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P018 Evolving contraceptive options in indigenous communities in Panama
  1. Alyssa Jacob2,1,
  2. Benjamin LaBrot1,
  3. Rachel Wallice3,1,
  4. Megan Lewis4,1
  1. 1Floating Doctors, Bocas del Toro, Panama
  2. 2University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  3. 3Swansea University, Swansea, UK
  4. 4University of San Francisco, San Francisco, USA

Abstract

Background Use of contraception in Panamanian indigenous groups is significantly lower than in the general population. Birth-rates in the Ng-be-Buglé group are the highest in the country. A large proportion of the Ng-be-Buglé live in isolated, rural communities with limited sanitation and education facilities and poor access to local health services. A non-governmental organisation (NGO) has been providing primary healthcare to these communities since 2011 and introduced the contraceptive injection in 2013.

Aims To assess the level and trends of contraceptive injection use and to identify associated challenges.

Methods An observational study of depot medroxyprogesterone acetate (DMPA) use in women attending the NGO clinics was carried out.

Results 143 women from 16 communities have used DMPA from the NGO; 46.9% started in the last 6 months. The most common reason for commencing is family completion. Average age at commencing is 27.6 years (range 12–46) and number of children is 4 (range 0–14). Since starting, 13.3% have discontinued use and 25.9% have missed their most recent dose. Missed doses are commonly due to clinic non-attendance. Influence from spouses and misconceptions regarding side-effects are key factors in discontinuation.

Discussion Ng-be-Buglé communities are experiencing unsustainable population growth. Contraceptive options available to these communities remain limited. Despite a recent surge in the uptake of DMPA from the NGO, major challenges regarding long-term use and compliance remain. Our ongoing work aims to broaden contraceptive options for these people and includes implementation of a pilot study introducing the contraceptive implant.

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