Browsing by Author "Blukacz, Alice"
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Publication Acceso a salud de migrantes internacionales en pandemia en Chile: resultados de encuesta cuantitativa(2023) Cabieses, Báltica; Blukacz, Alice; Obach, Alexandra; CARREÑO CALDERON, ALEJANDRA; Oyarte, Marcela; Alvarez, Maria; Osse, Claudio; Mezones, EdwardEl objetivo del estudio fue analizar barreras de acceso a la atención de salud en Chile reportadas por migrantes internacionales residentes en la región metropolitana del país y factores asociados. Para ello, se aplicó una encuesta en formato digital sobre vulnerabilidades y recursos de comunidades migrantes en Chile para enfrentar la pandemia SARS-CoV-2. Se realizó análisis descriptivo y estratificado por variables demográficas, socioeconómicas, tipo de previsión de salud y estatus migratorio. Como resultados, inmigrantes provenientes de Haití reportaron el mayor porcentaje de barreras de acceso a la atención en salud, esto tras ajustar por variables sociodemográficas y estatus migratorio. The objective of the study was to analyze barriers to access to health care in Chile reported by international migrants residing in the metropolitan region of the country and associated factors. For this purpose, a digital survey on vulnerabilities and resources of migrant communities in Chile to face the SARS-CoV-2 pandemic was applied. A descriptive and stratified analysis was performed by demographic and socioeconomic variables, type of health provision and migratory status. As results, immigrants from Haiti reported the highest percentage of barriers to health care access, after adjusting for socio-demographic variables and migratory status.Item Acceso a servicios de salud en personas migrantes internacionales en Chile(Universidad del Desarrollo. Facultad de Medicina. ICIM, 2022) Blukacz, Alice; Peña, Gonzalo; Malek, GabrielaPublication Acceso a servicios de salud para personas migrantes internacionales durante la pandemia por COVID-19: estudio cualitativo(2023) Obach, Alexandra; Blukacz, Alice; Cabieses, Báltica; CARREÑO CALDERON, ALEJANDRA; Stefoni, Carolina; Pérez, ClaudiaObjective: To explore the experience and perception of international migrants in Chile regarding access to health services during the pandemic. Method: Collective case study following the qualitative paradigm. Forty semi-structured interviews were carried out with 30 migrants from different countries in Latin America and the Caribbean and 10 key actors from the health or social sector in November and December 2020. The interviews were analyzed thematically. Results: Perceived facilitators for general access to health services are related to formal work, support networks, and good treatment, while barriers are linked to immigration status, information gaps, discrimination, lack of cross-cultural skills, and personal limits of the system. In the context of access to COVID-19 diagnosis and treatment, the main barriers identified are: cultural approach to the disease, communication gaps, experiences of discrimination, costs, and lack of support networks. Conclusion: Access to health services is related to social vulnerability and violation of international migrants rights.Publication Adequate housing as a social determinant of the health of international migrants and locals in Chile between 2013 and 2022(2024) Blukacz, Alice; Oyarte, Marcela; Cabieses, BálticaBackground: Adequate housing is a fundamental right and a social determinant of health. It also represents a historically contentious topic in Latin America. Migratory flows to Chile have become increasingly precarious in the past few years, limiting opportunities for adequate housing, with potential repercussions on the health of international migrants and the general population. This study aims to analyse adequate housing as a social determinant of health among international migrants and locals between 2013 and 2022 in Chile. Methods: Observational cross-sectional study based on repeated versions of the nationally representative Socioeconomic Characterization Survey in Chile. Adequate housing indicators adapted from the United Nations Housing Rights Programme guidelines were analyzed with relation to individual health, distinguishing between the local and international migrant populations. Logistic regression models were fitted for housing indicators with migration as the main independent variable and for short-term and long-term healthcare needs in locals and immigrants with housing as the main dependent variables. Models were adjusted for sociodemographic variables and considered the complex sample design. Results: Descriptive findings indicated higher availability of services and infrastructure among international migrants, and a disadvantage for habitability, location, and affordability by quintiles compared to locals. Logistic regression models, adjusting for demographic variables, revealed significant associations between migration status and overcrowding (OR 6.14, 2022), poor housing materiality (OR 5.65, 2022) and proximity to healthcare centres (OR 1.4, 2022) compared to locals. Experiencing hazardous situations consistently