Migration process of Venezuelan women to Brazil: living conditions and use of health services in Manaus and Boa Vista, 2018-2021.

BACKGROUND: The last decade saw the emergence of a new significant migration corridor due to the mass migration of Venezuelans to neighboring countries in South America. Since 2018, Brazil became the third host country of Venezuelan displaced populations. Little is known about how migratory processes affect needs, access to social programs, and public health services of migrant women. The goal of this study is to shed light on the socio-economic profile, living conditions, and use of health services of Venezuelan migrant women in two main reception cities in Brazil. METHODS: A survey was conducted using respondent-driven sampling (RDS) in the cities of Boa Vista (Roraima), and Manaus (Amazonas). The study included 2012 Venezuelan migrant women aged between 15 and 49 years old who migrated from Venezuela to Brazil between 2018 and 2021. Relative prevalence was calculated, and the χ2 test was used to analyse the homogeneity of proportions. All analyses considered the complex sampling. RESULTS: The main reasons for migrating relate to difficulties obtaining food (54%) and accessing health services (37.8%) in their country of origin. They were young and mixed race (65.7%) and had high school education (69.9%). In Manaus, 3.7% of the interviewees declared that they had no family income in the last month, while in Boa Vista, it was higher (66.2%) (p-value < 0.001). Almost one-third of them sought health care in the last 15 days, and 95% of them received care. The residents of Boa Vista arrived more recently and family income and access to paid work improved with time of residence in Brazil. CONCLUSIONS: Given the increasing flow of Venezuelan migrants crossing to Brazil, a reception system was established for the provision of food, shelter, access to health services, and income transfer programs to migrants. This was the case despite high unemployment and poverty levels and income inequality, particularly in the city of Boa Vista. However, the majority had legal migrant status and had access to the public and universal healthcare system in Brazil (SUS). The use of the SUS was similar in both cities, acting as a buffer for the differences in opportunities offered.

Using Respondent-Driven Sampling (RDS) to Identify the Healthcare Needs among Women of Reproductive Age Who Migrated from Venezuela to Brazil, 2018-2021.

In 2021, an RDS survey was conducted among Venezuelan migrant women of reproductive age who migrated to two Brazilian cities (Manaus and Boa Vista) from 2018 to 2021. To start the RDS recruitment, we chose seeds non-randomly in both cities. The study variables were age, educational level, self-rated health, pregnancy, migratory status and use of health services. We estimated the prevalence, confidence intervals and homophily effects by variable category. We used a multivariate logistic regression model to identify the main factors associated with healthcare use. A total of 761 women were recruited in Manaus and 1268 in Boa Vista. Manaus showed more irregular migrants than Boa Vista. The main reasons for using health services were as follows: illness, disease prevention and prenatal care. The logistic regression model showed the use of health services was associated with educational level and healthcare needs but not with migratory status. The social inclusion of Venezuelan migrants is extremely relevant, although many challenges must be overcome. The strategy of the Brazilian Federal Government for providing humanitarian assistance to Venezuelan migrants should be expanded to include and facilitate their integration into labor markets, access to healthcare and education, benefiting both migrants and the Brazilian people by reducing social inequality.

Estudo TransOdara: prevalência de HPV entre travestis e mulheres transexuais em situação de vulnerabilidade social em Manaus, Amazonas, Brasil / TransOdara study: HPV Prevalence among travestis and transsexual women in social vulnerability situation in Manaus, Amazonas, Brazil

Objetivo: Estimar a prevalência do papilomavírus humano (HPV) e avaliar a indicação e completude da vacinação contra o HPV entre travestis e mulheres transexuais (TrMT) em situação de vulnerabilidade social, participantes de estudo transversal multicêntrico (TransOdara), em Manaus, Amazonas (2020-2021). Métodos: O recrutamento ocorreu no Ambulatório de Diversidade Sexual e Gênero da Policlínica Pam/Codajás, utilizando Respondent-Driven Sampling. A variável dependente foi o resultado positivo para HPV, analisado por meio do resultado do swab anal e swab genital. Resultados: Participaram 39 TrMT. Cerca de 50% tinham entre 20 e 29 anos, com até Ensino Fundamental incompleto/completo e 81,6% identificaram-se como pretas/pardas. Um total de 97,4% apresentou infecção anal pelo HPV e 53,8%, infecção genital. As prevalências foram significativamente maiores entre as imigrantes (88,9%) e em situação de rua (72,7%) do que entre as privadas de liberdade (26,3%) (p = 0,003). Conclusão: Para reduzir a alta prevalência de HPV entre TrMT em situação de vulnerabilidade social, é importante aprimorar as políticas públicas vigentes e estabelecer estratégias de prevenção (ampliação da cobertura de imunização/diagnóstico precoce) e tratamento oportuno para melhor qualidade de vida.

