Reproductive and Sexual Health in socio-environmental risk areas in Santos, Brazil: Challenges for Public Policies

In a period of 30 years, Brazil experienced successive development changes, becoming from a low-income country, with a large portion of rural population and a complex health system, a middle-income country, urbanized, with a unified health system. Life expectancy at birth increased five years per decade, due to the reduction of deaths from infectious diseases and success in controlling HIV/AIDS and fertility rates decreased from five children per woman to less than two. However, still remains huge inequalities in sexual and reproductive health rights, including sexual activity without coercion, reproductive choice, contraception, safe pregnancy and motherhood, as well as the consequences of abortion. The objective of this study is to characterize and analyze the reproductive behaviours and health situation of the population living in areas of socio-environmental risk, guided by the importance of understanding the different needs of the most vulnerable social groups. The Social Inclusion and Exclusion Index, calculated for risk áreas, ilustrates the inequalities that the average indicators of Santos hide, unveiling the curtain is possible to discover in all its crudeness the naked city, the wealth of the few and the misery of the many steep hills, the abandoned historical center and the west area of the endless palafittes.