Inequalities in the health care system utilization for intrauterine device insertion

to investigate the utilization of the Health Care System by women of reproductive age for intrauterine device insertion and to analyze possible inequalities according to sociodemographic characteristics.

cross-sectional study, nested in a prospective cohort, with a random sample of 515 women ≥18 years old, conducted by obstetric nurses at a referral service for intrauterine device insertion. A structured face-to-face questionnaire was applied to obtain information on the use of the healthcare system for intrauterine device insertion. The analysis was based on the Behavioral Model of Health Service Use. Logistic regression and multinomial regression were used to estimate the Odds Ratio of the health care system use according to predisposing factors, race/color, and parity, and facilitating factor, education.

most women are aware of and utilize the system's health services, especially those with lower levels of education and multiparous women. However, the use of these services to access the intrauterine device is lower, with low access to guidance on reproductive planning and the insertion of the intrauterine device in the services, even lower among those with less education and nulliparous women.

the lower chance of using the health care system to access the intrauterine device among women with less education and nulliparous women reveals social inequalities in access to contraception.