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Blukacz, Alice

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Blukacz

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Alice

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Alice Blukacz

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Now showing 1 - 10 of 11
  • 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 Díaz
    Background: 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
    Emergency preparedness and response sensitive of migrant populations in Chile: postpandemic perspectives
    (2024) Blukacz, Alice; Cabieses, Báltica; Obach, Alexandra; CARREÑO CALDERON, ALEJANDRA; Mezones, Edward
    On 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.
  • 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, Báltica
    Background: 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.
  • 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, Faye
    INTRODUCTION 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.
  • Publication
    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, Claudia
    Objective: 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
    Health conditions of migrant children and adolescents from Latin America and the Caribbean: A narrative review
    (2024) CARREÑO CALDERON, ALEJANDRA; Blukacz, Alice; Cabieses, Báltica; Obach, Alexandra
    The presence of children and adolescents in migratory flows is growing in Latin America and the Caribbean. Little is known about migration's effects on these groups' health. This article aims to investigate the evidence available on the access and use of healthcare services by migrant children and adolescents in Latin America and the Caribbean. We seek to explore the role of social determinants of health at different levels in the health conditions of these groups. Also, to identify potential recommendations for healthcare systems and public policy to address them. For this purpose, a narrative review of 52 publications was carried out based on a search of scientific literature in the Web of Science and Google Scholar databases. Five relevant topics were identified: use of emergency care associated with lack of healthcare access, preventive services, and other social determinants of health; exposure to preventable infectious diseases; mental health; sexual and reproductive health; and vaccinations and dental health. We conclude that the evidence shows the need to address the inequities and disadvantages faced by migrant children from a perspective of social determinants of health and policies that consider health as a human right regardless of the migratory status of children and adolescents, as well as that of their parents or primary caregivers.
  • 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, Edward
    Objetivo.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
    Education as a social determinant of the health of international migrants and locals in Chile between 2013 and 2022
    (2025) Blukacz, Alice; Oyarte, Marcela; Cabieses, Báltica; Díaz, Janepsy
    Background: Education is a recognised social determinant of health and interacts with other determinants including employment and income. International migration may disrupt these interactions. Education in Chile reflects wider socioeconomic inequalities and in the last decade, it has welcomed an increasing number of migrants. Objective: To analyse education as a social determinant of health among international migrants and locals between 2013 and 2022. Methods: Observational cross-sectional study based on five versions of the CASEN survey. Education, employment, and income were analysed in relation to healthcare needs for both populations and logistic regression models were estimated for each year. For 2022, the interactions between education and employment were explored in relation to healthcare needs. Results: International migrants showed a higher education level and employment rate than Chileans, and a smaller proportion reported healthcare needs. After adjusting for demographic and socioeconomic factors, locals aged 19–25 and 26–59 were more likely to report healthcare needs compared to international migrants across multiple years. The effects of education, employment, and income on healthcare needs among locals and international migrants showed fluctuating ORs without marked trends. In 2022, significant differences in healthcare needs were observed among migrants and locals based on interactions between education and employment, with non-overlapping confidence intervals particularly among unemployed, less-educated youth, middle-aged migrants with incomplete basic education, and older individuals. Conclusions: This study provides an overview of education as a social determinant of health among international migrants and locals for the last decade and call for targeted in-depth analyses on the topic.
  • Publication
    Nutrición, niñez y migración: Desafío para su abordaje desde un enfoque de interculturalidad en salud
    (2024) CARREÑO CALDERON, ALEJANDRA; Cabieses, Báltica; Blukacz, Alice
