Unternaher Justin, Guillén José Rafael, Ortíz Jennifer, Stevenson Megan, Talero Miguel Ángel Barriga, Page Kathleen R, López Jhon Jairo, Correa Jhon Fredy Ramírez, Núñez Ricardo Luque, Fernandez-Niño Julián A, Spiegel Paul B, Liebow-Feeser Elana, Wirtz Andrea L
Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
Department of Infectious Diseases, Children's National Hospital, Washington, DC, USA.
J Migr Health. 2024 Oct 11;10:100273. doi: 10.1016/j.jmh.2024.100273. eCollection 2024.
Between 2015 and 2023, 7.3 million Venezuelans have been displaced globally. We aimed to assess uptake of and factors associated with prenatal care among Venezuelan refugees and migrants in Colombia. We analyzed data from a cross-sectional survey of 6,221 urban-residing adult Venezuelans who were displaced to Colombia between 2015 and 2022. Analyses were restricted to 917 women aged 18-49 years who reported at least one pregnancy and delivered in Colombia; of these, 564 (61.5%) women completed ≥4 prenatal care visits in their most recent pregnancy. We used general linear models with negative binomial regression to identify associations and estimate the adjusted prevalence ratios (aPrR) of variables associated with completing ≥4 prenatal care visits during last complete pregnancy (WHO's pre-2016 recommendations). Having an irregular migration status was independently associated with a 12% lower likelihood (aPrR:0.88, 95%CI:0.78-0.99; = 0.028) of completing ≥4 prenatal care visits compared to women with a regular status. Participants who reported an experience of denial of prenatal care at some point while Colombia ( = 135; 15.2%) were 42.8% less likely (aPrR:0.57, 95%CI:0.45-0.73; < 0.001) to complete ≥4 prenatal care visits than those with no reported denial of care. Urban area of residence was also independently associated with prenatal care, while there was no evidence of association with educational attainment, literacy levels, or year of migration. Prenatal care attendance is suboptimal among Venezuelan refugees and migrants, particularly those with an irregular migration status, despite that prenatal care became officially available in 2018 to all Venezuelans in Colombia regardless of migration status. Reducing barriers to prenatal care by ensuring Venezuelan refugees and migrants are aware of available care, are supported in navigating the health system, and by preventing discrimination and stigma in the health facility are critical to ensuring the health and wellbeing of displaced people, their children, and the surrounding community.
2015年至2023年期间，全球有730万委内瑞拉人被迫流离失所。我们旨在评估哥伦比亚境内委内瑞拉难民和移民的产前保健服务利用情况及其相关因素。我们分析了一项横断面调查的数据，该调查涵盖了2015年至2022年间流离至哥伦比亚的6221名居住在城市的成年委内瑞拉人。分析仅限于917名年龄在18至49岁之间、报告至少有一次怀孕且在哥伦比亚分娩的女性；其中，564名（61.5%）女性在最近一次怀孕中完成了≥4次产前检查。我们使用带有负二项回归的一般线性模型来确定关联，并估计与在最后一次完整怀孕期间完成≥4次产前检查相关的变量的调整患病率比（aPrR）（世卫组织2016年前的建议）。与具有正规移民身份的女性相比，具有非正规移民身份的女性完成≥4次产前检查的可能性独立降低12%（aPrR：0.88，95%置信区间：0.78 - 0.99；P = 0.028）。报告在哥伦比亚期间曾在某个时候被拒绝提供产前保健服务的参与者（n = 135；15.2%）完成≥4次产前检查的可能性比未报告被拒绝提供保健服务的参与者低42.8%（aPrR：0.57，95%置信区间：0.45 - 0.73；P < 0.001）。居住的城市地区也与产前保健独立相关，而没有证据表明与教育程度、识字水平或移民年份有关联。尽管2018年起哥伦比亚所有委内瑞拉人无论移民身份均可正式获得产前保健服务，但委内瑞拉难民和移民的产前保健服务利用率仍不理想，尤其是那些具有非正规移民身份的人。通过确保委内瑞拉难民和移民了解可获得的保健服务、在就医过程中得到支持以及防止医疗机构中的歧视和污名化来减少产前保健的障碍，对于确保流离失所者及其子女以及周边社区的健康和福祉至关重要。
