The healthcare trajectory of riverside women in reproductive planning at a fluvial Primary Health Unit in Amazonas

Abstract

This study analyzes the care trajectory of riverine women assisted by the Fluvial Primary Health Unit (UBSF) in reproductive planning, highlighting challenges in access and continuity of care. Using a qualitative approach within a sequential mixedmethods study, interviews were conducted with users, UBSF professionals, and managers from the Municipal Health Secretariat. The results indicate that, although the presence of the UBSF facilitates care in rural areas, barriers such as river seasonality, logistical difficulties, and limited availability of contraceptive methods compromise the effectiveness of reproductive planning. Additionally, the fragmentation of the care pathway and the lack of coordination between healthcare levels hinder access to specialized contraceptive methods, such as intrauterine devices (IUDs) and tubal ligation, forcing users to face costly travel and excessive bureaucracy. The absence of coordination between Primary and Specialized Care exacerbates these difficulties, placing the burden on women to secure their own access to essential health services. This study underscores the importance of differentiated care flows that ensure comprehensive access to reproductive planning for riverine women.