    Introducción La presencia de niños y niñas migrantes en Chile ha crecido numéricamente, especialmente de aquellos provenientes de América Latina y el Caribe. Hoy se calcula que en Chile un 10,4% de los niños entre 0-14 años son migrantes (CASEN 2020). Desde la determinación social de la salud, la bibliografía indica que la presencia de niñez migrante implica diversos desafíos en temas como inequidades en la afiliación a servicios, el acceso a programas de prevención y promoción de salud, así como mayor exposición a pobreza multidimensional y condiciones de vida desfavorables para su bienestar integral. Sin embargo, una de las dimensiones menos exploradas de estas inequidades se refiere a los temas nutricionales que a nivel internacional han sido identificados como prioritarios tanto por los efectos que la transición alimentaria tiene sobre los niños migrantes, como el registro de desnutrición en niños provenientes de países a alto riesgo de inseguridad alimentaria. Objetivos La propuesta pretende indagar en las percepciones de padres, madres y tutores migrantes así como de personal de atención primaria, sobre las necesidades nutricionales que enfrentan los niños durante su trayectoria migratoria (en país de origen, tránsito y destino) y los desafíos que enfrenta el sistema de salud para abordar las temáticas nutricionales desde un enfoque de interculturalidad Método Enmarcado en un proyecto cualitativo-etnográfico mayor se desarrollaron 10 entrevistas en profundidad a padres, madres y tutores de niños, niñas y adolescentes que pasaron por paso no habilitado en Chile entre los años 2019-2023, a 10 miembros de equipos de atención primaria encargados de atención directa a población migrantes, a 5 informantes clave, encargados de programas sociales y de salud dedicados a infancia y adolescencia y a 5 miembros de ONG’s dedicados al abordaje de temas migratorios, logrando un N=30. Las entrevistas fueron transcritas y se realizó análisis temático a través de la codificación de las mismas. Resultados principales Si bien en Chile existen desde hace años esfuerzos importantes para el abordaje de la desnutrición por exceso durante la infancia y adolescencia, los hallazgos demuestran: 1) el resurgimiento de temas de desnutrición por déficit, especialmente en niños que se encuentran en situación migratoria irregular y en madres migrantes que viven gestaciones en condiciones de vulnerabilidad social; 2) las dificultades que encuentran los equipos de salud para abordar temáticas nutricionales desde un enfoque de interculturalidad, especialmente en temas como la introducción de alimentación sólida en lactantes y la adecuación de recomendaciones alimentarias y 3) la necesidad de profundizar sobre los efectos de la transición alimentaria en niños, niñas y adolescentes migrantes considerando el mayor acceso en Chile a alimentación ultraprocesada, el mayor consumo de carbohidratos como el pan y la adecuación de las dietas a ritmos laborales que reducen los tiempos para el acceso y preparación de alimentos considerados saludables. Conclusiones Se presentan resultados sobre la situación nutricional de niños, niñas y adolescentes migrantes en Chile. Se destaca el resurgimiento de la desnutrición por déficit como problemática que afecta a población infanto-juvenil, las posibles consecuencias de la transición alimentaria debido al mayor acceso a alimentos ultraprocesados y la necesidad de incorporar el enfoque intercultural en los programas de atención dedicados a la nutrición de niños y niñas.
  • Publication
    Unravelling the potential relationship between the climate crisis and the health of migrant children in LAC: perceptions from migrant parents and healthcare professionals in Chile
    (2024) CARREÑO CALDERON, ALEJANDRA; Blukacz, Alice; Cabieses, Báltica
    Introduction Latin America and the Caribbean (LAC) is one of the regions most affected by the climate crisis, which is connected to international migration through a complex nexus. During the last years, migratory flows on the continent have increasingly included children and adolescents who are migrating through non-authorised crossing points. The existing literature shows how inequities negatively affect migrant children and the role that healthcare systems can play to mitigate them. Objective Based on a qualitative study, the paper aims to analyse the role of the climate crisis on the healthcare needs of migrant children from LAC who are currently living in Chile, from the point of view of parents from five main countries of immigration in Chile and healthcare professionals. Method An exploratory study was conducted in Arica, Antofagasta and Santiago. In-depth interviews with 20 migrant parents and 20 healthcare professionals were carried out. The interviews were transcribed verbatim and a thematic analysis was performed. Results Three findings emerged from this study: (1) food insecurity affects LAC migrant children in their country of origin and during their migratory trajectories to Chile, (2) natural disasters and environmental degradation in the countries of origin are not the only drivers of migration for LAC families but also prevent returns, even when they remain undocumented and (3) LAC migrant children are exposed to urban pollution and contaminants in informal settlements due to difficulties in accessing formal housing, among others. Conclusions The climate crisis must be integrated into the study of migrant health in LAC, considering the current context of multiple political, health and economic crises in the region. Healthcare professionals and communities play a central role in creating interventions to build sustainable and resilient universal healthcare systems.