Chavez Leidy Janeth Erazo, Lamy Zeni Carvalho, Veloso Larissa da Costa, da Silva Laura Froes Nunes, Goulart Ana Maria Ramos, Cintra Natalia, Neal Sarah, Riggirozzi Pía
Postgraduate Program in Collective Health at the Federal University of Maranhão, Rua Barão de Itapary N 155, Centro, 65020-070, São Luís, MA, Brazil.
Medical School of Federal University of Maranhão, Av. dos Portugueses, 1966 - Vila Bacanga, 65080-805, São Luís, MA, Brazil.
J Migr Health. 2024 Jul 22;10:100252. doi: 10.1016/j.jmh.2024.100252. eCollection 2024.
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.
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.
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.
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.
委内瑞拉的危机迫使近800万人逃往主要邻国，包括巴西。流离失所的委内瑞拉人中有一半是妇女和女孩，青春期女孩在流离失所和定居期间面临着独特的性健康和生殖健康挑战。本研究的目的是了解居住在巴西的委内瑞拉青春期女孩性健康和生殖健康的障碍与促进因素。
本研究采用定性方法，包括在博阿维斯塔和马瑙斯对19名委内瑞拉移民青春期女孩进行半结构化访谈。我们使用主题分析法分析访谈记录，并将研究结果映射到一个基于布朗芬布伦纳社会生态模型的理论框架，我们对该模型进行了调整，以探讨个体层面的交叉脆弱性如何与背景因素相互作用，从而为移民青春期女孩的健康和权利创造障碍与促进因素。
在巴西的委内瑞拉青春期移民在四个方面实现其性健康和生殖健康及权利时面临实际和结构性障碍：月经；计划生育、避孕和性传播感染；产前、分娩和产后护理；以及预防基于性别的暴力。报告的障碍包括缺乏性健康和生殖健康权利方面的知识、遭受暴力以及无法获得适合其年龄的医疗服务。缓解因素包括教育（家庭环境和学校教育）；卫生服务机构开展的预防活动；非政府组织和国际机构提供的护理；以及当地卫生服务机构的最佳做法。
东道国必须采取行动，增强移民青春期女孩的性健康和生殖健康权利，使她们能够做出自主、独立和明智的选择。从社会生态角度看待性健康和生殖健康及权利有助于制定交叉政策，将移民青春期女孩不同层面的经历联系起来。
