
This article was exclusively written for The European Sting by Ms. Isabela Silvestri, born in 2002 in Brazil, Rio Grande do Sul, Flores da Cunha, nowadays she lives in Recife, Pernambuco, Brazil where is enrolled as a medical student at Universidade de Pernambuco (UPE). She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.
The SUS is the only Brazilian health system, which promotes equality, with care for all individuals. In addition, it is the largest public health system in the world,assisting approximately 190 million people, 80% of them depend exclusively on the system for health care.¹ According to federal law 9,263/96 of the Brazilian Constitution of 1988,the SUS offers a family planning program that is characterized by a set of fertility regulation methods that guarantee equal rights of constitution, limitation or increase of offspring by women, men or couples.² Furthermore, methods of control, such as male and female condoms, diaphragm, spermicides and the intrauterine device (IUD); hormonal methods, which are combined and injectable pills. Tubal ligation and vasectomy are the definitive contraceptive methods. All those mentioned are made available by the SUS. ³ Despite this, Brazil is still above the world average in terms of teenage pregnancy rates. According to data from the Ministry of Health gathered by the United Nations Population Fund (UNFPA), there are more than 19,000 live births per year by women aged between 10 and 14 years. ⁴
It is evident that the issue of teenage pregnancy is not only related to the health system, but to something more deep, such as the situation of social and economic vulnerability of young Brazilians. Thus, the medical student, as a future health professional, must prioritize this issue.
The socioeconomic profile of the medical student is mostly white people, with an annual income above US$ 8,640, coming from a private school, with financial support from the family, both parents with higher education and without gender difference.⁵ On the other hand, the profile of the SUS user is: marginalized people, with low education, and are usually brown or black (84%). ⁶ With this social disparity between medical student and patient, it is essential to have an unbiased look at the individual.The student must show interest, encouragement, and empathy.This will create an opportunity to establish or intensify the unique bond that forms the ideal basis of the doctor-patient relationship.⁷ Only then will the medical student be able to embrace these young people, understanding the situation vulnerability, which leads many young girls to believe that they can get out of their condition and violence at home by becoming pregnant with their partner and establish their own family.
Therefore, it is important that medical students implement awareness campaigns on contraceptive methods and provide guidance on the importance of prevention. But, above all, we must focus on this broader problem and use listening as an ally to face this scenario.
References
1- Maior sistema público de saúde do mundo, SUS completa 31 anos. (n.d.). Retrieved October 25, 2022, from https://www.unasus.gov.br/noticia/maior-sistema-publico-de-saude-do-mundo-sus-completa-31-anos
2-O que é planejamento familiar? – BVS Atenção Primária em Saúde. (n.d.). Retrieved October 25, 2022, from https://aps-repo.bvs.br/aps/o-que-e-planejamento-familiar/
3- FMS, F. M. de S.-. (n.d.). SUS disponibiliza métodos contraceptivos para planejamento familiar. Fundação Municipal de Saúde de Teresina – FMS. Retrieved October 25, 2022, from https://site.fms.pmt.pi.gov.br/noticia/2401/sus-disponibiliza-metodos-contraceptivos-para-planejamento-familiar
4 – Apesar da redução dos índices de gravidez na adolescência, Brasil tem cerca de 19 mil nascimentos, ao ano, de mães entre 10 a 14 anos. (2021, September 23). UNFPA Brazil. https://brazil.unfpa.org/pt-br/news/apesar-da-redu%C3%A7%C3%A3o-dos-%C3%ADndices-de-gravidez-na-adolesc%C3%AAncia-brasil-tem-cerca-de-19-mil
5-de Souza, P. G. A., Pôrto, A. C. C. de A., de Souza, A., Júnior, A. G. da S., Borges, F. T., de Souza, P. G. A., Pôrto, A. C. C. de A., de Souza, A., Júnior, A. G. da S., & Borges, F. T. (n.d.). Perfil Socioeconômico e Racial de Estudantes de Medicina em uma Universidade Pública do Rio de Janeiro. Revista Brasileira de Educação Médica, 44(3). https://doi.org/10.1590/1981-5271v44.3-20190111.ing
6- Silva, Z. P. da, Ribeiro, M. C. S. de A., Barata, R. B., & de Almeida, M. F. (n.d.). Perfil sociodemográfico e padrão de utilização dos serviços de saúde do Sistema Único de Saúde (SUS), 2003- 2008. Ciência & Saúde Coletiva, 16, 3807–3816. https://doi.org/10.1590/S1413-81232011001000016
7- Jameson, J. L., Fauci, A. S., Kasper, D. L., Hauser, S. L., Longo, D. L., & Loscalzo, J. (n.d.-b). Medicina interna de harrison – 2 volumes – 20.ed. McGraw Hill Brasil.
About the author
Isabela Silvestri was born in 2002 in Brazil, Rio Grande do Sul, Flores da Cunha, nowadays she lives in Recife, Pernambuco, Brazil where is enrolled as a medical student at Universidade de Pernambuco (UPE). Living in one of the cities in Brazil with the highest rate of social disparity has had a big impact on her. Also as the director of sexual and reproductive health axis in The International Federation of Medical Students Association (IFMSA) of UPE she is in constant contact with people in poverty, helping and assisting them.
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