predicted short-term healthcare needs in both migrants (OR = 1.4, 2022) and locals (OR = 2.8, 2022). Overcrowding predicted both long and short-term healthcare needs among locals across the years and long term needs among migrants in 2013 and 2015. Conclusions: We found significant inequities in adequate housing between migrant populations and locals in Chile, and some inequities among both populations based on structural socioeconomic deprivation. Experiencing hazardous situations emerged as a social determinant of health among international migrants in 2022, potentially suggesting growing challenges related to social exclusion in urban areas. However, limitations such as exclusion criteria of the survey and sample sizes for data on the migrant population potentially suggest that housing challenges and their impact on health are underestimated.Item Alternativas de estrategias para una respuesta ética dirigida a personas migrantes internacionales en residencias sanitarias durante emergencias sanitarias. Policy Brief(Instituto de Ciencias e Innovaión en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo;Organización Mundial de la Salud, 2021) Cabieses, Báltica; Obach, Alexandra; Blukacz, Alice; Carreño Calderón, Alejandra; Larenas, Daniel; Rada, Isabel; Mompoint, EmanuelEl Programa de Estudios Sociales en Salud (PROESSA) del Instituto de Ciencias e Innovación Médica (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, con el patrocinio de la Organización Mundial de la Salud (OMS), presenta este documento, realizado en base a los resultados obtenidos en el Proyecto Migrantes internacionales en residencias sanitarias en Chile durante la pandemia COVID-19: Hacia una respuesta ética en emergencias sanitarias. Este Policy Brief, estructura cuatro alternativas de estrategia a implementar, explicitando para cada una sus beneficios, potenciales perjuicios, factores de incertidumbre, aspectos clave para su implementación y la visión de actores interesados. Tiene como propósito facilitar un proceso de toma de decisiones basadas en evidencia en torno al cuidado ético de migrantes internacionales en centros de cuarentena, siendo un insumo para tomadores de decisiones, organizaciones internacionales, organizaciones no gubernamentales y organizaciones de la sociedad civil interesadas en temáticas relacionadas a la salud de migrantes internacionales.Item Alternativas de estrategias Sanitarias con perspectiva intercultural dirigidas a comunidades de migrantes internacionales vulnerables en Chile en contexto de pandemia. Policy brief(Instituto de Ciencias e Innovaión en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo; Agencia Nacional de Investigación, 2021) Cabieses, Báltica; Obach, Alexandra; Blukacz, Alice; Vicuña, José Tomás; Carreño Calderón, Alejandra; Stefoni, Carolina; Pérez, Claudia; Avaria, Andrea; Urrutia, Carla; Oyarte, Marcela; Rada, Isabel; Schneider, StephenEl Programa de Estudios Sociales en Salud (PROESSA) del Instituto de Ciencias e Innovación Médica (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, con el patrocinio de la Agencia Nacional de Investigación y Desarrollo (ANID), presenta el Policy Brief Alternativas de estrategias sanitarias interculturales dirigidas a comunidades de migrantes internacionales vulnerables en Chile en contexto de pandemia. Este se encuentra enmarcado en el Proyecto Vulnerabilidades y recursos de comunidades migrantes internacionales en Chile para enfrentar la pandemia SARS-CoV-2: Construyendo estrategias diferenciadas desde la interculturalidad, financiado por la Dirección de Investigación y Desarrollo (DID) de la Universidad del Desarrollo y alojado en los proyectos ANID COVID-19 (código COVID0873). En base a los resultados del proyecto de investigación, el presente Policy Brief estructura cinco alternativas de estrategia a implementar, explicitando para cada una sus beneficios, potenciales perjuicios, factores de incertidumbre, aspectos clave para su implementación y la visión de actores interesados. A través de esto, el presente Policy Brief tiene como propósito contribuir al proceso de toma de decisiones basadas en evidencia para abordar la vulnerabilidad psicosocial y socioeconómica de migrantes internacionales en contexto de pandemia. Este Policy Brief se presenta como un apoyo para la toma de decisiones de diseñadoras de políticas públicas, organizaciones internacionales, organizaciones no gubernamentales y organizaciones de la sociedad civil que trabajan en temáticas de vulnerabilidad social, migración internacional y salud.Item Barreras y facilitadores de adherencia a tratamientos en la comunidad migrante con enfermedades crónicas durante la pandemia del año 2022(Universidad del Desarrollo. Facultad de Medicina, 2022) Aybar, Francisca; Alvear, Ignacio; De La Rosa, Felipe; Larraín, Josefina; Cea, María Francisca; Blukacz, AliceIntroducción: Se ha descrito cómo los pacientes migrantes internacionales tienen menor adherencia al tratamiento en comparación a personas residentes con patologías similares, sin embargo, se desconoce cómo la pandemia actual ha afectado esta brecha. La necesidad de este estudio surge del vacío de conocimiento