ABSTRACT
Background: The crisis in Venezuela has forced almost eight million people to flee to mainly neighbouring countries, including Brazil. Half of the displaced Venezuelans are women and girls, with adolescent girls facing distinctive challenges to their sexual and reproductive health during displacement and settlement. The aim of this study is to understand the barriers and facilitators for the sexual and reproductive health of adolescent Venezuelan girls residing in Brazil. Methods: The study used qualitative methods, including semi-structured interviews with 19 Venezuelan migrant adolescent girls conducted in Boa Vista and Manaus. We analysed transcripts using thematic analysis, and mapped findings to a theoretical framework based on the Bronfenbrenner Socio-ecological Model, which we adapted to explore how intersectional vulnerabilities at the individual level interact with contextual factors creating barriers and facilitators for health and rights of migrant adolescent girls. Results: Venezuelan adolescent migrants in Brazil face practical and structural barriers in realising their sexual and reproductive health and rights in four areas: menstruation; family planning, contraception and sexually transmitted infection; prenatal, childbirth and postnatal care; and preventing gender-based violence. The reported barriers were lack of knowledge around sexual and reproductive health rights, exposure to violence and lack of access to age-appropriate healthcare services. Mitigating factors included education (both in the family setting and at school); prevention activities undertaken by health services; care provision from non-governmental organisations and international agencies; and best practices in local health services. Conclusions: Host states must take action to enhance the right to sexual and reproductive health for adolescent migrants to allow them to make autonomous, independent and informed choices. A socioecological perspective on sexual and reproductive health and rights can help formulate intersectional policies that interconnect different levels of adolescent migrants' experience.
ABSTRACT
RESUMO Este estudo tem como objetivo apresentar os resultados da tradução, validação transcultural e avaliação preliminar de uma ferramenta, originalmente desenvolvida no Reino Unido, para orientar pesquisadores brasileiros na elaboração de projetos e pesquisas de implementação rigorosos e de alta qualidade: ImpRes-BR. Seguindo boas práticas atualmente estabelecidas para validação transcultural de instrumentos e escalas, a ferramenta, juntamente com seu guia de utilização, foi traduzida e retrotraduzida, submetida a um teste piloto com 20 profissionais de saúde e avaliada por um painel de 10 especialistas que atribuíram os valores utilizados para os cálculos do Índice de Validade de Conteúdo ao nível do item (IVC-I) e escala (IVC-E). Nesse processo, além de índices de validade conceitual superiores à 90%, foi observado um IVC-I de pelo menos 0,90 em todos os domínios da ferramenta e seu guia e um IVC-E de 0,98. Estabelecida a validade da ferramenta e seu guia, a mesma foi aplicada em 14 projetos de pesquisa em fase de planejamento ou execução e foi reconhecida enquanto um instrumento potente para autoanálise das equipes na qualificação de seus projetos e fortalecimento destes em relação aos princípios da Ciência de Implementação.
ABSTRACT This study aims to present the results of the translation, cross-cultural validation and preliminary evaluation of a tool, originally developed in the United Kingdom, to guide Brazilian researchers in the elaboration of projects and rigorous and high-quality implementation research: ImpRes-BR. Following currently established good practices for cross-cultural validation of instruments and scales, the tool, together with its user guide, was translated and back-translated, subjected to a pilot test with 20 health professionals and evaluated by a panel of 10 specialists who assigned the values used for the calculations of the Content Validity Index at the item level (CVI-I) and scale (CVI-E). In this process, in addition to conceptual validity indices greater than 90%, an IVC-I of at least 0.90 was observed in all domains of the tool and its guide, and an IVC-E of 0.98. Having established the validity of the tool and its guide, it was applied in 14 research projects in the planning or execution phase and was recognized as a powerful instrument for self-analysis of the teams in the qualification of their projects and strengthening them in relation to the principles of the Implementation Science.