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Fernandez-Sanchez H, Rocha-Fernandez M, Salma J, Santa Maria DM, Benavides-Torres RA, Salami B. Sexual Health Implications of Return Migration for Women and Their Partners in Rural Mexico: A Critical Ethnography. J Assoc Nurses AIDS Care 2024:00001782-990000000-00111. [PMID: 39145669 DOI: 10.1097/jnc.0000000000000494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
ABSTRACT The return of a migrant partner can negatively impact the sexual health of women who stayed in their communities. Understanding their sexual health needs is crucial for developing targeted interventions and support systems. Our study used a critical ethnographic approach in Agua Dulce, a rural community in Mexico, involving 50 key informants: women who stayed behind (n = 20), returnees (n = 12), community leaders (n = 12), and health care professionals (n = 6). We used participant observation, policy analysis, and interviews, using purposeful and snowball sampling methods. A gender-based thematic analysis revealed economic hardships and early separations affect the sexual well-being of women who stay behind. Infidelity, discovered through social media or calls, causes emotional distress and family disruptions. Male migrants spend an average of 8.85 years abroad, leading to fears of risky sexual behaviors. Our study highlights the urgent need for specialized support centers and comprehensive health interventions.
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Affiliation(s)
- Higinio Fernandez-Sanchez
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Minerva Rocha-Fernandez
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jordana Salma
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Diane M Santa Maria
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raquel A Benavides-Torres
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bukola Salami
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Chavez LJE, Lamy ZC, Veloso LDC, da Silva LFN, Goulart AMR, Cintra N, Neal S, Riggirozzi P. Barriers and facilitators for the sexual and reproductive health and rights of displaced Venezuelan adolescent girls in Brazil. J Migr Health 2024; 10:100252. [PMID: 39184240 PMCID: PMC11341930 DOI: 10.1016/j.jmh.2024.100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/21/2024] [Accepted: 07/21/2024] [Indexed: 08/27/2024] Open
Abstract
Background The crisis in Venezuela has forced almost eight million people to flee to mainly neighbouring countries, including Brazil. Half of the displaced Venezuelans are women and girls, with adolescent girls facing distinctive challenges to their sexual and reproductive health during displacement and settlement. The aim of this study is to understand the barriers and facilitators for the sexual and reproductive health of adolescent Venezuelan girls residing in Brazil. Methods The study used qualitative methods, including semi-structured interviews with 19 Venezuelan migrant adolescent girls conducted in Boa Vista and Manaus. We analysed transcripts using thematic analysis, and mapped findings to a theoretical framework based on the Bronfenbrenner Socio-ecological Model, which we adapted to explore how intersectional vulnerabilities at the individual level interact with contextual factors creating barriers and facilitators for health and rights of migrant adolescent girls. Results Venezuelan adolescent migrants in Brazil face practical and structural barriers in realising their sexual and reproductive health and rights in four areas: menstruation; family planning, contraception and sexually transmitted infection; prenatal, childbirth and postnatal care; and preventing gender-based violence. The reported barriers were lack of knowledge around sexual and reproductive health rights, exposure to violence and lack of access to age-appropriate healthcare services. Mitigating factors included education (both in the family setting and at school); prevention activities undertaken by health services; care provision from non-governmental organisations and international agencies; and best practices in local health services. Conclusions Host states must take action to enhance the right to sexual and reproductive health for adolescent migrants to allow them to make autonomous, independent and informed choices. A socioecological perspective on sexual and reproductive health and rights can help formulate intersectional policies that interconnect different levels of adolescent migrants' experience.
