Sexual Health

Migration and access to sexual and reproductive health from the perspective of health agents in northern Chile.

TL;DR

There are gaps in the access and use of sexual and reproductive health services by migrants, whose central axis is associated with the lack of information on their right to health in Chile and ignorance of sexual and reproductive health services.

Key Findings

Health agents identified gaps in migrants' access to sexual and reproductive healthcare associated with lack of information about the Chilean health system.

  • Migrants were found to lack knowledge of their health rights in Chile
  • Ignorance of available sexual and reproductive health services was identified as a central barrier
  • This was identified through semi-structured interviews and a focus group with health agents in northern Chile
  • Sample included midwives from primary healthcare (n=4) and NGO staff working with migrants (n=7)

Geographic distance between migrants' places of residence and health centers was identified as a barrier to accessing sexual and reproductive health services.

  • Health agents specifically named physical distance as one of several structural access gaps
  • This barrier was identified from the perspective of both primary healthcare midwives and NGO workers
  • Data was collected and analyzed using ATLAS.ti qualitative content analysis software

Health not being migrants' priority was identified as a barrier to accessing sexual and reproductive health services.

  • Health agents noted that migrants' living conditions meant health was not their primary concern
  • This was contextualized within the broader socioeconomic circumstances of migrant populations
  • The finding emerged from an exploratory-descriptive qualitative study with a phenomenological approach

Specific additional access gaps affecting the LGBTQIA+ migrant community were identified by health agents.

  • Health agents recognized distinct barriers faced by LGBTQIA+ migrants beyond those affecting the general migrant population
  • These gaps were identified as separate from the general access barriers discussed for all migrants
  • The study used theoretical intentional sampling to capture perspectives from both clinical and NGO settings

Health agents identified positive elements in primary healthcare teams' capacity to serve migrant populations.

  • Primary healthcare teams were noted to have knowledge of health profiles by nationality
  • Agents demonstrated ability to adapt their speech and language to migrant patients
  • Willingness to adapt healthcare to different cultural practices was highlighted as a positive element
  • These positive elements were identified alongside the barriers by the same health agents

Health agents suggested expanding information strategies and facilitating cross-sector collaboration to mitigate access gaps.

  • Increasing information strategies directed at the migrant community was recommended
  • Favoring intersectoral collaboration ('articulación intersectorial') was proposed as a mitigation strategy
  • Suggestions came from both midwives in primary care and NGO staff working with migrants
  • The study was conducted in northern Chile, a region characterized by high migration flows

The study used an exploratory-descriptive qualitative methodology with a phenomenological approach to examine migrants' access to sexual and reproductive health.

  • Theoretical intentional sampling was employed
  • Participants included 4 midwives from primary healthcare and 7 NGO staff members working with migrants
  • Data was collected via in-depth semi-structured interviews and a focus group
  • All interviews were recorded, transcribed, and analyzed with ATLAS.ti software
  • The study was motivated by the increase and feminization of migration in Chile and resulting increased demand for sexual and reproductive health consultations

What This Means

This research examined how migrants in northern Chile access sexual and reproductive health services, but from an unusual angle — instead of asking migrants directly, the researchers asked the health workers and NGO staff who serve them. The team interviewed four midwives working in primary healthcare clinics and seven staff members from non-governmental organizations, then analyzed what they said using qualitative research methods. The study was motivated by the fact that migration to Chile has been increasing and becoming more female-dominated, which has raised demand for sexual and reproductive health services. The health workers identified several key barriers that prevent migrants from getting the care they need. The most central problem was that migrants often don't know they have the right to healthcare in Chile, and don't know what sexual and reproductive health services are available to them. Other barriers included the physical distance between where migrants live and where health centers are located, and the fact that — given the difficult living conditions many migrants face — healthcare is not always their top priority. Health workers also noted additional, specific challenges faced by LGBTQIA+ migrants. On the positive side, primary healthcare teams showed knowledge of health patterns by nationality, adapted their communication style for different patients, and were willing to adjust care to respect different cultural practices. This research suggests that the most impactful way to improve migrants' access to sexual and reproductive healthcare would be to expand information campaigns so migrants know their rights and what services exist. The health workers also recommended better coordination between different sectors — such as health services, NGOs, and community organizations — to reach migrant populations more effectively. These findings are particularly relevant for health policymakers and service providers in regions with large migrant populations, pointing toward practical, low-cost interventions like targeted outreach and information sharing rather than structural changes alone.

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Citation

Reinoso-Cataldo M, Carrasco-Portiño M, Bustos-Ibarra C, Stuardo-Ávila V. (2025). Migration and access to sexual and reproductive health from the perspective of health agents in northern Chile.. Medwave. https://doi.org/10.5867/medwave.2025.02.3009