Contraceptive Discontinuation And Non-use In Santarém, Brazilian Amazon [interrupção Do Uso E Não-uso De Métodos Contraceptivos Em Santarém, Amazônia Brasileira]

In this paper we discuss the causes of non-adherence to reversible contraceptives, especially hormonal methods, among women in rural Santarém in the Brazilian Amazon. The analysis is based on questionnaires with 398 women and visits to health centers. We consider the motives reported by women who: never used contraception; used some method in the past; and who at the time of the survey were using a different method from the ones they used in the past. The results indicate a rejection of hormonal contraception and a preference for female sterilization, an option possibly influenced by the characteristics of health services in the region. The side effects of hormonal contraceptive use reported by part of the interviewees contribute to a generalized fear of the side effects even among women who have never used such methods. To improve women's health services in the Amazon, we recommend further studies of the relationship between reported side effects and available services and prescriptions, as well as an analysis of women's discourse and perceptions.25920212032Siqueira, A.D., D'Antona, A.O., D'Antona, M.F., Moran, E., Embodied decisions: Reversible and irreversible contraceptive methods among rural women in the Brazilian Amazon (2007) Human Organ, 66, pp. 185-95Cottingham, J., Introduction (1997) Beyond Acceptability: Users' Perspectives On Contraception, pp. 1-5. , In: Ravindran TS, Berer M, Cottingham J, editors, London: Reproductive Health MattersHardon, A.P., Women's views and experiences of hormonal contraceptives (1997) Beyond Acceptability: Users' Perspectives On Contraception, pp. 68-77. , In: Ravindran TS, Berer M, Cottingham J, editors, London: Reproductive Health MattersMcIntosh, C.A., Finkle, J.L., The Cairo conference on population and development (1995) Popul Dev Rev, 21, pp. 223-60Vitzthum, V.J., Ringheim, K., Hormonal contraception and physiology: A research-based theory of discontinuation due to side effects (2005) Stud Fam Plann, 36, pp. 13-32Bertrand, J., Magnani, R., Knowles, J., (1994) Handbook of Indicators For Family Planning Program Evaluation, , Chapel Hill: Evaluation ProjectBongaarts, J., Elof, J., Future trends in contraceptive prevalence and method mix in the developing world (2002) Stud Fam Plann, 33, pp. 24-36Jain, A.K., Fertility reduction and the quality of family planning services (1989) Stud Fam Plann, 20, pp. 1-16Blanc, A., Monitoring contraceptive continuation: Links to fertility outcomes and quality of care (2002) Stud Fam Plann, 33, pp. 127-40Bertrand, J., Hardee, K., Magnani, R., Angle, M., Access, quality of care and medical barriers in family planning programs (1995) Int Fam Plan Perspect, 21, pp. 64-9Chayovan, N., Hermalin, A., Knodel, J., Measuring accessibility to family planning services in Thailand (1984) Stud Fam Plann, 15, pp. 201-11Tsui, A., Ochoa, L., Service proximity as a determinant of contraceptive behavior: Evidence from cross-national studies of survey data (1992) Family Planning Programs and Fertility, pp. 222-56. , In: Phillips J, Ross J, editors, Oxford: Clarendon PressForeit, J.R., Gorosh, M.E., Gillespie, D.G., Merritt, C.G., Community-based and commercial contraceptive distribution: An inventory and appraisal (1978) Popul Rep J, 19, pp. J1-29Bruce, J., Fundamental elements of the quality of care: A simple framework (1990) Stud Fam Plann, 21, pp. 61-91Veney, J., Magnani, R.J., Gorbach, P., Measurement of the quality of family planning services (1993) Popul Res Policy Rev, 12, pp. 243-59Heise, L., Beyond acceptability: Reorienting research on contraceptive choice (1997) Beyond Acceptability: Users' Perspectives On Contraception, pp. 6-14. , In: Ravindran TS, Berer M, Cottingham J, editors, London: Reproductive Health MattersWorld Health Organization Task Force on Psychosocial Research in Family Planning and Task Force on Service Research in Family Planning (1980) Stud Fam Plann, 11, pp. 267-73. , User preferences for contraceptive methods in India, Korea, the Philippines, and TurkeyRoss, J., Hardee, K., Mumford, E., Eid, S., Contraceptive method choice in developing countries (2002) Int Fam Plan Perspect, 28, pp. 32-40Freedman, R., Berelson, B., The record of family planning programs (1976) Stud Fam Plann, 7, pp. 1-40World Contraceptive Use 2007, , http://www.un.org/esa/population/publications/contraceptive_2007_table.p df, United Nations, Department of Economic and Social Affairs, Population Division, accessed on 15/Mar/2009(2008) Pesquisa Nacional De Demografia E Saúde Da Criança E Da Mulher, , Ministério da Saúde, Brasília: Ministério da SaúdeBerquó, E., Brasil, um caso exemplar, anticoncepção e partos cirúrgicos, à espera de uma ação exemplar (1993) Revista Estudos Feministas, 1, pp. 366-81Caetano, A., (2000) Sterilization For Votes In the Brazilian Northeast: The Case of Pernambuco, , Austin: University of Texas at AustinBerquó, E., Cavenaghi, S., Direitos reprodutivos de mulheres e homens face à nova legislação brasileira sobre esterilização voluntária (2003) Cad Saúde Pública, 19 (SUPPL. 2), pp. S441-53Westoff, C., (2001) Unmet Need At the End of The Century, , Calverton: ORC Macro, (DHS Comparative Reports, 1)Ali, M., Cleland, J., Contraceptive discontinuation in six developing countries: A cause-specific analysis (1995) Int Fam Plan Perspect, 21, pp. 92-7Sanders, S.A., Graham, C.A., Bass, J.L., Bancroft, J., A prospective study of the effects of oral contraceptives on sexuality and well-being and their relationship to discontinuation (2001) Contraception, 64, pp. 51-8Koenig, M.A., Hossain, M.B., Whittaker, M., The influence of quality of care upon contraceptive use in rural Bangladesh (1997) Stud Fam Plann, 28, pp. 278-89(1995) Requirements For the Quality Assurance of Hormonal Contraceptives, , World Health Organization, Geneva: World Health Organization(1994) An Assessment of The Need For Contraceptive Introduction In Brazil, , World Health Organization, Geneva: World Health OrganizationGraham, C.A., Ramos, R., Bancroft, J., Maglaya, C., Farley, T., The effects of steroidal contraceptives on the well-being and sexuality of women (1995) Contraception, 52, pp. 363-9Castle, S., Factors influencing young Malians' reluctance to use hormonal contraceptives (2003) Stud Fam Plann, 34, pp. 186-99Rashid, S., Indigenous notions of the workings of the body: Conflicts and dilemmas with norplant use in rural Bangladesh (2001) Qual Health Res, 11, pp. 85-102Good, M.J., Of blood and babies: The relationship of popular Islamic physiology to fertility (1980) Soc Sci Med [med Anthropol], 14 B, pp. 147-56D'Antona, A.O., Vanwey, L., Hayashi, C., Property size and land cover change in the Brazilian Amazon (2006) Popul Environ, 27, pp. 37-96Moran, E., Brondizio, E., Vanwey, L., Population and environment in Amazonia: Landscape and household dynamics (2005) Population, Land Use, and Environment, pp. 106-34. , In: Entwisle B, Stern C, editors, Washington DC: National Academies Press(2003) Gestão Financeira Do Sistema Único De Saúde: Manual Básico, , Fundo Nacional de Saúde, Brasília: Ministério da Saúd