que se pesquisa luego de la revisión del estado del arte. Objetivo general: Indagar las diferentes barreras y facilitadores que han surgido para la adherencia al tratamiento de enfermedades crónicas de pacientes inmigrantes miembros de la fundación RED Migrantes durante la pandemia por SARS-COV-2 durante el año 2022. Métodos: Corresponderá a un estudio de tipo cualitativo, clasificado como estudio de caso. Se realizará una entrevista de carácter semi estructurado e individual. Se realiza el reclutamiento a través de la fundación RED Migrantes. Los resultados serán ordenados y analizados por medio de un diario de campo. Resultados: Las principales barreras encontradas dentro de los participantes fueron Discusión: Estudio señalan que las principales barreras van enfocadas a la situación migratoria irregular de los migrantes, por otra parte los facilitadores van enfocados a políticas públicas enfocadas en beneficio de los migrantes, por el contrario de este estudio. Conclusión: Se encontró que hay una buena adherencia al tratamiento, sin embargo hay existencia de poco conocimiento sobre el sistema de salud chileno, hechos que se asimilan con la literatura preexistente. Se sugiere como recomendación para los próximos estudios ampliar la muestra del estudio a comunidades que se encuentren en situaciones más vulnerables.Item Barriers and challenges around the mental health of refugees and asylum seekers in Chile(2022) Blukacz, Alice; Carreño, Alejandra; Cabieses, BálticaAsylum and refuge in Chile h¬ave received limited attention in policymaking and academia, and there is scarce evidence on their mental health needs and outcomes. Studies on mental healthcare access for international migrants suggest systemic barriers linked to costs and coverage, administrative issues, and adequacy of services. Today, we see that asylum and refuge is an emerging topic in Chile, which opens up the challenges around the mental health of refugees and asylum seekers. This topic is gaining visibility due to increased asylum claims over the past ten years, making it an urgent topic at a policy level. An exploratory qualitative study was conducted in 2018 on the health and social needs of asylum seekers and refugees from Latin America in Chile. This study indicated a general lack of knowledge on the mental health needs of refugees and asylum seekers and Chile and a lack of training in mental health professionals to address specific needs. Consequently, the health needs of these people remain largely unaddressed in terms of the number of available services and the relevance and pertinence of the services delivered. As Chile is positioning itself as a receiving country of refugees and asylum seekers in Latin America and the Caribbean, there is an opportunity to "do better" and adequately address the mental health of these marginalized populations.Publication Barriers and facilitators to access sexual and reproductive health services among young migrants in Tarapacá, Chile: a qualitative study(2024) Obach, Alexandra; Blukacz, Alice; Sadler, Michelle; CARREÑO CALDERON, ALEJANDRA; Cabieses, Báltica; Carolina DíazBackground: Chile has become a destination country for immigrants from Latin America, including youth. Guaranteeing access and use of sexual and reproductive health services for young migrants is crucial because of their overlapping experiences of transitioning to a new country and to adulthood. However, the existing evidence shows barriers to accessing sexual and reproductive healthcare among young migrant populations. In this context, the main objective of this article is to identify the barriers and facilitators that young migrants experience to access sexual and reproductive healthcare in the Tarapacá region of Chile. Methods: A qualitative study was conducted in the Tarapacá region of Chile. Semi-structured interviews with 25 young migrants from Venezuela, Colombia, and Ecuador, as well as 10 health workers, were carried out. The interviews were transcribed and thematically analysed. The study was approved by the Ethics Committee of the Universidad del Desarrollo (#2019-22). Results: Young migrants face barriers linked to structural shortcomings within the healthcare system, which may be similar to those faced by the local population. Barriers are also derived from reductionist sexual and reproductive health approaches, which prioritise the prevention of pregnancy, sexually transmitted infections, and HIV, with a predominantly heteronormative focus. The prevailing narratives from the health system are those of risk and lack of control and self-care among young people, and they are exacerbated in the case of migrants. Young migrants, especially from the Caribbean, are stereotyped as over-sexualised and liberal in comparison to the local population and believed to be engaging in riskier sexual behaviours that should be kept under check. This may translate into experiences of discrimination and mistreatment when receiving care. Facilitators include good-quality information and community-level interventions. Conclusions: This study shows a limited approach to the sexual and reproductive health of young migrants in