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

Abstract

Background Venezuela has been immersed in an economic and social crisis with a high number of migrant people. An important proportion of Venezuelan migrants have crossed the north western border Brazil-Venezuela were the United Nations High Commissioner for Refugees (UNHCR) has established 13 shelters. Our objectives were to know perspectives and views of Venezuelan migrant women hosted at UNHCR shelters on some SRH issues. Methods We conducted a qualitative study between November 2019 and February 2020 with 12 focus group discussions (FGDs), with 111 Venezuelan migrant women of reproductive age (18–49 years old). FGDs were performed in a closed space that guaranteed confidentiality, were recorded, verbatim transcribed and data were analised for thematic manifest content. Findings The themes identified were perspectives on: i) health care for pregnant and postnatal women, ii) access to modern contraceptive methods, and iii) HIV and sexually transmitted diseases (STDs). Despite the general satisfaction with obstetric care, women noted few challenges pertaining to their experiences during first entry to antenatal care, labour, delivery and postnatal care. They were in agreement that access to long-acting reversible contraceptives was difficult, mainly to the copper-intrauterine device (IUD); which when available it was erratic. Hormonal-IUD and implants were almost inexistent. This was of major concern to the women, as it prevented them from the ability to plan their reproductive lives. Although knowledge on STDs/HIV prevention and transmission was adequate; the predominance of traditional gender imbalance in the relations was observed and these attitudes have been discussed as a barrier for migrant women to protect themselves against HIV/STD infection. Conclusion These migrant women needed help to understand the language and functioning of the healthcare system, to overcome barriers and challenges while seeking access to SRH care. They faced significant gender vulnerability that needs to be addressed within their new life. Our findings could be useful for health authorities and international organisations to start actions to improve SRH and mitigate suffering.

Assessment of sexual and reproductive access and use of menstrual products among Venezuelan migrant adult women at the Brazilian–Venezuelan border

“…The situation of the migrant women in the Brazilian Amazon region regarding access to SRH care is not different from that previously described by our group which was aggravated by the COVID-19 pandemic ( Bahamondes et al ., 2020 ; Makuch et al., 2021a , Makuch et al., 2021b ; Soeiro et al., 2021a , Soeiro et al., 2021b ). In addition to migration problems, migrant women of reproductive age are vulnerable due to gender inequalities, including unplanned pregnancy due to lack of access to or availability of contraceptive methods ( Olsen et al ., 2021 ).…”

“…Ministério da Saúde 2020 ). Our group conducted three rounds of visits to the Roraima state to interviewed women at reproductive health and adolescents to assess access to SRH care, violence against women, and menstrual poverty ( Bahamondes et al ., 2020 ; Makuch et al., 2021a , Makuch et al., 2021b ; Soeiro et al., 2021a , Soeiro et al., 2021b ). We found difficulties for Venezuelan migrants to access to SRH, among those who requested contraceptives, 63.3% reported that they were unable to obtain the contraceptive that they wished, and 50.6% reported that they were unable to obtain any contraceptives due to lack of availability ( Bahamondes et al ., 2020 ), and according to the perspective of these migrant women violence was part of everyday life ( Makuch et al., 2021a , Makuch et al., 2021b ).…”

“…We found difficulties for Venezuelan migrants to access to SRH, among those who requested contraceptives, 63.3% reported that they were unable to obtain the contraceptive that they wished, and 50.6% reported that they were unable to obtain any contraceptives due to lack of availability ( Bahamondes et al ., 2020 ), and according to the perspective of these migrant women violence was part of everyday life ( Makuch et al., 2021a , Makuch et al., 2021b ). However, the interviews that we conducted previously and presented in previous reports ( Bahamondes et al ., 2020 ; Makuch et al., 2021a , Makuch et al., 2021b ; Bahamondes et al , 2022 ) were performed with women living in the official shelters established by the United Nations High Commissioner for Refugees (UNHCR) and the Brazilian army and the other two reports ( Soeiro et al., 2021a , Soeiro et al., 2021b ) were conducted with interviews with adolescent girls.…”

Assessment of the availability of sexual and reproductive healthcare for Venezuelan migrant women during the SARS-CoV-2 pandemic at the north-western border of Brazil-Venezuela

“…Actions taken to deal with the emergency created by the COVID-19 has created imbalances in healthcare services. The needs for SRH care, the constraints of access to services and the culture barriers, from the perspective of Venezuelan migrant women in the region had been a source of concern ( Albaladejo, 2018 ; UNHCR, 2019; Page et al, 2019 ; Doocy et al, 2019 ; Bahamondes et al, 2020 ; Asociación Profamilia and USAID, 2020; Makuch et al, 2021a ; b ; Soeiro et al, 2021a ; b, Rivillas-García et al, 2021 ). These reports indicated that in Brazil when migrant women had access to services they reported to be satisfied with the attention care mainly obstetric care ( Bahamondes et al, 2020 ; Makuch et al, 2021a ).…”

“…The needs for SRH care, the constraints of access to services and the culture barriers, from the perspective of Venezuelan migrant women in the region had been a source of concern ( Albaladejo, 2018 ; UNHCR, 2019; Page et al, 2019 ; Doocy et al, 2019 ; Bahamondes et al, 2020 ; Asociación Profamilia and USAID, 2020; Makuch et al, 2021a ; b ; Soeiro et al, 2021a ; b, Rivillas-García et al, 2021 ). These reports indicated that in Brazil when migrant women had access to services they reported to be satisfied with the attention care mainly obstetric care ( Bahamondes et al, 2020 ; Makuch et al, 2021a ). However, data from Colombia indicated that Venezuelan migrant women encounter barriers to access to SRH services (Asociación Profamilia and USAID, 2020; Rivillas-García et al, 2021 ).…”