Poverty and inequality in the rural brazilian Amazon: a multidimensional approach

This paper analyses poverty and inequality dynamics among smallholders along the Transamazon Highway. We measure changes in poverty and inequality for original settlers and new owners, contrasting income-based with multidimensional indices of well-being. Our results show an overall reduction in both poverty and inequality among smallholders, although poverty decline was more pronounced among new owners, while inequality reduction was larger among original settlers. This trend suggests that families have an initial improvement in livelihood and well-being which tends to reach a limit later-a sign of structural limitations common to rural areas and maybe a replication of boom and bust trends in local economies among Amazonian municipalities. In addition, our multidimensional estimates of well-being reveal that some economically viable land use strategies of smallholders (e. g., pasture) may have important ecological implications for the regional landscape. These findings highlight the public policy challenges for fostering sustainable development among rural populations.401415

Desmatamento no sul do estado de Roraima: padrões de distribuição em função de projetos de assentamento do INCRA e da distância das principais rodovias (BR-174 e BR-210) Deforestation in the southern portion of the Roraima state: distribution with respect to INCRA settlement projects and distance from major highways (BR-174 and BR-210)

O desmatamento na Amazônia representa, atualmente, um dos principais problemas ambientais do Brasil. A contenção deste processo requer políticas públicas baseadas no entendimento das forças que controlam, aceleram e desaceleram a perda de floresta. Para avaliar ocorrências de desmatamento no sul do Estado de Roraima foram utilizados dois buffers de 20 km de largura subdivididos em oito faixas de 2500 metros ao longo das duas principais rodovias da região: BR-174 e BR-210 em um ambiente de Sistema de Informações Geográficas - SIG. O período analisado foi entre 2001 e 2007, sendo utilizados dados de desmatamento do PRODES e análises visuais em imagens TM Landsat 5. Também foram utilizados arquivos shapefile da malha viária e de Projetos de Assentamento (PAs) do Sul do Estado de Roraima, junto com observações de campo. Os resultados mostraram que os desmatamentos do período estão fortemente relacionados com a disponibilidade de estradas e com o número de famílias dentro dos PAs. O desmatamento foi maior na área da BR-210 pela presença na região de grandes proprietários e invasões de terras. O pólo madeireiro, situado à margem da BR-174, pode ter influenciado na formação de pequenas áreas de desmatamento na região de Rorainópolis. A exploração madeireira predatória e novas ocupações de terras estão acontecendo de forma rápida e desordenada. Este quadro indica forte potencial para a perda de floresta em Roraima caso o fluxo de migração para esta área aumentar, como seria esperado se Roraima for conectada ao "Arco do Desmatamento" pela reabertura da Rodovia BR-319, ligando Manaus a Porto Velho.<br>Deforestation in the Amazon currently represents one of the greatest environmental issues in Brazil, and stopping this process requires public policies based on understanding the forces that control the forest loss in different parts of Amazonia. We evaluated deforestation in the southern portion of Roraima State using a Geographical Information System (GIS) to delineate buffers along each of the two main highways that cross the region: BR-174 and BR-210. Each buffer was 20 km wide and was divided into eight strips 2500 m in width. The study covered the 2001-2007 period using annual deforestation data from PRODES vector files and visual analysis of TM Landsat 5 imagery. We also used shape files of roads and settlement projects in the southern part of Roraima coupled with field observations. Deforestation in the period was strongly related to the availability of roads and to the number of families present in the settlement project. The occurrence of deforestation was highest in the area of the BR-210 where large landowners and land invasions were present. The logging center on the BR-174 may have influenced the formation of small clearings in the Rorainópolis city neighbor. Predatory logging and new land occupations by both small and large landholders are spreading quickly in a disorderly fashion. This situation has high potential for forest loss since migration is expected to increase if Roraima is connected to the "Arc of Deforestation" by reopening the BR-319 Highway, which would connect Manaus to Porto Velho