Reflexos da imigração venezuelana na assistência em saúde no maior hospital de Roraima: análise qualitativa

Accessibility to prenatal care at the Street Outreach Office: nurse perceptions in northern Brazil

OBJECTIVES

to understand nurse perspectives regarding homeless pregnant women's accessibility to prenatal care.

METHODS

a qualitative study, with analysis based on the concept of accessibility. Semi-structured interviews were carried out with 11 nurses who work at the Street Outreach Office in northern Brazil.

RESULTS

nurses are faced with geographic barriers and dangerous situations in border regions, recognizing that there is a context of physical, sexual and psychological violence that involves homeless pregnant women who seek care at the Street Outreach Office. Street Outreach Office nurses' work occurs in conjunction with other services in the Health Care Network. The implementation of educational measures is a powerful strategy, as is establishing links with women.

FINAL CONSIDERATIONS

the Street Outreach Office's work provides meetings with pregnant women on site in the territory, which can provide geographic and socio-organizational accessibility to prenatal care.

The vulnerabilities of Venezuelan immigrants in Brazil and Colombia from the perspective of Intervention Bioethics

OBJECTIVE

To understand the vulnerabilities to which Venezuelan immigrants living in Brazil and Colombia are exposed, from the perspective of Intervention Bioethics.

METHOD

Qualitative study, carried out through a semi-structured interview, with 15 immigrants living in Brasília-Brazil and 20 in Medellín-Colombia, analyzed by the IRAMUTEQ software, in the Descending Hierarchical Classification and Similitude Analysis modalities.

RESULTS

The first thematic axis dealt with the reasons for immigrating, above all, difficulties in accessing food and health services. The second axis revealed the trajectory of the migration process, especially the adversities faced before arriving in the countries. The third axis highlighted the challenges of integration in the destination countries, with emphasis on the processes of exclusion and discrimination faced.

CONCLUSION

It was observed that both Brazil and Colombia need, as proposed by Bioethics of Intervention, to develop policies to reduce the vulnerabilities of immigrants to guarantee a dignified life without discrimination against them.

Evidence on tuberculosis in migrants at Brazil's international borders: A scoping review

Objective

to map scientific evidence on the extent of tuberculosis in migrants from the international borders between Brazil and the countries of South America.

Design

Scoping review of quantitative, qualitative and mixed studies. The research was conducted between February and April 2021. The terms "migrants", "tuberculosis", "Brazil", "Uruguay", "Paraguay", "Bolivia", "Peru", "British Guiana" "English Guiana", "French Guiana", "Suriname", "Venezuela", "Argentina", "Colombia" combined with Boolean operators "AND" and "OR" to identified relevant documents. Studies addressing tuberculosis on migrants from international borders of Brazil were included. Pubmed Central (PMC), LILACS (Scientific and technical literature of Latin America and the Caribbean/BVS), Scopus (Elsevier), Scielo (Scientific Electronic Library Online) and gray literature CAPES thesis database were searched. The study was carried out in three stages where the data was selected and extracted by two independent reviewers for full reading.

Results

A total of 705 articles were extracted from the databases chosen for the search, 04 master's dissertations and 01 doctoral thesis. Of these 456 were excluded because they did not meet at least one of the eligibility criteria for this SR and 4 were further excluded because they were duplicates who had not been previously identified. A total of 58 documents were, thus, selected for assessment of the full text. Of these, 40 were further excluded for not meeting at least one of the eligibility criteria. A total of 18 studies were included for data collection: 15 articles, 2 master's dissertations and 1 doctoral thesis, produced between 2002 and 2021.

Conclusion

This scoping review mapped the existing evidence on tuberculosis at the international borders of Brazil and on access of immigrants with tuberculosis to health services in Brazil.

Descriptors

tuberculosis; immigrants; public health surveillance; epidemiological surveillance; sanitary control of borders; health services accessibility.

[Addressing HIV/AIDS and syphilis in Venezuelan migrant women from the perspective of health managers in the North of BrazilManejo de la infección por el VIH/sida y la sífilis en mujeres migrantes venezolanas desde la perspectiva de los gestores de salud en el norte de Brasil]

Objective

To identify the perception of health managers regarding the actions taken and the challenges encountered in addressing HIV and syphilis in Venezuelan migrant women in Brazil.

Method

This descriptive-exploratory study using a qualitative approach was conducted from January to March 2021 in the municipalities of Boa Vista (state of Roraima) and Manaus (state of Amazonas). Audio interviews with the participants were transcribed in full and examined using thematic content analysis.

Results

Ten managers were interviewed (five in Boa Vista and five in Manaus). Content analysis identified the following domains and themes: available infrastructure for diagnosis and treatment of AIDS and syphilis - access, availability of medical appointments /waiting list, training of health teams, and psychosocial support; challenges faced by Venezuelan women - language, documentation issues, and frequent address changes; and strategies and actions adopted and expectations for addressing HIV/AIDS and syphilis in the context of migration.

