Women’s experiences of gynaecological consultations – uncovering its technological toolboxes: challenges in a Brazilian context

Historically, the medical definition of women as an object of biomedical knowledge has restricted the way by which gynecology is understood. In Brazil’s Unified Health System (Sistema Unificado de Saúde – SUS, in Portuguese), it is the responsibility of gynaecological care services to identify, diagnose and treat reproductive related conditions. However, gynaecological consultations are based predominantly on a medicalised model of diagnosis, treatment and disease management which often fails to address the wider determinants of women’s reproductive health and its impact on their general health and life chances. This paper is focused on the way the Brazilian health system has responded to women’s health needs in gynaecological consultations, given its central role in maintaining and promoting women’s health. it explores variations between “what should be” and “what is” offered to Brazilian women in gynaecological consultations. The authors argue that while gynaecological consultations in Brazil (and elsewhere) are currently restricted to programmatic targets, complaints and symptoms associated with sexual and reproductive functions; consultations could be used to respond to women’s needs, using a broader life course approach if a combination of health technologies ‘toolboxes’ are employed. Implementation of care services utilising a ‘toolbox’ approach provides an opportunity to truly follow the principle of ‘integrality’, one of the doctrinal principles of the Brazilian health system, which furthermore could have application in women’s health care services elsewhere.