Chile, severely hampering their reproductive and sexual rights. Policies and initiatives must work towards removing structural barriers, changing narratives, and empowering young migrants regarding their sexual and reproductive health.Publication Desafíos para el abordaje de la salud de los migrantes en Chile durante la pandemia por Covid-19: una revisión de alcance(2023) Cabieses, Báltica; Obach, Alexandra; Blukacz, Alice; Rada, Isabel; CARREÑO CALDERON, ALEJANDRA; Mezones, EdwardObjetivo.Indagar sobre los principales desafíos reportados en el marco de la emergencia sanitaria de SARS-CoV-2 según la evidencia científica disponible a la fecha en esta materia en Chile. Material y métodos. Revisión de alcance con base en tres búsquedas en Web of Science, PubMed y Google Scholar de publicaciones en inglés y español publicadas entre 2020 y 2023. Resultados. Se identificaron tres áreas clave: desafíos de acceso y uso efectivo del sistema de salud, desafíos más allá del sistema de salud, incluyendo aquellas relaciones con determinantes sociales de la salud, autocuidado e información y, finalmente, desafíos de integración de los enfoques de interculturalidad, género y cooperación internacional. Conclusiones. Se evidencian oportunidades de mejorar el abordaje de la salud de personas migrantes internacionales en Chile a raíz de la pandemia por Covid-19, de cara a futuras crisis sanitarias y para reducir brechas e inequidades que impactan la salud poblacional. Objective. To investigate the main challenges in the context of the SARS-CoV-2 health emergency according to the scientific evidence available to date in this area in Chile. Materials and methods. Scoping review based on three searches in Web of Science, PubMed and Google Scholar of publications in English and Spanish published between 2020 and 2023. Results. Three key areas were identified: the challenges of access and effective use of the health system, the challenges beyond the health system, including those related to social determinants of health, self-care and information, and finally, the challenges of integrating intercultural, gender and international cooperation approaches. Conclusions. There are opportunities to better address the health of international migrants in Chile in the wake of the Covid-19 pandemic, anticipating future health crises and to reduce gaps and inequities that impact population health.Publication Emergency preparedness and response sensitive of migrant populations in Chile: postpandemic perspectives(2024) Blukacz, Alice; Cabieses, Báltica; Obach, Alexandra; CARREÑO CALDERON, ALEJANDRA; Mezones, EdwardOn August 31, 2023, the Chilean government ended the health alert for COVID-19. This milestone invites us to reflect on lessons learned in emergency preparedness and response regarding migrant populations in the country. In this context, three perspectives are presented. The first focuses on avoiding pointing to individual responsibility for non-compliance with prevention measures, as this approach ignores structural and historical inequities. Emergency recommendations should be constructed considering a collective approach and diverse sociocultural and political contexts. The second perspective calls for considering and addressing migration as a social determinant of health. During the pandemic, changes in the governance of migration around the world made migration processes more precarious, with risks to the physical and mental health of migrants, which needs better planning and evidence-based decision-making in future pandemics. The third perspective focuses on promoting intercultural health, as effective communication of contagion risks and preventive measures were hampered among migrant populations with diverse worldviews and interpretations of health and disease processes. Responding to the needs of historically marginalized communities requires establishing ways of life that respect diversity in narratives and everyday practices. Governments and health systems must incorporate migration into their emergency preparedness and response strategies, creating the conditions for optimal compliance.Item Estudio de acceso y pertinencia cultural en la atención de salud de niñas, niños y adolescentes en contextos de migración en atención primaria(Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, ICIM, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, 2023) Alejandra Carreño,; Cabieses, Báltica; Obach, Alexandra; Blukacz, Alice; Olivares, Daniela; Oyarte, Marcela; Meneses, Katherine; Robledo, María Consuelo; Ortega, AndreaLa migración es un reconocido determinante social de la salud debido a que tiene un impacto sobre la salud física y mental de la persona que migra, en todas las etapas del ciclo migratorio, desde la fase pre-migratoria hasta la fase de asentamiento (Castañeda et al., 2015). Si bien todos los niños, niñas y adolescentes (NNA) tienen el derecho de acceder a servicios de salud y al disfrute del más alto nivel posible de salud que les permita vivir dignamente, aquellos que migran en condiciones peligrosas y se enfrentan a condiciones de vida adversas necesitan atención específica por parte de los