Practical training of health care providers in insertion of contraceptive implants: findings from two Brazilian centres

Abstract

Background and objectives

Lack of information and myths or inadequate training of health care providers in the guidance and management of contraceptives could negatively affect choice and eventually continuation rates. Our objectives were to evaluate the impact of clinical and theoretical training of health care professionals on insertion and removal of etonogestrel (ENG)-implant regarding this contraceptive, including pre- and post-training knowledge about insertion and removal techniques, clinical characteristics, side effects and outcomes.

Material and methods

We conducted a cross-sectional study in which a questionnaire was sent to health care providers after they received clinical training in the management of ENG-implant.

Results

After training, 78.2% of the 139 participants initiated to offer and inserted up to 5 implants/month and 17.6% between 6 to 10/month. None of the interviewees reported having difficulty with insertions after training, and 87.9% reported feeling very confident for removal.

Conclusion

Theoretical and practical training appeared important to prepare health care professionals, clarify doubts and promote higher rates of use of contraceptive implants in Brazil, contributing to reduce the rates of unintended pregnancies.

卫生保健人员在植入避孕药具方面的实践培训：巴西两个中心的调查结果 摘要

背景和目的：在指导和管理避孕药具方面, 信息缺乏和误解, 或对卫生保健提供者培训不足, 可能会对避孕药具的选择和最终续用率产生负面影响。我们的目的是评估卫生保健专业人员在植入和取出依托孕烯（ENG）避孕药方面的临床和理论培训的影响, 包括培训前和培训后关于植入和取出技术、临床特征、副作用和结果的认知。材料和方法：我们进行了一项横断面研究, 在医疗服务提供者接受了ENG植入剂管理的临床培训后, 向他们发放了一份问卷。结果：139名受试者中, 78.2%的人主动提供并植入5枚植入剂/月, 17.6%的人在6∼10枚/月之间。没有受访者在训练后报告植入有困难, 87.9%的人报告说对取出非常有信心。结论：理论和实践培训似乎对培养卫生保健专业人员、澄清疑虑和提高巴西避孕植入剂的使用率非常重要, 有助于降低意外妊娠率。

Keywords:

• Etonogestrel
• education
• Brazil
• contraception
• health personnel

Author contributions

All authors contributed to the design of the study, were involved in the data collection, data analysis and/or interpretation. Also, all authors contributed to manuscript writing/substantive editing and review and approved the final draft of the manuscript.

Disclosure statement

LB received an honorarium from MSD as speaker and member of Boards. The other authors declare no conflict of interest.

Additional information

Funding

This study received partial financial support from the Fundação de Apoio à Pesquisa do Estado de São Paulo (FAPESP) award No. 2015/20504-9 (Campinas centre) and from the Brazilian National Research Council (CNPq) grant No. 573747/2008-3.