Access to reproductive health medicines in primary health care: a descriptive study in a municipality in Maranhão, Brazil

Abstract

Ensuring access to essential medicines is a central component of reproductive health care within primary health care (PHC). This study aimed to describe the availability and dispensing of reproductive health medicines in a PHC pharmacy in a municipality in the state of Maranhão, Brazil. This descriptive, documentary study was based on secondary data from routine dispensing records, covering the period from June to July 2021. Medicine availability was assessed in relation to the Municipal List of Essential Medicines (REMUME), and dispensations were described according to type of medicine and therapeutic purpose. A total of 300 dispensing events of medicines and products related to reproductive health were recorded. Injectable contraceptives accounted for the largest proportion of dispensations (60%), followed by pregnancy-related supplementation (15%), oral contraceptives (16.7%), and emergency contraception (5%). Availability below 10% was observed for most medicines listed in the REMUME, except for levonorgestrel used for emergency contraception, and no medicines for climacteric or menopause care were identified. These findings reveal important limitations in access to reproductive health medicines in PHC, highlighting the need to strengthen pharmaceutical services in small and socioeconomically vulnerable municipalities.