Moura Escolástica Rejane Ferreira, Silva Raimunda Magalhães da, Galvão Marli Teresinha Gimeniz
Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, Rua Alexandre Baraúna 1115, Fortaleza, Ceará 60430-160, Brazil.
Cad Saude Publica. 2007 Apr;23(4):961-70. doi: 10.1590/s0102-311x2007000400023.
This evaluative study was performed in eight counties in Ceará State, Brazil, from July to September 2003. Data were collected through interviews with 29 nurses and 50 users of the Family Health Program (FHP), besides observations at health units. The aim was to identify the nature of family planning services and verify the existence of barriers to services and provision of contraceptives with a view towards ensuring an appropriate services network. Five styles of services were identified, although none followed a formal protocol, which raises a legal and ethical dilemma regarding prescription of contraceptives by nurses; delivery of contraceptive methods requires a monthly return visit by users due to excessive and unnecessary technical requirements that create barriers to access by users; and there is a lack of appropriate services, with nurse- and doctor-centered treatment and lack of partnership with other reproductive health services or community groups. Future studies should be designed to identify distinct dynamics in the FHP that innovate in family planning, as well as to define the legal and ethical framework for nurses to prescribe the methods.
这项评估研究于2003年7月至9月在巴西塞阿拉州的八个县进行。除了在卫生单位进行观察外，还通过对29名护士和50名家庭健康计划（FHP）使用者的访谈收集数据。目的是确定计划生育服务的性质，并核实服务和避孕药具供应方面存在的障碍，以确保建立一个适当的服务网络。确定了五种服务方式，尽管没有一种遵循正式的方案，这就引发了护士在避孕药具处方方面的法律和伦理困境；由于过多且不必要的技术要求，使用者需要每月回访以领取避孕方法，这给使用者获取服务造成了障碍；而且缺乏适当的服务，以护士和医生为中心进行治疗，缺乏与其他生殖健康服务或社区团体的合作。未来的研究应旨在确定家庭健康计划中在计划生育方面进行创新的不同动态，以及界定护士开具避孕方法的法律和伦理框架。
