Cost, travel barriers may prevent use of IUDs: study

Significant cost and travel barriers may prevent southern women from using contraceptive devices such as IUDs, new research suggests.

Long-acting reversible contraceptives such as intrauterine devices (IUDs) are recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

An article published in the New Zealand Medical Journal last week said women in the Southern District Health Board region could be charged anything from nothing up to $270 for the device, as well having to meet the cost of anywhere between one and three GP appointments.

For women in rural areas there was the additional inconvenience of having to travel to those appointments, the article — written by University of Otago student Robina Stevens and lecturers Charlene Rapsey and Antoni Moore — said.

"There are populations in the SDHB catchment for whom distance and cost remain potential barriers to accessing an IUD," it said.

"With all the physical, social, economic and financial benefits that effective family planning confers to individuals and communities, this is arguably a public health priority."

All 88 practices which supply the devices responded to some or all of the authors’ questions.

Most required a pre-insertion appointment, and 22 required three appointments.

While some provided the IUD free, the median cost was $115 and the highest price $270.

While most recipients lived within 5km of their GP practice, just under 30% lived further afield.

Another possible deterrent was that many providers had very limited hours.

"For example, the sexual health clinic in Gore operates one day a month, and many GPs doing insertions work part time," the article said.

"Distance and travel time are not the only factors in determining how accessible an IUD is for a given person living in a high-deprivation area, but these would certainly be contributing factors," the article said.

The widespread nature of the region lent itself to a mobile service being set up, and the authors noted that while they were drafting their article, Te Waka Wahine Hauora/The Women’s Health Bus began.

"Increasing the capacity for all primary providers to offer insertion, funding the insertion process, minimising the number of appointments required and providing mobile services would improve access."

mike.houlahan@odt.co.nz

 

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