Access and right to health for Bolivian migrants in a Brazilian metropolis

Abstract

This paper analyzes the health care accessibility conditions afforded to Bolivian immigrants in the Brazilian health system and their perception of the right to health. This was a cross-sectional, quantitative and qualitative study carried out from 2013 to 2015. Data were collected by a questionnaire with closed questions answered by 633 Bolivian individuals; questions regarding access to health were answered by 472 immigrants over 18 years old. Semi-structured interviews conducted with 55 subjects (Bolivians, health professionals, representatives of Health Departments, Consulate of Bolivia, Public Defender’s Office, Federal Public Prosecutor’s Office and Non-Governmental Organizations) underwent content analysis. Most Bolivian immigrants know the Brazilian National Health System (SUS) and often use Primary Health Care; however, they described structural and systemic barriers to health accessibility, such as lack of documentation, working conditions, medium and high complexity procedures, language barriers, among others. The National Health Card (CNS) is an important gateway to access health care, playing a role of social integration. Interviewees recognize health as a social right, pointing it out as a human and solidary value. Ensuring this recognition, when not based on the consolidation of social policies aimed at strengthening universal social protection, is threatened.

Experiences of Providers and Immigrants/Refugees with Health Care: A Meta-Synthesis of the Latin American Context

“…The primary findings show that health systems in Latin American countries and professional activities with immigrants/refugees are determined by the hegemonic, curative and disease-centered biomedical model (Aizenberg et al, 2015). In addition, there is lack of formal health policies aimed at caring for immigrants/refugees (Aizenberg et al, 2015), adequate infrastructure, inputs, and human resources for care (Barbosa et al, 2020;Duden & Martins-Borges, 2021), and health services that are more articulated and less bureaucratic (Carneiro-Junior et al, 2018;Carneiro-Junior et al, 2022;Motizuki et al, 2019;Ojeda et al, 2020). As a consequence, immigrants/ refugees face difficulties accessing health services (Aizenberg et al, 2015;Arcos et al, 2018;Calderón et al, 2020;Giraldo et al, 2021;Ramírez-Santana et al, 2019), especially primary care services (Pedrozo et al, 2021;Pinto et al, 2019), compelling them, especially undocumented ones, to extensivily use emergency units as a gateway (Agudelo-Suárez et al, 2022;Barreto et al, 2019;Giraldo et al, 2021;Pedrozo et al, 2021).…”