Expanding contraceptive choice: Findings from Brazil

This article presents findings from a participatory action research project in a municipality in southern Brazil that models a new and holistic approa ch to broadening women's contraceptive choices. The project encourages a co llaborative process between researchers, community members, and public heal th managers to diagnose service-delivery problems, to design and implement interventions, and to evaluate their effectiveness. Findings from the basel ine evaluation revealed major constraints in availability of and access to family planning and reproductive health services for women, as well as seve re deficiencies in quality of care. Interventions designed to address these weaknesses, bound by the limited resources of the public sector, focused o n training, restructuring of providers' roles and service-delivery patterns , the management process, the creation of a referral center, and the introd uction of injectables, vasectomy services, and a program for adolescents. E valuation results show the project's considerable impact in broadening repr oductive options, although not all issues, especially those related to sust ainability, have been resolved.