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Affiliation(s)
- Leidy Janeth Erazo Chavez
- Postgraduate Program in Collective Health at the Federal University of Maranhão, Rua Barão de Itapary N 155, Centro, 65020-070, São Luís, MA, Brazil
| | - Zeni Carvalho Lamy
- Postgraduate Program in Collective Health at the Federal University of Maranhão, Rua Barão de Itapary N 155, Centro, 65020-070, São Luís, MA, Brazil
| | - Larissa da Costa Veloso
- Medical School of Federal University of Maranhão, Av. dos Portugueses, 1966 - Vila Bacanga, 65080-805, São Luís, MA, Brazil
| | - Laura Froes Nunes da Silva
- Medical School of Federal University of Maranhão, Av. dos Portugueses, 1966 - Vila Bacanga, 65080-805, São Luís, MA, Brazil
| | - Ana Maria Ramos Goulart
- Medical School of Federal University of Maranhão, Av. dos Portugueses, 1966 - Vila Bacanga, 65080-805, São Luís, MA, Brazil
| | - Natalia Cintra
- Department of Politics and International Relations, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, United Kingdom
| | - Sarah Neal
- Department of Social Statistics and Demography, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, United Kingdom
| | - Pía Riggirozzi
- Department of Politics and International Relations, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, United Kingdom
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Obach A, Blukacz A, Sadler M, Carreño Calderón A, Cabieses B, Díaz C. Barriers and facilitators to access sexual and reproductive health services among young migrants in Tarapacá, Chile: a qualitative study. BMC Public Health 2024; 24:386. [PMID: 38317103 PMCID: PMC10845769 DOI: 10.1186/s12889-024-17884-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Chile has become a destination country for immigrants from Latin America, including youth. Guaranteeing access and use of sexual and reproductive health services for young migrants is crucial because of their overlapping experiences of transitioning to a new country and to adulthood. However, the existing evidence shows barriers to accessing sexual and reproductive healthcare among young migrant populations. In this context, the main objective of this article is to identify the barriers and facilitators that young migrants experience to access sexual and reproductive healthcare in the Tarapacá region of Chile. METHODS A qualitative study was conducted in the Tarapacá region of Chile. Semi-structured interviews with 25 young migrants from Venezuela, Colombia, and Ecuador, as well as 10 health workers, were carried out. The interviews were transcribed and thematically analysed. The study was approved by the Ethics Committee of the Universidad del Desarrollo (#2019-22). RESULTS Young migrants face barriers linked to structural shortcomings within the healthcare system, which may be similar to those faced by the local population. Barriers are also derived from reductionist sexual and reproductive health approaches, which prioritise the prevention of pregnancy, sexually transmitted infections, and HIV, with a predominantly heteronormative focus. The prevailing narratives from the health system are those of risk and lack of control and self-care among young people, and they are exacerbated in the case of migrants. Young migrants, especially from the Caribbean, are stereotyped as over-sexualised and liberal in comparison to the local population and believed to be engaging in riskier sexual behaviours that should be kept under check. This may translate into experiences of discrimination and mistreatment when receiving care. Facilitators include good-quality information and community-level interventions. CONCLUSIONS This study shows a limited approach to the sexual and reproductive health of young migrants in Chile, severely hampering their reproductive and sexual rights. Policies and initiatives must work towards removing structural barriers, changing narratives, and empowering young migrants regarding their sexual and reproductive health.
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Affiliation(s)
- Alexandra Obach
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Alice Blukacz
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile.
