TY - JOUR

T1 - Healthcare access, quality and financial risk protection among displaced Venezuelan women living in Brazil

T2 - a cross-sectional study

AU - Moreno-Serra, Rodrigo

AU - Ochoa-Moreno, Ivan

AU - Anaya-Montes, Misael

AU - Cardoso Fernandes, Luis

AU - Gomes, Thaiza

AU - Leal, Maria Do Carmo

AU - Cuadrado, Cristóbal

PY - 2024/9/30

Y1 - 2024/9/30

N2 - Background: Millions of Venezuelans have been displaced because of deteriorating socio-economic conditions in their country. We examine key domains of universal health coverage among migrant Venezuelan women in Brazil: healthcare access, care quality and financial risk protection. Methods: We collected primary data on 2012 Venezuelan women aged 15–49 who migrated to Brazil between 2018 and 2021, in the cities of Boa Vista and Manaus, along with secondary data for Brazilian women. We used linear regression with entropy balance matching to estimate associations between migrant status and healthcare spending, utilisation and quality indicators. Findings: Our sample had a mean age of 29.5 years (S.D. 8.9), 64% (1286/2011) of mixed ethnicity, 29% (577/2011) white, 4% (71/2011) black, 3% (62/2011) indigenous and 1% (15/2011) other ethnicities. Compared to Brazilian women, migrant women had 9.5 percentage points (pp) (95% CI: 6 pp–13 pp; p < 0.0001) higher catastrophic health expenditure incidence. Migrants were 27 pp (95% CI: 11 pp–43 pp; p = 0.0008) more likely to receive healthcare when sought, but 37 pp (95% CI: −45 pp to −29 pp; p < 0.0001) less likely to have had a pap smear in the last three years. Migrants were as likely as non-migrants to have received pap smear results within three months (95% CI: −9 pp to 22 pp; p = 0.39) and clinically appropriate antenatal consultations (95% CI: −10 pp to 40 pp; p = 0.23). Interpretation: Migrant women in Brazil have relatively good healthcare access and quality outcomes. Yet a potential backlog of unmet sexual and reproductive healthcare needs and inadequate financial risk protection require policy attention. 

AB - Background: Millions of Venezuelans have been displaced because of deteriorating socio-economic conditions in their country. We examine key domains of universal health coverage among migrant Venezuelan women in Brazil: healthcare access, care quality and financial risk protection. Methods: We collected primary data on 2012 Venezuelan women aged 15–49 who migrated to Brazil between 2018 and 2021, in the cities of Boa Vista and Manaus, along with secondary data for Brazilian women. We used linear regression with entropy balance matching to estimate associations between migrant status and healthcare spending, utilisation and quality indicators. Findings: Our sample had a mean age of 29.5 years (S.D. 8.9), 64% (1286/2011) of mixed ethnicity, 29% (577/2011) white, 4% (71/2011) black, 3% (62/2011) indigenous and 1% (15/2011) other ethnicities. Compared to Brazilian women, migrant women had 9.5 percentage points (pp) (95% CI: 6 pp–13 pp; p < 0.0001) higher catastrophic health expenditure incidence. Migrants were 27 pp (95% CI: 11 pp–43 pp; p = 0.0008) more likely to receive healthcare when sought, but 37 pp (95% CI: −45 pp to −29 pp; p < 0.0001) less likely to have had a pap smear in the last three years. Migrants were as likely as non-migrants to have received pap smear results within three months (95% CI: −9 pp to 22 pp; p = 0.39) and clinically appropriate antenatal consultations (95% CI: −10 pp to 40 pp; p = 0.23). Interpretation: Migrant women in Brazil have relatively good healthcare access and quality outcomes. Yet a potential backlog of unmet sexual and reproductive healthcare needs and inadequate financial risk protection require policy attention. 

KW - Financial risk protection

KW - Forced displaced populations

KW - Healthcare access

KW - Quality of care

KW - Universal healthcare coverage

U2 - 10.1016/j.lana.2024.100830

DO - 10.1016/j.lana.2024.100830

M3 - Journal article

AN - SCOPUS:85197099086

VL - 37

JO - The Lancet Regional Health - Americas

JF - The Lancet Regional Health - Americas

SN - 2667-193X

M1 - 100830

ER -