Person: Cabieses, Báltica
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Publication The social and health protection of migrants in Chile: qualitative analysis of civil society proposals for constitutional change(2023) Cabieses, Báltica; Obach, Alexandra; Blukacz, Alice; Esnouf, Sophie; Mezones, Edward; Espinoza, Manuel; DeJong, JocelynBackground: A sustained period of social, economic, and political unrest took place during October of 2019 in Chile. As an institutional solution, the "Agreement for Social Peace and the New Constitution" was signed. In this document, most political parties committed to reestablishing peace and public order in Chile, agreeing on the initiation of a constitutional process. To promote participation of civil society actors, the "Popular Initiative for Norms" was enabled. This was a platform where civilians could submit proposals for constitutional norms to be discussed by the Constitutional Convention. We aimed to analyze proposals related to migrants and migrant health. Methods: We conducted a qualitative thematic analysis of the proposals. Sixteen of them were related to migrants, and we analyzed their association to health. We also evaluated their link to the Health Goals 2030 set out by the Chilean Ministry of Health and the Global Action Plan 2019-2023 for Promoting the Health of Refugees and Migrants by the World Health Organization. Results: Four main thematic categories were identified: 1) Humans rights of migrants, refugees, and asylum seekers; 2) Nationality and regularization of migrants and refugees; 3) Political participation and cultural integration of migrants and refugees; and 4) Specific regulations on slavery and human trafficking. These resonated with broader frameworks established in the Health Goals 2030 (Chile) and the Global Action Plan 2019-2023 for Promoting the Health of Refugees and Migrants by the World Health Organization. Conclusions: The 'Popular Initiative for Norms' was a non-binding participatory mechanism. Although the proposals sent through were not guaranteed to be included in the constitutional draft-and despite the final draft being rejected last September 2022-the platform allowed to gain insights into civilian opinions. Our findings showed that there is an incipient yet weak recognition of the rights and situation of migrants in Chile. There was no direct mention of health nor an explicit contemplation of social determinants of health. Despite there being an urgent need to define strategies for migrants' health in Chile, this study demonstrated that civil awareness and interest are still insufficient.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.Publication Intersections between gender approaches, migration and health in Latin America and the Caribbean: a discussion based on a scoping review(2023) Cabieses, Báltica; Blukacz, Alice; Velázquez, Benelli; Farante, Sofia; Bojórquez, Ietza; Mezones, EdwardGender is a sociocultural construct that assigns forms of behaviour, power, and roles to individuals based on their sexual differentiation. There are multiple gender approaches that help distinguish risks, health conditions and behaviours related to the body, health-disease processes, and differential opportunities to access health care. Based on a scoping review of scientific and grey literature in LAC, we discuss existing understandings of international migrants’ health in LAC with a focus on gender approaches. Our discussion covers the following seven dimensions: genderbased violence, sexual and reproductive health, sexually transmitted diseases, mental health, barriers to healthcare services, and emerging patterns of health and healthcare among men and LGBTIQA+. The evidence indicates the urgent need to adopt gender approaches when addressing migrant and refugee health in LAC. Including gender approaches into ongoing strategies for promoting and protecting the health and rights of migrants and refugees is a pending challenge in the region.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.