Contraception and family planning services as viewed by users of three clinics in the Unified National Health System, Rio de Janeiro State, Brazil

This article presents partial data from a larger qualitative, socio-anthropological survey in five States of Brazil, aimed at grasping the perspectives of users in urban and rural areas on their contraceptive and reproductive experiences, and their perceptions concerning contraceptive and family planning care in the Unified National Health System. The article focuses on findings in the State of Rio de Janeiro from 60 individual semi-structured interviews with users 18 to 49 years of age in two primary care clinics in the State capital and one rural clinic under the Family Health Program (FHP). There was a greater diversity in the use of methods in the capital as compared to the interior, where tubal ligation was the only alternative to the pill. Group education work in the capital expands the possibilities for choice of methods and collective learning, although access to the IUD and tubal ligation is still considered problematic, due to difficulties in providing such care. The health services prioritize care for women that have already begun childbearing, and more care is needed for nonpregnant adult women and adolescents, in addition to strengthening the educational work in the FHP.