Organizational barriers to the availability and insertion of intrauterine devices in Primary Health Care Services

To identify organizational barriers to IUD availability in Primary Health Care services from the perspective of women's health coordinators. This is a quantitative study carried out with women's health officials from the municipalities of the southern macro region of Minas Gerais, Brazil, with an on-line completion of a structured instrument and a descriptive data analysis. 79 technicians participated in the study. Among the municipalities, 15.2% do not provide IUDs and 8.3% do not refer women to other services, 53.7% do not provide IUDs at basic health units. Among those who provide the IUD, 68.7% do not have a specific protocol and 10.5% do not adopt pregnancy as a condition that makes it impossible to insert the IUD, and 80.6% adopt unnecessary conditions, such as vaginal infection. As a criterion for IUD access, 86.5% referred to a medical prescription, 71.6% required exams, 44.6% were over 18 years of age and 24.4% participation in groups, none based on scientific evidence. Only the doctor inserted the IUD. Problems in the access to the IUD were identified due to organizational barriers to its availability and insertion, such as the lack of availability of the method or the excess of unnecessary criteria to make it available.