the prick of the needle for anesthesia. No puncture is made, as it already comes with a needle in the Implanon applicator. After the anesthesia, we insert it with the applicator, and it takes a maximum of five minutes. What takes longer is the conversation with the patient. A pregnancy test is always done before application, as the patient cannot be pregnant,” he explained.
After the procedure, the doctor explains that no medication, such as antibiotics or anti-inflammatories, will be necessary. “The care is very simple. You won't need to take antibiotics or anti-inflammatories; you'll leave the unit with just the dressing, which will be removed after 24 hours. The puncture site where the Implanon was inserted doesn't need stitches because it's very small, leaving a mark similar to a chickenpox scar, for example – it's very tiny,” the doctor emphasized.
Doctors and nurses underwent training offered by the Ministry of Health.
The medical regulator at Semsa, Olívia Permegiani Vilarinho, explains that the health professionals underwent training offered by the Ministry of Health (MS), and then the participants replicated the knowledge to the doctors in the municipality so that they could then perform the application on patients. “All doctors and nurses from all the UBSs (Basic Health Units) received this training, and they are qualified to administer the Implanon. Women who are interested in having it inserted should go to the Basic Health Unit closest to their home, and then they will have an evaluation with the unit's doctor,” she said.
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“We have a protocol, based on the Ministry of Health guidelines, which we adapted to our reality here in the city, and the doctor will follow these clinical criteria to perform the subdermal implant placement,” Olivia pointed out.
The Brazilian public health system (SUS) offers various contraceptive methods.
According to the doctor, today the Brazilian Unified Health System (SUS) offers several contraceptive methods, such as oral contraceptives, monthly and quarterly intramuscular injections, the IUD (which is already offered in the network), tubal ligation, male and female condoms, and now, the "Implanon" implant. "Women always have doubts about which method they should use. So it's always important to consult a doctor at the health unit, because they will discuss it according to your lifestyle, what you expect for a future pregnancy. In other words, it's always important for women to visit a health unit and talk to the multidisciplinary team, who, together with the social worker, work on family planning, so that, together with the team, they can decide which method is best for them," she advised.
Implanon
Implanon is a subcutaneous implant containing etonogestrel, a hormone similar to progesterone, which works by preventing ovulation and hindering the passage of sperm, making it a safe and practical alternative for reproductive planning.
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