Estudio cualitativo

Migration and access to sexual and reproductive health from the perspective of health agents in northern Chile

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Characteristics of access to sexual and reproductive health care for the migrant population.
CategoriesPHC midwivesNGO officials
Knowledge about access to the health system

Lack of access information.

Fear of deportation.

Lack of information regarding access to health services.

Association between irregular migratory status and not having the right to access health services.

Fear of deportation.

Lack of information network among compatriots.

Sexual and reproductive health benefits

Low awareness of the availability of sexual and reproductive health services.

Perception of limited supply of family planning methods in the public health system.

Late admissions for prenatal care.

Continuity of HIV treatment.

Lack of knowledge of sexual and reproductive health services.

Services focused on prenatal care.

Access to benefits according to referrals indicated by health professionals.

Non-priority healthThey come on the recommendation of peers rather than because of their need for care.

Migration for economic, labor, quality of life, political or armed conflicts.

Less relevance of practices associated with access to and use of health services mediated by cultural practices of the context of origin.

Non-priority sexual and reproductive health services.

Lack of autonomy on the part of clients

Perception of fear and inferiority on the part of the consulting migrant.

Perception of self-hierarchization in an inferior position and of lesser possibilities compared to the national population.

They are subordinated to the professional’s indications.

No information available.
Facilitators of access

Common language.

Adequacy of language by the professional.

Community organizations facilitate access to care by providing information.
Appreciation of the scientific-technical quality of healthcare

Very short consult times.

Professional knowledge of a profile by nationality.

Adaptation of sexual and reproductive health care according to diverse cultural practices.

No information available.
Access barriers

Scarce human resources versus demand for care.

Geographic distance 1.

Constant change in immigration policies, such as the request for more documentation.

Increasing misinformation regarding immigration policies.

Lack of information on how to obtain the PIN.

Not having formal residency documents2 to obtain the PIN.

Labor situation of migrants3.

Mistreatment by administrative/professional staff.

Conditioning of health care due to migratory status.

Geographic distance1

LGTBIQA+

Guaranteed access and equal health.

Lack of training for health professionals on the subject.

Perception of self-marginalization added to non-regular migratory status.

Lack of knowledge or invisibilization of sexual and reproductive health services for this population.

Closeness among peers from the sexually diverse community.

Perception of Chile as a more prejudice-free country than their countries of origin.

Internalization of stigma4.

Lack of training for health professionals on the subject.

Suggestions for improvementStrengthening the work with the intersector to massify the supply of health services.

Greater initiative on the part of the local government to provide information on access to health care in the mass media.

More information on access to the health care system for the migrant community directly from the health facility itself.

Information work on access to health care in the field.

Raise awareness among the migrant population about the importance of the basic right of access to health care and regular health check-ups.

Strengthen PHC-NGO links to carry out articulated work that allows access to health care for the migrant population.

HIV, human immunodeficiency virus. LGTBIQA+, lesbian, gay, bisexual, transgender, queer, intersex and asexual, +. NGOs, non-governmental organizations.PHC, primary health care. PIN, Provisional Identification Number.

1Population mainly living in squatter settlements, far from health centers, do not have good road access or nearby locomotion, connectivity is not adequate.

2Illegal occupations.

3Non-formal employment.

4Self-marginalization from care centers for fear of discrimination.

Analysis carried out from the perspective of health agents in the Province of Iquique, Chile.

Source: Prepared by the authors based on interviews with four primary health care midwives and seven people who provide services as employees of non-governmental organizations.