Effect of expanding the provision of long-acting reversible contraceptives on the number of adolescent births in Ribeirão Preto from 2012 to 2023

• Grant number: 24/16767-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2024
• End date: November 30, 2025
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Carolina Sales Vieira
• Grantee: Laura Carolina da Silva Garcia
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Objectives: Starting in 2012, Ribeirão Preto implemented a series of strategies to expand access to reproductive health, particularly by increasing access to long-acting reversible contraceptives. However, there are no publications on the impact of these strategies on reproductive health indicators, such as the number of adolescent births. This evaluation is important for disseminating a successful public health experience that could serve as a model for other locations in Brazil and worldwide. Considering this, the objective of this study is to describe the variation in the number of adolescent births and the proportion of adolescent births relative to the total number of births in the municipality of Ribeirão Preto, in the state of São Paulo, and in Brazil, between the years 2012 and 2023. We expect that the decline in the number of adolescent births will be more pronounced in Ribeirão Preto than in the state and the country. Methods: This is an analytical observational ecological study using secondary data collected from 2012 to 2023. The data sources will be the National System of Live Births (SINASC) and the Mortality Information System (SIM). These data will be extracted from TABWIN, an application that extracts data from the Brazilian Unified Health System (SUS). Additionally, the Brazilian Ministry of Health, the São Paulo State Health Department, and the Ribeirão Preto Municipal Health Department will be consulted for any questions regarding the data. The data will be stored in Excel spreadsheets. A descriptive analysis will be conducted on the number of births per month and per year among adolescents aged 10 to 19 years, adolescents in two age groups (10 to 14 years and 15 to 19 years), and all women in the study locations (the city of Ribeirão Preto, the state of São Paulo, and Brazil) from 2012 to 2023. The proportion of births to adolescents aged 10 to 19 years relative to the total number of births in the study locations (the city of Ribeirão Preto, the state of São Paulo, and Brazil) from 2012 to 2023 will also be described. Subsequently, the variation in the number of births per year between 2012 and 2023 (number of births in 2012 - number of births in 2023) will be described, presenting the absolute and relative frequency of births to adolescents aged 10 to 19 years, in two age groups (10 to 14 years and 15 to 19 years), and in all women in the city of Ribeirão Preto, the state of São Paulo, and Brazil. To compare the variation in the number of births among adolescents aged 10 to 19 years and in two age groups (10 to 14 years and 15 to 19 years) in the municipality of Ribeirão Preto, in the state of São Paulo, and in Brazil, between the years 2012 and 2023, we will use the Kruskal-Wallis test for independent samples, with Dunn's post-test. To compare the proportion of adolescent births (10 to 19 years) relative to the total number of births in the municipality of Ribeirão Preto, in the state of São Paulo, and in Brazil, in the years 2012 and 2023, we will use the Chi-Square test.