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Estimated disability-adjusted life years averted by free-of-charge provision of the levonorgestrel-releasing intrauterine system over a 9-year period in Brazil.
J Fam Plann Reprod Health Care 2017; 43(3):181-185JF

Abstract

BACKGROUND

The objective was to analyse the contribution of the provision at no cost to users of the 20 µg/day levonorgestrel-releasing intrauterine system (LNG-IUS) towards disability-adjusted life years (DALY) averted over a 9-year period.

METHODS

We analysed data from 15 030 new users of the LNG-IUS who had the device inserted at 26 Brazilian teaching hospitals between January 2007 and December 2015. The devices came from the International Contraceptive Access Foundation (ICA), a not-for-profit foundation that donates the devices to developing countries for use by low-income women who desire long-term contraception and who freely choose to use this device. Estimation of the DALY averted included live births averted, maternal morbidity and mortality, child mortality and unsafe abortions averted.

RESULTS

A total of 15 030 women chose the LNG-IUS as a contraceptive method during the study period. Over the 9 years of evaluation, the estimated cumulative contribution of the Brazilian program in terms of DALY averted consisted of 486 live births, 14 cases of combined maternal mortality and morbidity, 143 cases of child mortality and 410 unsafe abortions.

CONCLUSIONS

Provision of the LNG-IUS at no cost to low-income Brazilian women reduced unwanted pregnancies and probably averted maternal mortality and morbidity, child mortality and unsafe abortions. Family planning programs, policymakers and stakeholders based in low-resource settings could take advantage of the information that the provision of this contraceptive at no cost, or at affordable cost to a publicly-insured population, is an effective policy to help promote women's health.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28330857

Citation

Ferreira, Jessica M., et al. "Estimated Disability-adjusted Life Years Averted By Free-of-charge Provision of the Levonorgestrel-releasing Intrauterine System Over a 9-year Period in Brazil." The Journal of Family Planning and Reproductive Health Care, vol. 43, no. 3, 2017, pp. 181-185.
Ferreira JM, Monteiro I, Fernandes A, et al. Estimated disability-adjusted life years averted by free-of-charge provision of the levonorgestrel-releasing intrauterine system over a 9-year period in Brazil. J Fam Plann Reprod Health Care. 2017;43(3):181-185.
Ferreira, J. M., Monteiro, I., Fernandes, A., Bahamondes, M. V., Pitoli, A., & Bahamondes, L. (2017). Estimated disability-adjusted life years averted by free-of-charge provision of the levonorgestrel-releasing intrauterine system over a 9-year period in Brazil. The Journal of Family Planning and Reproductive Health Care, 43(3), pp. 181-185. doi:10.1136/jfprhc-2016-101569.
Ferreira JM, et al. Estimated Disability-adjusted Life Years Averted By Free-of-charge Provision of the Levonorgestrel-releasing Intrauterine System Over a 9-year Period in Brazil. J Fam Plann Reprod Health Care. 2017;43(3):181-185. PubMed PMID: 28330857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estimated disability-adjusted life years averted by free-of-charge provision of the levonorgestrel-releasing intrauterine system over a 9-year period in Brazil. AU - Ferreira,Jessica M, AU - Monteiro,Ilza, AU - Fernandes,Arlete, AU - Bahamondes,Maria V, AU - Pitoli,Ana, AU - Bahamondes,Luis, Y1 - 2017/03/22/ PY - 2016/07/08/received PY - 2017/02/13/revised PY - 2017/02/27/accepted PY - 2017/3/24/pubmed PY - 2017/3/24/medline PY - 2017/3/24/entrez KW - Levonorgestrel-releasing intrauterine system KW - disability-adjusted life years. KW - unintended pregnancies SP - 181 EP - 185 JF - The journal of family planning and reproductive health care JO - J Fam Plann Reprod Health Care VL - 43 IS - 3 N2 - BACKGROUND: The objective was to analyse the contribution of the provision at no cost to users of the 20 µg/day levonorgestrel-releasing intrauterine system (LNG-IUS) towards disability-adjusted life years (DALY) averted over a 9-year period. METHODS: We analysed data from 15 030 new users of the LNG-IUS who had the device inserted at 26 Brazilian teaching hospitals between January 2007 and December 2015. The devices came from the International Contraceptive Access Foundation (ICA), a not-for-profit foundation that donates the devices to developing countries for use by low-income women who desire long-term contraception and who freely choose to use this device. Estimation of the DALY averted included live births averted, maternal morbidity and mortality, child mortality and unsafe abortions averted. RESULTS: A total of 15 030 women chose the LNG-IUS as a contraceptive method during the study period. Over the 9 years of evaluation, the estimated cumulative contribution of the Brazilian program in terms of DALY averted consisted of 486 live births, 14 cases of combined maternal mortality and morbidity, 143 cases of child mortality and 410 unsafe abortions. CONCLUSIONS: Provision of the LNG-IUS at no cost to low-income Brazilian women reduced unwanted pregnancies and probably averted maternal mortality and morbidity, child mortality and unsafe abortions. Family planning programs, policymakers and stakeholders based in low-resource settings could take advantage of the information that the provision of this contraceptive at no cost, or at affordable cost to a publicly-insured population, is an effective policy to help promote women's health. SN - 2045-2098 UR - https://www.unboundmedicine.com/medline/citation/28330857/Estimated_disability_adjusted_life_years_averted_by_free_of_charge_provision_of_the_levonorgestrel_releasing_intrauterine_system_over_a_9_year_period_in_Brazil_ L2 - http://jfprhc.bmj.com/cgi/pmidlookup?view=long&pmid=28330857 DB - PRIME DP - Unbound Medicine ER -