Perfis e percepções acerca da consulta ginecológica em Belo Horizonte no início do século XXI

Abstract

This thesis focuses on the gynecological consultation. It aims at investigating the access to the gynechologist of 18 to 59 year-old resident women of Belo Horizonte, ,as well as their perceptions about the visit as a whole. It has been developed in two stages. The first one is a quantitative analysis using Grade of Membership (GoM), in order to define profiles of women who have been to a gynecological visit in the 12 months prior to the research, compared to those who have not. The second stage is a qualitative analysis of semi-structured interviews with women whose characteristics are similar to the profiles defined in the first stage, in order to capture their perceptions regarding the visit. Quantitative data come from the project SRSR - Saúde Reprodutiva, Sexualidade e Raça/cor (Reproductive Health, Sexuality, and Race/Color), carried out by Cedeplar in 2002. Interviews were made with 1302 15 to 59 year-old women in Belo Horizonte, which are representative of the female population of Belo Horizonte for this age bracket. Qualitative data come from the project Aspectos quantitativos e qualitativos acerca do acesso à contracepção e ao diagnóstico e tratamento do câncer de colo uterino: uma proposta de análise para o município de Belo Horizonte, MG. (Quantitative and qualitative aspects of access to contraception, diagnosis, and treatment of uterine cancer: a proposal of analysis to the municipality of Belo Horizonte, MG), carried out in 2005 and 2006 by Cedeplar. Sixty women between 18 and 59 years of age were interviewed and talked about their reproductive health.The quantitative results suggest that having had a gynecological visit in the previous year is strongly correlated to the socioeconomic and demographic characteristics of the women. Women who visit the gynecologist regularly and either pay for the visit or use some kind of health insurance are the ones with higher probabilities of having been to the gynecologist in the last 12 months. Those whose access are through the public system are clearly disadvantaged. The qualitative results indicate that women feel uncomfortable during the visit the less educated women report feeling more embarrassed than the more educated. There are also strong differences between the more and the less educated women regarding the first gynecological visit. For those with more schooling, the first visit happens earlier in life and is generally related to sexual debut and contraceptive use. Among the less educated, the first visit is commonly related to pregnancy. Regardless educational level, age or frequency of visits, it is clear that going to the gynecologist has great importance for the women interviewed.The contributions of this thesis are twofold. The first one is related to the profiles, which allow a better understanding of access to gynecological visits in Belo Horizonte. The second contribution is in the understanding of what women think about the gynecological visit, how they feel at the doctor's office, and what they are looking for when they go to the gynecologist. Understanding the gynecological consultation more deeply can certainly contribute to improve access for all women.