sistemas de salud y otras estructuras sociales para abordar su protección, bienestar y salud en todas las fases de su ciclo migratorio y vital (Mendoza, 2009). Las y los NNA migrantes se enfrentan a desafíos diferentes en comparación con la población local, porque afrontan dificultades vinculadas a la falta de acceso a atención de salud y otros servicios básicos, todos estos conocidos factores de riesgo para su salud (UNICEF, 2016). Basados en la necesidad de conocer las condiciones de vida y salud de niños, niñas y adolescentes migrantes presentes en Chile, se presentan los resultados del estudio “ESTUDIO DE ACCESO Y PERTINENCIA CULTURAL EN LA ATENCIÓN DE SALUD DE NIÑAS, NIÑOS Y ADOLESCENTES EN CONTEXTOS DE MIGRACIÓN EN ATENCIÓN PRIMARIA” ejecutado por Departamento de Salud y Pueblos Indígenas (DIVAP, MINSAL) y el Centro de Salud Global Intercultural de la Universidad del Desarrollo.Item Feeling prepared to face COVID-19 pandemic among Venezuelans in Chile: findings from an opinion poll - Medwave(2021) Cabieses, Báltica; Darrigrandi, Florencia; Blukacz, Alice; Obach, Alexandra; Silva, ClaudiaIntroduction International migration is a social determinant of health. The past decade has seen a large exodus of Venezuelans within Latin America, including Chile. In the past months, the world has been facing the SARS-CoV-2 coronavirus pandemic and its respiratory disease COVID-19. Objective To explore what factors are associated with feeling prepared to face the COVID-19 pandemic among the Venezuelan population residing in Chile. Methods Cross-sectional quantitative study with an opinion poll design. An online self-reported survey in Spanish and Creole was designed and piloted with experts and international migrants. It was disseminated to various international migrant groups through networks of migrant and promigrant organizations and the Chilean public health care network across the national territory. An effective sample size for analysis of 1690 participants was reached, of which 1008 (60%) were from Venezuela and included in this analysis. Feeling prepared to face the COVID-19 pandemic (yes/no) among Venezuelan migrants was described, as well as relevant variables like sex, level of education, length of stay, healthcare provision, anxiety or depression due to COVID-19, confinement, and evaluation of the quality of the information provided by the COVID-19 government. Results 65% of the Venezuelan participants reported not feeling prepared for the pandemic. Compared to Venezuelan migrants who feel prepared to face the COVID-19 pandemic, migrants who reported not feeling prepared were in a higher proportion female, with secondary education level, had arrived in Chile in the past year, do not have a job but want to work, and belong to the public healthcare provision. Discussion Receiving good quality information on the pandemic and mental health symptoms are important factors associated with feeling prepared to face COVID-19 in Venezuelan migrants in Chile, suggesting that increased attention towards the physical and mental health of Venezuelan migrants in Chile and the region is needed.Item Guía de apoyo a equipos de salud: para la atención a poblaciones migrantes en contexto de crisis socio-sanitarias con enfoque intercultural en salud. Desarrollada a partir de resultados de estudio multi-métodos(Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, 2021) Cabieses, Báltica; Obach, Alexandra; Blukacz, Alice; Vicuña, José Tomás; Carreño Calderón, Alejandra; Stefoni, Carolina; Pérez, Claudia; Avaria, AndreaItem Hacia un cuidado ético en residencias sanitarias durante la pandemia de COVID-19: estudio cualitativo con migrantes internacionales en Chile(2022) Cabieses, Báltica; Obach, Alexandra; Blukacz, Alice; Carreño, Alejandra; Larenas, Daniel; Mompoint, Emmanuel; Beca, Juan PabloMigrantes internacionales han sido reconocidos como población de riesgo en el contexto de la pandemia de COVID-19. A nivel mundial se han desplegado diversas estrategias para la protección de esta población, como la habilitación de centros de recepción y cuarentena o aislamiento. El artículo da cuenta de los resultados de un estudio que exploró las experiencias de migrantes internacionales en residencias sanitarias dispuestas en Chile para la realización de cuarentenas seguras en el marco de la pandemia COVID-19, desde un enfoque de condiciones éticas para el cuidado. Se realizó un estudio cualitativo entre los años 2020-2021. Se efectuaron 30 entrevistas individuales semi-estructuradas en línea en las ciudades de Arica, Iquique, Antofagasta y Santiago a migrantes internacionales con experiencia de uso de residencias sanitarias; equipos de salud de residencias sanitarias; mánagers de dichos recintos; autoridades locales; y expertos nacionales. Se realizó análisis temático de la información. El estudio concluye que para migrantes internacionales, si bien la experiencia en residencias sanitarias ha significado un apoyo sanitario significativo, es imprescindible que el cuidado proporcionado, además de la exigencia que se enmarque en un enfoque de derechos y de respeto a la dignidad de cada persona, incorpore la perspectiva de la