Bahamondes Luis, Makuch Maria Y, Margatho Deborah, Charles Charles M, Brasil Cinthia, de Amorin Helder Sf
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Caixa Postal 6181, Campinas, SP 13084-971, Brazil.
Direction of Basic Attention Care, Health Secretary, Municipality of Boa Vista, Boa Vista, RR, Brazil.
J Migr Health. 2022;5:100092. doi: 10.1016/j.jmh.2022.100092. Epub 2022 Mar 17.
The public healthcare system of Roraima state, at the north-western border Brazil-Venezuela, experienced an impact due to the incoming of Venezuelan migrants and to the SARS-CoV-2 (COVID-19) pandemic. After the beginning of the pandemic, the Brazilian government closed the border; however, migration continued through informal paths. There is scarce information regarding the availability of sexual and reproductive health (SRH) services at settings impacted both by migration and the COVID-19 pandemic. Consequently, we aimed to assess the availability and access to SRH services for Venezuelan migrant at Roraima state during the COVID-19 pandemic.
We conducted a cross-sectional study with data collected during the pandemic using an electronic questionnaire. We interviewed three policy makers responsible for the directorate of primary care both at the municipal and state level; the directors of the two public hospitals and the two referral centres for women's health in Boa Vista, and in Pacaraima the director of the hospital and of the basic health post. We also interviewed 20 out of the 34 (58.8%) managers of the basic health posts in Boa Vista and 10 healthcare providers (physicians and nurses). Data collected covered issues pertaining to access to SRH services, and explored the impacts of the COVID-19 on continuation, access, and use of SRH services.
It was reported that 60% of the beds in the public sector were reallocated for COVID-19 cases and 26 out of the 34 (76%) health posts assessed interrupted the provision of SRH services, including contraceptive provision and gynaecological consultation, since these were considered not essential services. Most of the participants, (25/36; 69.4%) reported that both the state and the municipal health authorities implemented community outreach using telephone, social media, radio, and television, with guidance for the population on how to seek care using the healthcare network.
The healthcare system in Roraima was impacted firstly by the need to provide SRH to a large number of Venezuelan migrant women, and after an effort to adapt to the reality that this migrant crisis posed; this system was affected by the needs to adapt to the COVID-19 pandemic.
位于巴西与委内瑞拉西北边境的罗赖马州公共医疗系统，因委内瑞拉移民的涌入以及严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新冠病毒病）疫情而受到冲击。疫情开始后，巴西政府关闭了边境；然而，移民仍通过非正式途径继续涌入。关于在受移民和新冠疫情双重影响的地区性与生殖健康（SRH）服务的可及性，相关信息匮乏。因此，我们旨在评估新冠疫情期间罗赖马州委内瑞拉移民获得性与生殖健康服务的可及性。
我们开展了一项横断面研究，使用电子问卷收集疫情期间的数据。我们采访了负责市和州一级初级保健管理部门的三名政策制定者；博阿维斯塔市两家公立医院和两家妇女健康转诊中心的主任，以及帕卡拉伊马市医院和基层卫生站的主任。我们还采访了博阿维斯塔市34个基层卫生站中的20名（58.8%）管理人员和10名医疗服务提供者（医生和护士）。收集的数据涵盖了与获得性与生殖健康服务相关的问题，并探讨了新冠疫情对性与生殖健康服务的延续、可及性和使用的影响。
据报告，公共部门60%的床位被重新分配用于收治新冠病例，在评估的34个卫生站中，有26个（76%）中断了性与生殖健康服务的提供，包括避孕药具供应和妇科咨询，因为这些被视为非必要服务。大多数参与者（25/36；69.4%）报告称，州和市卫生当局都利用电话、社交媒体、广播和电视开展了社区外展活动，并为民众提供了如何利用医疗网络寻求医疗服务的指导。
罗赖马州的医疗系统首先受到为大量委内瑞拉移民妇女提供性与生殖健康服务需求的影响，在努力适应这一移民危机带来的现实之后，该系统又受到适应新冠疫情需求的影响。