Objective: To estimate the prevalence of human papillomavirus (HPV) and evaluate the indication and completeness of vaccination against HPV among 'travestis" and transsexual women (TrTW) in vulnerable social, participants of a multicenter cross-sectional study (TransOdara), in Manaus, Amazonas (2020-2021). Methods: Recruitment took place at the Sexual Diversity and Gender Outpatient Clinic of the Policlínica Pam/Codajás, using Respondent-Driven Sampling. The dependent variable was the positive result for HPV, analyzed through the result of the anal swab and genital swab. Results: 39 participated TrTW. About 50% were between 20 and 29 years old, with incomplete/complete Elementary School and 81.6% identified themselves as black/brown. A total of 97.4% had anal HPV infection and 53.8%, genital infection. Prevalences were significantly higher among immigrants (88.9%) and homeless (72.7%) than among those incarcerated (26.3%) (p = 0.003). Conclusion: To reduce the high prevalence of HPV among TrMT in socially vulnerable situations, it is important to improve current public policies and establish prevention strategies (expansion immunization coverage/early diagnosis) and timely treatment for better quality of life

The World Health Survey: a report on the field experience in Brazil.

This article reports on the field experience with the World Health Survey in Brazil with the aim of collaborating in the development and enhancement of the methodology and analyzing interview questions based on the interviewers' experience. The authors comment on the field experience and application of the questionnaire, based on reports by regional coordinators and interviewers, in order to shed light on the context in which the interviews took place. The article reports on how the respondents grasped and interpreted the questionnaire. The authors propose improvements in interviewer training and simple interview reporting measures aimed at improved logistics with such nationwide survey instruments.

The World Health Survey: a report on the field experience in Brazil / Pesquisa Mundial de Saúde: relato da experiência de campo no Brasil

O objetivo deste trabalho é relatar as experiências de campo da Pesquisa Mundial de Saúde no Brasil com o intuito de colaborar com o desenvolvimento e aprimoramento da metodologia e analisar questões do questionário confrontando-as com a experiência dos entrevistadores. Comentou-se sobre a experiência de campo e a aplicação do questionário aproveitando-se relatos de coordenadores regionais e dos entrevistadores para conhecer o contexto em que transcorreram as entrevistas. Foram relatadas as experiências com relação ao entendimento e compreensão do questionário por parte dos entrevistados. Os autores propõem melhorias na forma de treinamento dos entrevistadores e medidas simples para que elas possam ser relatadas visando o aprimoramento da logística na aplicação de instrumentos desta abrangência territorial.

The World Health Survey: a report on the field experience in Brazil / Pesquisa Mundial de Saúde: relato da experiência de campo no Brasil

This article reports on the field experience with the World Health Survey in Brazil with the aim of collaborating in the development and enhancement of the methodology and analyzing interview questions based on the interviewers' experience. The authors comment on the field experience and application of the questionnaire, based on reports by regional coordinators and interviewers, in order to shed light on the context in which the interviews took place. The article reports on how the respondents grasped and interpreted the questionnaire. The authors propose improvements in interviewer training and simple interview reporting measures aimed at improved logistics with such nationwide survey instruments.

O objetivo deste trabalho é relatar as experiências decampo da Pesquisa Mundial de Saúde no Brasil com ointuito de colaborar com o desenvolvimento e aprimoramentoda metodologia e analisar questões doquestionário confrontando-as com a experiência dosentrevistadores. Comentou-se sobre a experiência decampo e a aplicação do questionário aproveitando-serelatos de coordenadores regionais e dos entrevistadorespara conhecer o contexto em que transcorreramas entrevistas. Foram relatadas as experiências com relaçãoao entendimento e compreensão do questionáriopor parte dos entrevistados. Os autores propõem melhoriasna forma de treinamento dos entrevistadores emedidas simples para que elas possam ser relatadasvisando o aprimoramento da logística na aplicação deinstrumentos desta abrangência territorial.

Grandes empreendimentos e impactos sobre a saúde: análise e monitoramento das condições de vida e de processos endêmico-epidêmicos

A Coleção Saúde, Ambiente e Sustentabilidade inaugura a Série de Documentos Institucionais da Fiocruz com o intuito de abrir mais um canal de divulgação científica em torno dos temas considerados estratégicos pela instituição. Os seus oito volumes desvelam a rica trajetória deste campo de conhecimento, seus pensamentos, suas práticas, inquietações e os desejados caminhos a seguir. O volume 5, Grandes Empreendimentos e Impactos sobre a Saúde, apresenta os antecedentes históricos, os aspectos teóricos, conceituais, metodológicos e políticos da área, as interfaces relevantes com o SUS e a atuação, a produção e a rede de pesquisa da Fiocruz nesse campo, o papel dos movimentos sociais e as agendas temáticas e os desafios diante dos grandes empreendimentos.

Pesquisa mundial de saúde 2003: o Brasil em números

Apresenta dados exclusivos da extensa Pesquisa Mundial de Saúde 2003, uma iniciativa da Organização Mundial de Saúde para 71 países, cuja execução no Brasil foi entregue a pesquisadores do Departamento de Informações em Saúde do Centro de Informação Científica e Tecnológica da Fiocruz. A pesquisa teve início em fins de 2002, com a tradução e a adaptação a nossas especificidades do questionário da OMS, que foi então submetido, entre janeiro e setembro de 2003, a 5 mil brasileiros com idade acima de 18 anos, em 250 setores censitários (locais visitados pelos entrevistadores) dentro de 188 municípios, em 25 estados (ficaram de fora Acre e Roraima).