Maternal health among Venezuelan women migrants at the border of Brazil

Abstract

Background Guaranteeing the sexual and reproductive health and rights (SRHR) of populations living in fragile and humanitarian settings is essential and constitutes a basic human right. Compounded by the inherent vulnerabilities of women in crises, substantial complications are directly associated with increased risks of poor SRHR outcomes for displaced populations. The migration of Venezuelans, displaced due to current economic circumstances, is one of the largest in Latin America’s history. This study aims to provide an overview of the sexual and reproductive health (SRH) issues affecting migrant Venezuelan women in the state of Roraima, Brazil. Methods Face-to-face interviews were conducted from 24 to 30 November 2019. Data collection covered various issues involving access to and use of SRH services by 405 migrant Venezuelan women aged 18–49 years. The Minimum Initial Service Package readiness assessment tools, available from the Inter-Agency Working Group on Reproductive Health in Crises, were used in the data collection. Results Most commonly, the women reported unmet family planning needs. Of these, a significant proportion reported being unable to obtain contraceptive methods, particularly long-acting reversible contraceptives, either due to the woman’s inability to access them or their unavailability at healthcare centres. Although a significant proportion of women were largely satisfied with the attention received at the maternity hospital, both before and during childbirth, 24.0% of pregnant or postpartum women failed to receive any prenatal or postnatal care. Conclusion Meeting the essential SRHR needs of migrant Venezuelan women in Roraima, Brazil is a challenge that has yet to be fully addressed. Given the size of this migrant population, the Brazilian healthcare system has failed to adapt sufficiently to meet their needs; however, problems with healthcare provision are similar for migrants and Brazilian citizens. Efforts need to be encouraged not only in governmental health sectors, but also with academic, non-governmental and international organisations, including a coordinated approach to ensure a comprehensive SRHR response. Given the current high risks associated with the SARS-CoV-2 pandemic, meeting the SRHR needs of migrant populations has become more critical than ever.

Reproductive health among Venezuelan migrant women at the north western border of Brazil: A qualitative study

“…Our research protocol was approved by the Ethics Committee of the University of Campinas, Campinas, SP, Brazil. The quantitative data was published previously ( Bahamondes et al., 2020 ) and in this report we analysed qualitative data regarding SRH excluding gender-based violence which will be reported separately.…”

Migração, refúgio e saúde sexual e reprodutiva de mulheres na América Central, Sul e EUA: revisão integrativa

“…Acesso aos serviços de saúde: barreiras e facilidades ➢ Foram apontados como limitações do acesso aos serviços de saúde: falta de domínio do idioma (Waldman, 2011;Valdez, 2001), discriminação, preconceito, exclusão social e xenofobia por parte dos profissionais dos serviços de saúde (Salas et al, 2010;Waldmann, 2011;Martes & Faleiros, 2013;Valdez, 2001), o status migratório associado à precariedade do atendimento à saúde sexual e reprodutiva (Salas et al, 2010;Fortuna et. al., 2019;White, Blackburn, Manzella, Welty & Menachemi, 2014;Madi, Cassanti & Silveira, 2009;Leal-Mateos, 2008;Joyce, Bauer, Minkoff & Kaestner, 2001); desconhecimento e falta de informação sobre o sistema de saúde do país de acolhimento (Arcos et al, 2018;Loue, Cooper & Lloyd, 2005;Bahamondes et al, 2020), a necessidade de ausentar-se do trabalho para consultas (Waldman, 2011); barreiras institucionais e estruturais como falta de testes e medicamentos (Arcos et al, 2018;Rocha-Jiménez et al, 2017); baixa vinculação ao sistema de saúde (Fernández-Niño et al, 2019); ➢ Menor acesso aos serviços de saúde sexual e reprodutiva de mulheres indígenas, pelas que não estavam gestantes (Martes & Faleiros, 2013) ou que não pariram após a migração (Bahamondes et al, 2020); Falta de comunicação com os serviços de atendimento em situações de violência sexual (Santos et al 2015); e a exigência de documentos para o atendimento nos serviços de saúde (Rocha-Jiménez et al, 2017;Waldman, 2011); Políticas anti-imigratórias (Spetz, Baker, Phibbs, Pedersen & Tafoya, 2000;Joyce et al, 2001;Fuentes-Afflick et al, 2006;Fullerton, Nelson, Shannon & Bader, 2004;Loue et al, 2005); ➢ Algumas facilidades no acesso à saúde foram observadas como: transporte para o local de atendimento (Fullerton et al, 2004); gratuidade de serviços de saúde pública, e material de educação em s...…”

Narratives of experiences of violence of Venezuelan migrant women sheltered at the northwestern Brazilian border

“…Recognition that some kind of attention is important for women victims of domestic and other forms of violence may be a determinant for the future of these women, the couples and the families involved in these violent episodes and may be the first step towards action. Frontline humanitarian workers should be aware of the existence of these violent episodes and of the quantity and intensity with which they occur and should be trained to handle these situations properly [33,40].…”

“…We are reporting data on violence from a study on SRH issues conducted with Venezuelan migrant women transitorily sheltered in the city of Boa Vista, the capital of Roraima state, Brazil, who were waiting for reallocation to other parts of the country [33,34]. In this paper we present data from the qualitative arm of the study on domestic and everyday violence.…”

“…Since 2016, an average of 600 Venezuelan migrants have entered Brazil through this border daily, posing challenges for the region to manage this constant incoming number of people. The Brazilian government has been transferring migrants to Boa Vista, the state capital, as initial settlements [1,32,33]. As a response to the crisis originated by this migration, the United Nations High Commissioner for Refugees (UNHCR), in cooperation with the International Organization for Migrations (IOM), the Brazilian federal government and the Brazilian army, established 13 shelters in Roraima in the context of a "welcoming operation" (Operação Acolhida) as a transit settlement before they will be reallocated to other Brazilian cities.…”