Needs and Access to Family Planning and Sexual and Reproductive Health Satisfaction of Immigrant Women in Portugal

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaBackground: Studies in European countries point out that many immigrant women may have unmet needs for family planning and that the access to family planning is unequal. In Portugal, little data is known on this topic. The main objective of this study was to investigate family planning needs, access to family planning and sexual and reproductive health satisfaction of immigrant women in Portugal. Materials and methods: An observational and cross-sectional study was carried out using an online questionnaire applied to a snowball sample of immigrant women living for more than 6 months in Portugal, and residing in the central region of the country at that moment. The questionnaire was applied through immigrant associations, and through public or private entities in contact with that population, as well as social networks. Sociodemographic characteristics; family planning needs and its perception; use, perception and knowledge about family planning services; satisfaction with the number of children, contraception and access to family planning services were questioned. Results: From the 137 immigrant women in Portugal questioned, 10.9% had unmet needs for family planning, 56.2% never had a family planning consultation in the country, 42.3% did not know a place/service where to obtain contraceptive methods for free, and 63.5% considered that they should resort to a family planning consultation. As for sexual and reproductive health satisfaction, we found that dissatisfaction in the ease of accessing and using family planning services was greater. The length of stay of 6 months to 2 years in Portugal (OR = 0.221, 95% CI 0.112-0.477, p <0.001) and being from a Latin American country (OR = 0.350, 95% CI 0.170-0.723, p = 0.004) were associated with having attended less family planning consultation, while having attended more family planning consultation was associated with the length of stay of 10 years (OR = 7.507, 95% CI 2.046-27.549, p = 0.001) and being from an African country (OR = 3,136, 95% CI 1,396-7,044, p = 0,005). Similarly, knowing a place/service where to obtain family planning methods for free was also associated with the length of the stay in Portugal and with the country of origin. Discussion: The percentage of immigrant women with unmet needs for family planning was higher than the estimate of this indicator for Portugal. Although family planning services are available and free of charge, the lack of knowledge and low use represents a challenge in the functioning and publicity of services, especially for immigrants with a shorter length of stay in Portugal. Conclusion: Greater dissemination of the family planning services and the way to access these services through entities and associations in contact with this population can increase access. It is important to raise the awareness of health professionals for counselling and information on sexual and reproductive health for this population. Keywords: Emigrants and Immigrants, Women’s Health, Contraception, Family Planning Services, Sexual HealthIntrodução: Estudos em países europeus apontam para que muitas mulheres imigrantes possam ter necessidades de planeamento familiar não atendidas e que o acesso ao planeamento familiar seja inequitativo. Em Portugal conhecem-se poucos dados sobre este tema. O principal objetivo deste estudo foi conhecer as necessidades de contraceção, o acesso ao planeamento familiar e a satisfação com a saúde sexual e reprodutiva em mulheres imigrantes em Portugal. Materiais e métodos: Estudo observacional e transversal, por aplicação de um questionário online a uma amostra de conveniência de mulheres imigrantes há mais de 6 meses em Portugal, a residir na zona centro do país, divulgado através de associações de imigrantes, entidades públicas ou particulares com contacto com esta população e redes sociais específicas. Foram questionadas características sociodemográficas; necessidades de contraceção e perceção sobre as mesmas; utilização, perceção e conhecimentos sobre os serviços de planeamento familiar; satisfação com número de filhos, contraceção e acesso aos serviços de planeamento familiar. Resultados: Numa amostra de 137 mulheres imigrantes em Portugal, 10,9% tinham necessidades de contraceção não atendidas, 56,2% nunca realizaram uma consulta de planeamento familiar no país, 42,3% não conheciam um local/serviço onde obter métodos contracetivos gratuitamente e 63,5% consideraram que deveriam recorrer a uma consulta de planeamento familiar. Quanto à satisfação com a saúde sexual e reprodutiva, verificamos maior insatisfação na facilidade em aceder e utilização dos serviços de planeamento familiar. O tempo de permanência em Portugal de 6 meses a 2 anos (OR=0,231, IC 95% 0,112-0,477, p