interculturalidad en su quehacer, es decir, asegurando el derecho a servicios de salud culturalmente pertinentes, respetuosos de la cultura de las personas, las minorías, los pueblos y las comunidades.Item Health in Chile’s Recent Constitutional Process: A Qualitative Thematic Analysis of Civil Proposals(2022) Cabieses, Báltica; Esnouf, Sophie; Blukacz, Alice; Espinoza, Manuel; Mezones, Edward; Leyva, RenéBackground: In response to the recent political crisis in Chile, the “Agreement for Social Peace and the New Constitution’’ was approved. We aimed to analyze the health-related civil proposals uploaded to the official website for popular participation in the new constitution in Chile. (2) Methods: We carried out a qualitative thematic analysis of 126 health-related valid proposals. Moreover, we analyzed their link to the Health Goals 2030, established by the Ministry of Health of Chile and to the Sustainable Development Goals (SDGs). (3) Results: Sixteen main categories were reached. In all, they were organized into four main areas: (i) the right to health and the establishment of a universal health system; (ii) effective access to selected healthcare services; (iii) improving health outcomes for all and for the relevant subgroups; and (iv) the social determinants of health, health in all the policies, and community health. We found that these four areas were strongly linked to the Health Goals 2030 for Chile and to the SDGs. (4) Conclusions: Despite the fact that the new constitutional proposal was rejected in September 2022, the civil health-related proposals and the areas of health and healthcare were of interest to the citizens as the request showed a strong demand from the population for participation in matters of health, healthcare, and public health.Item Healthcare and social needs of international migrants during the COVID-19 pandemic in Latin America: analysis of the Chilean case(2022) Blukacz, Alice; Cabieses, Báltica; Mezones, Edward; Cardona, JoséInternational migrants are a particularly vulnerable group in the context of the coronavirus disease 2019 (COVID-19) pandemic. Immigrants in Chile tend to experience multidimensional poverty and layers of social vulnerability. Our analysis aims to describe the perceived social and health-related needs of international migrants during the COVID-19 pandemic in Chile in terms of migration as a social determinant of health and layered social vulnerability. We carried out a qualitative analysis of responses to an open-ended question focused on the social and health-related needs linked to the pandemic included in an online questionnaire disseminated during April 2020 aimed at international migrants residing in Chile. The information gathered was thematically analysed. We included 1690 participants. They expressed needs related to health and others linked to the overall socio-economic and political response, employment, material conditions and psychosocial aspects. They also reported needs related to 'being a migrant'. Additionally, some participants described situations of vulnerability. We analysed their needs and situations of vulnerability identified around the following emerging frames: (a) work and living conditions, (b) regularisation traps and perceived lack of support and (c) and physical and mental health needs. International migrants in Chile report experiencing interrelated layers of social vulnerability during the COVID-19 pandemic, where 'being a migrant' exacerbates physical and mental health risks. The issues revealed are immediate and direct public health challenges, as well as different aspects of social vulnerability linked to migratory status, employment and barriers to accessing healthcare that should be addressed through comprehensive policies and measuresItem “If I get sick here, I will never see my children again”: The mental health of international migrants during the COVID-19 pandemic in Chile(2022) Blukacz, Alice; Cabieses, Báltica; Obach, Alexandra; Madrid, Paula; Carreño, Alejandra; Pickett, Kate; Markkula, NiinaBackground: The COVID-19 pandemic has had an impact on the mental health of international migrants globally. Chile has managed its response to the pandemic in an ongoing context of social unrest and combined regional migratory and humanitarian crisis. The country's population presents a high prevalence of common mental disorders and a high suicide rate, with limited access to mental healthcare. International migrants in Chile represent 8% of the total population, and although a socioeconomically heterogenous group, they face social vulnerability, a range of mental health stressors and additional barriers to access mental healthcare. This study describes the mental health outcomes, stressors, response, and coping strategies perceived by international migrants during the COVID-19 pandemic in Chile. Methods and findings: A qualitative case study was carried out through individual online interviews to 30 international migrants living in Chile during the pandemic and 10 experts of the social and health care sectors. An inductive content analysis was carried out, a process during which the researchers sought to