Conclusions

Despite the care provided to Venezuelan women in Brazil - guaranteed by the universal nature of the Brazilian health system - language and lack of documentation remain as barriers. Given the absence of action plans and future planning for the care of migrant women with HIV or syphilis in municipalities, it is important to develop public policies aimed at minimizing the difficulties faced by this population.

[Barriers and facilitators to confronting HIV/aids and syphilis experienced by Venezuelan women living in BrazilFactores facilitadores y barreras que tienen las mujeres venezolanas residentes en Brasil respecto de la infección por el VIH/sida y la sífilis]

Objective

To describe the perception of Venezuelan women regarding access to health care, diagnosis, and treatment of HIV/aids and syphilis in Brazil.

Method

This is a descriptive, exploratory study employing a qualitative approach, performed from February to May 2021 in the municipalities of Manaus, state of Amazonas, and Boa Vista, state of Roraima. The interviews with participants were fully transcribed, with identification of themes based on content analysis.

Results

Forty women were interviewed (20 in Manaus and 20 in Boa Vista). Following transcription and translation of the accounts, two analytical categories were identified: barriers to healthcare access, with four subcategories - language, cost, adverse drug reactions, and COVID-19 pandemic; and facilitators of healthcare access, again with four subcategories - Unified Health System (SUS), National Policy of Comprehensive Women's Health, National Social Assistance Policy, and relationship between healthcare professionals and SUS users.

Conclusion

The results showed the need to design strategies to mitigate the difficulties faced by migrant women from Venezuela living in Brazil regarding the diagnosis and treatment of HIV/aids and syphilis, going beyond the healthcare support guaranteed by law.

Migrações, trabalho de cuidado e saúde de cuidadoras: revisão integrativa

Resumo Introdução: o trabalho remunerado de cuidado em domicílio é exercido predominantemente por mulheres e caracterizado por baixos salários e pouca valoração social. Objetivo: analisar a migração no trabalho de cuidado e as suas relações com as condições de trabalho e saúde de cuidadoras latino-americanas. Método: foi realizada uma revisão integrativa da literatura com busca nas bases de dados BVS, SciELO, PubMed, Sociological Abstract, Scopus e Web of Science. Foram incluídos estudos sobre a América Latina, publicados no período de 2010 a agosto de 2019. Resultados: foram incluídos 21 artigos, dos quais 20 relatam estudos qualitativos. A migração influencia as trajetórias de cuidadoras ao se deslocarem pela América Latina, Estados Unidos e Europa; foram identificadas contradições entre cuidar de outras pessoas enquanto os filhos/família ficam no país de origem; dificuldades com a língua; ausência de permissões para o exercício do trabalho; condições de trabalho precárias; situações de exploração e maus-tratos, discriminações, racismo, problemas de saúde físicos e emocionais. Conclusão: as trajetórias de migração das cuidadoras latino-americanas revelam dificuldades que estão relacionadas a condições de trabalho precárias e situações de violência no trabalho.

Data and cooperation required for Venezuela's refugee crisis during COVID-19

The deteriorating political and economic situation in Venezuela has ramifications far beyond the Latin American country’s borders as almost five million Venezuelans fled and migrated into countries in the region due to the crisis at home. The scarcity of health services, the lack of information sharing, and the absence of reliable data in Venezuela create challenges for confronting developing health emergencies and disease outbreaks. The need for accurate data is especially dire given the current COVID-19 pandemic and evolving movement of refugees. While countries and international organizations came together to form a coordinated response to Venezuela’s political and humanitarian crisis, this geopolitical progress is threatened by the rapid spread of COVID-19, and the instinct for countries to focus inwards on domestic response priorities, rather than engage in regional cooperation. It is critical that the international community set aside geopolitical differences and cooperate to seek an accurate picture of the conditions on the ground to improve the welfare of Venezuelan migrants and to provide a more robust response to the current pandemic.

Vector-Focused Approaches to Curb Malaria Transmission in the Brazilian Amazon: An Overview of Current and Future Challenges and Strategies

In Brazil, malaria transmission is mostly confined to the Amazon, where substantial progress has been made towards disease control in the past decade. Vector control has been historically considered a fundamental part of the main malaria control programs implemented in Brazil. However, the conventional vector-control tools have been insufficient to control or eliminate local vector populations due to the complexity of the Amazonian rainforest environment and ecological features of malaria vector species in the Amazon, especially Anopheles darlingi. Malaria elimination in Brazil and worldwide eradication will require a combination of conventional and new approaches that takes into account the regional specificities of vector populations and malaria transmission dynamics. Here we present an overview on both conventional and novel promising vector-focused tools to curb malaria transmission in the Brazilian Amazon. If well designed and employed, vector-based approaches may improve the implementation of malaria-control programs, particularly in remote or difficult-to-access areas and in regions where existing interventions have been unable to eliminate disease transmission. However, much effort still has to be put into research expanding the knowledge of neotropical malaria vectors to set the steppingstones for the optimization of conventional and development of innovative vector-control tools.