Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Centro de Investigação e Estudos de Sociologia, ISCTE - Instituto Universitário de Lisboa (ISCTE-IUL), Lisboa, Portugal.
Front Public Health. 2021 May 13;9:656454. doi: 10.3389/fpubh.2021.656454. eCollection 2021.
The increasing number of international migrants (ranging from 153 million in 1990 to ~272 million in 2019) brought to attention the wide variation of national contexts concerning the policy measures to protect migrants' rights and ensuring their equal access to basic and essential services, namely in health. Sexual and Reproductive Health (SRH) is a key component to the overall health and quality of life and is impacted by power inequities inherent to society's institutions, environment, economics, and culture. In Portugal, guidelines for intervention in SRH are insufficient, a gap that is more pronounced with migrant populations due to the absence of culturally sensitive indicators to assess and monitor SRH. The aim of this work was 2-fold: to identify good practices in the SRH field, with a particular focus, whenever possible, on migrant populations, and to identify relevant and inclusive indicators to monitor SRH in Portugal. A Delphi panel (via online survey) with 66 experts (researchers, teachers, and health professionals) and 16 stakeholders (non-governmental organizations, civil society, and governmental organizations) was implemented in two rounds. Panelists were asked to state their level of agreement (5-point Likert-type scale) regarding four different SRH areas: Sexual Health, Reproductive Health, Social-Structural Factors, and Good Practices. Items were based on literature review and a World Café with 15 experts and stakeholders. Participation rate was 68% and response rate was 97% on the first round. From the initial list of 142 items, a total of 118 (83%) items were approved by consensus. Findings may provide extended opportunities for the healthcare system to engage in better informed decisions and more inclusive and integrative strategies regarding SRH, contributing to build political measures toward sexual and reproductive justice.
国际移民人数不断增加（从 1990 年的 1.53 亿增加到 2019 年的约 2.72 亿），引起了人们对保护移民权利和确保他们平等获得基本和必要服务（包括卫生保健）的国家政策措施的广泛差异的关注。性健康和生殖健康（SRH）是整体健康和生活质量的关键组成部分，受到社会机构、环境、经济和文化中固有权力不平等的影响。在葡萄牙，SRH 干预指南不足，由于缺乏评估和监测 SRH 的文化敏感指标，这种差距在移民群体中更为明显。这项工作的目的有两个：一是确定 SRH 领域的良好做法，特别是在可能的情况下关注移民群体；二是确定监测葡萄牙 SRH 的相关和包容的指标。采用两轮在线调查的 Delphi 小组（共有 66 名专家（研究人员、教师和卫生专业人员）和 16 名利益相关者（非政府组织、民间社会和政府组织）参与了这项研究。小组成员被要求就四个不同的 SRH 领域（性健康、生殖健康、社会结构因素和良好做法）表示他们的同意程度（5 点 Likert 量表）。项目依据文献综述和与 15 名专家和利益相关者的世界咖啡会制定。参与率为 68%，第一轮的回复率为 97%。在最初的 142 项清单中，共有 118 项（83%）经协商一致通过。研究结果可能为医疗保健系统提供更多机会，使其能够就 SRH 问题做出更明智的决策和更具包容性和整体性的策略，为建立性和生殖健康方面的政治措施做出贡献。