| | - Michelle Sadler
- Departamento de Historia y Ciencias Sociales, Facultad de Artes Liberales, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Alejandra Carreño Calderón
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Báltica Cabieses
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Carolina Díaz
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
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Panchenko S, Mayaud P, Baranyi Nicholls S, López González C, Ordáz KM, Baird M, Gabster A. " You are the first person to ask me how I'm doing sexually": sexual and reproductive health needs and sexual behaviours among migrant people in transit through Panama. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1157622. [PMID: 37502614 PMCID: PMC10370347 DOI: 10.3389/frph.2023.1157622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/26/2023] [Indexed: 07/29/2023] Open
Abstract
Background Unprecedented numbers of migrant people transiting through the Darién Gap at the Panama-Colombia border were recorded in 2021 and 2022. Data on sexual and reproductive health (SRH) needs and service provision among migrant people in transit is generally extremely sparse. This study aimed to collect personal accounts of sexual behaviours and SRH needs and access to services among migrant people in transit through Panama. Methods We conducted a rapid-assessment qualitative study using semi-structured interviews during June-July 2022. Participants were migrant people in transit at three locations across Panama: (i) at the Migrant Reception Station (MRS) in Darién province at the Panama-Colombia border, (ii) in the city of David near the Costa Rica-Panama border, and (iii) at the Costa Rica-Panama border. Migrant peoples (>18 years) were invited to participate using purposive sampling. Results Overall, 26 adult migrant people (16 men, 10 women) across the three sites participated in the study. We identified three overarching themes from the interviews: (1) increased need for SRH service provision, (2) experiences of sex, relationships, and transactional sex, and (3) vulnerability to exploitation and sexual violence. All accounts reported that no formal SRH care was present during the journey through the Gap and described as inconsistent at the MRS in Darién. Provision of gynaecological or genital examinations, laboratory testing for urinary tract or STI, and prenatal care were mentioned to be the most pressing needs. Participants reported a change in their sexual behaviour while travelling, whether a decline in sexual libido or preference towards short-term partners. Most female participants recounted constantly fearing sexual violence during the journey through the Gap and several respondents reported witnessing incidents of sexual and other forms of violence. Conclusion There are significant unmet needs regarding SRH care during the journey of migrant people transiting through the Darién Gap, at the MRS in the Darién province, and across Panama. Provision of antenatal care, rapid testing for HIV/STI, condom distribution, and care for victims of sexual violence would significantly reduce adverse SRH outcomes and improve the well-being of migrant people, even when in transit.
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Affiliation(s)
- Sofya Panchenko
- Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
| | - Philippe Mayaud
- Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | - Madeline Baird
- Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Faculty of Anthropology, Univeristy of Connecticut, Storrs, CT, United States
| | - Amanda Gabster
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- National Research System of Panamá (SNI), Panamá, Panamá
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States
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Granero-Molina J, Gómez-Vinuesa AS, Granero-Heredia G, Fernández-Férez A, Ruiz-Fernández MD, Fernández-Medina IM, Jiménez-Lasserrotte MDM. Sexual and Reproductive Health Care for Irregular Migrant Women: A Meta-Synthesis of Qualitative Data. Healthcare (Basel) 2023; 11:healthcare11111659. [PMID: 37297799 DOI: 10.3390/healthcare11111659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023] Open
Abstract
Migratory movements are a political, social, and public health issue on a global scale. Access to sexual and reproductive health services for irregular migrant women (IMW) is a public health issue. The aim of this study is to identify qualitative evidence of IMW's experiences of sexual and reproductive health care in emergency and primary care settings. The methods employed involve conducting a meta-synthesis of qualitative studies. Synthesis includes assembling and categorising findings based on similarity in meaning. The search was conducted between January 2010 and June 2022 using PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases. Out of the initial pool of 142 articles identified, only 9 fulfilled the predetermined criteria and were subsequently included in the review. Four main themes were established: (1) the need to focus emergency care on sexual and reproductive health; (2) unsatisfactory clinical experiences; (3) forced reproduction; and (4) alternating between formal and informal healthcare services. The attitudes of IMW towards sexual and reproductive health are influenced by culture, educational level, fear, barriers, and the attitude of healthcare providers. Healthcare institutions need to be aware of the IMW's experiences to understand the specific difficulties they face. IMW calls for socially and culturally sensitive health care, cultural mediators, improved communication, and safe environments that ensure confidentiality.
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Affiliation(s)
- José Granero-Molina
- Nursing, Phisiotheraphy and Medicine Department, University of Almería, 04120 Almería, Spain
- Associate Researcher, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago 7500000, Chile
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