Abstract

CARVACHO, Ingrid Espejo; MELLO, Maeve Brito de; MORAIS, Sirlei Siani  and  SILVA, João Luiz Pinto e. Factors associated with access to health services prior to pregnancy by pregnant adolescents. Rev. Saúde Pública [online]. 2008, vol.42, n.5, pp. 886-894. ISSN 0034-8910.  http://dx.doi.org/10.1590/S0034-89102008000500014.

OBJECTIVE: To assess determinants of access to primary care services prior to pregnancy by pregnant adolescents. METHODS: Theory-based cross-sectional study conducted to examine access to heath services at five dimensions: geographic, economic, administrative, psychosocial and information. There were included in the study 200 first-time pregnant adolescents (aged 10 to 19 years) who attended a primary care unit in the municipality of Indaiatuba, Southeastern Brazil, in 2003. Data was collected using a semi-structured questionnaire applied in face-to-face interviews conducted just before their first pre-natal care visit. Data analyses were performed through Person's chi-square or Fisher's exact test, and by a multivariate logistic regression model including all five dimensions of access. RESULTS: More than half (63.7%) of the adolescents utilized some gynecological care service. Information (43.8%) or psychosocial feelings of embarrassment or fear (37.0%) barriers were the most frequent reasons given for not having sought care before. The main barrier to health service access was related to the psychosocial dimension, reported by 77.0% of the adolescents studied. CONCLUSIONS: Among all barriers to health service access, the most important were those related to the psychosocial dimension. There is a need for new strategies to facilitate access to health services by adolescents, including actions to reduce gender-based barriers taking into consideration sociodemographic characteristics of this population and the relationship they have with their partners.

Keywords : Adolescent; Pregnancy in Adolescence; Health Services Accessibility; Socioeconomic Factors; Health Knowledge [Attitudes]; Health Knowledge [Practice]; Cross-Sectional Studies.