identify patterns and themes derived from the data. Participants experienced mainly negative mental health outcomes, including anxiety and depression symptomatology. Stressors included the virus itself, work, living and socioeconomic conditions, discrimination, fear for their family and distance caring. Institutional responses to address the mental health of international migrants during the pandemic in Chile were limited and participants relied mainly on individual coping strategies. Conclusions: The pandemic can represent an important opportunity to strengthen mental health systems for the general population as well as for population groups experiencing social vulnerability, if the issues identified and the lessons learned are translated into action at national, regional, and international level. Promoting the mental health of international migrants means recognising migration as a social determinant of mental health and adopting a cross-cultural as well as a Human Rights approach.Item Inequities in mental health and mental healthcare between international immigrants and locals in Chile: a narrative review(2020) Blukacz, Alice; Cabieses, Báltica; Markkula, NiinaMental health in a context of international migration is a particularly pressing issue, as migration is recognised as a social determinant of physical and mental health. As Chile is increasingly becoming a receiving country of South-South migration, immigrants face mental health inequities, with regards to outcomes and access to care. In order to identify and synthetize mental healthcare inequities faced by international migrants with regards to locals in Chile, a narrative review of the literature on national mental healthcare policies in Chile and a narrative review of the literature on migrants’ mental healthcare in Chile were conducted, with a focus on describing mental health outcomes, policy environment and persisting gaps and barriers for both topics. The existing literature on mental healthcare in Chile, both for the general population and for international migrants, following the social determinant of health framework and categorised in terms of i) Inequities in mental health outcomes; ii) Description of the mental health policy environment and iii) Identification of the main barriers to access mental healthcare. Despite incremental policy efforts to improve the reach of mental healthcare in Chile, persisting inequities are identified for both locals and international migrants: lack of funding and low prioritisation, exacerbation of social vulnerability in the context of a mixed health insurance system, and inadequacy of mental healthcare services. International migrants may experience specific layers of vulnerability linked to migration as a social determinant of health, nested in a system that exacerbates social vulnerability. Based on the findings, the article discusses how mental health is a privilege for migrant populations as well as locals experiencing layers of social vulnerability in the Chilean context. International migrants’ access to comprehensive and culturally relevant mental healthcare in Chile and other countries is an urgent need in order to contribute to reducing social vulnerability and fostering mechanisms of social inclusion. International migration, social determinants of mental health, mental health inequities, social vulnerability, review.Publication International migration, food insecurity, and mental health: A scoping review protocol(2024) Blukacz, Alice; Cabieses, Báltica; Huerta, Catalina; Lake, Amelia A.; Smith, Jo; Giles, Emma L.; Deane, FayeINTRODUCTION Food insecurity is a global priority that has been found to negatively impact mental health, increasing the risk of mental disorders and severe mental illness. International migrants may face food insecurity throughout their migratory cycle due to a range of risk factors, such as poor transit conditions, precarious employment, financial pressure, discrimination, and lack of availability and access to culturally relevant food, among others. Although there are multiple reviews on migration, food insecurity, and health in general, no scoping review has been conducted on food insecurity among international migrants focusing on mental health. OBJECTIVE To investigate the available evidence on food insecurity and mental health among international migrants. METHODS A search of scientific literature in English, Spanish, French, Italian, and Portuguese published since 2013 will be performed in the Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, and ASSIA databases, including grey literature available in Google Scholar. Two authors will independently review titles, abstracts, and full texts before extracting data from publications complying with the eligibility criteria. Extracted data will be descriptively mapped according to emerging thematic categories. EXPECTED RESULTS The review will contribute to identifying what is known about international migration, food insecurity, and mental health, gaps in the literature, opportunities for specific research subtopics, and how food insecurity and mental health can be linked in the existing literature.