Exploring Social and Economic Factors that Influence Access to Sexual and Reproductive Health Services Among Venezuelan Migrant Women Living in Colombia Open Access
Ballesteros, Valentina (Spring 2022)
Abstract
Background: Colombia has welcomed 1.7 million refugees since 2016, almost 50% of the migrant population are women and girls. Studies have shown that Venezuelan women are fleeing to Colombia to access gynecological services that were unavailable in their home country. Currently, there is a general unmet need for contraception, HIV among Venezuelans in Colombia is increasing, and bordering departments have seen an increase in gestational syphilis.
Purpose: The purpose of this project is to understand what access to reproductive services looks like for Venezuelan migrants in Colombia and what external factors can limit that access.
Methods: A secondary analysis from the 2020 GIFMM joint needs assessment was performed from surveys of 3,112 households of Venezuelan migrants currently living in Colombia. Binary logistic regression models were developed to evaluate the effects of social contexts on access to SRH products and services. Two primary variables of consideration were access to SRH services and access to menstrual hygiene products. Different exposure models: secured housing, access to the internet, education level, minimum wage, adequate hygiene and sanitation stations, and department of residence. The data were analyzed using SAS. 9.3. Odds ratios with confidence levels of 95% were computed to ensure the validity of our models.
Results: A total of 577 (23% of all female respondents) women needed access to at least one SRH service, which included access to contraceptives, condoms, pregnancy-related services, gynecological services, and/or others. Out of 577 who reported a need to access SRH services, only 55% were able to access them. The proportion of women who report having the most access are located in La Guajira, where almost 80% of Venezuelan women can successfully access SRH services. In contrast, almost 40% of the women living in Bogota report having difficulty accessing SRH services. Secured housing was the only variable in our analysis of contextual factors that showed statistical significance for both access to menstrual products and SRH services. If you do not have secure housing, the odds of not having access to menstrual products or SRH services are 1.79 and 1.55 times higher compared to those individuals who have secure housing.
Discussion: While many of the general findings of the present study demonstrate that Venezuelan migrants have fairly good access to menstrual hygiene products, this appears to vary wildly by geographic location and is inconsistent with the needs of the general Colombian population. Organizations on the ground are reaching migrants at the border but must expand their reach to individuals who are living in the interior of the country. All future interventions and needs assessments should take into consideration that most migrants will travel to larger cities, like Bogota, where services may be harder to access. Thus, providing individuals with resources to access those services when they arrive in larger cities is key to their full integration in Colombia.
Table of Contents
Introduction 1
Introduction & Rationale 1
Problem statement 2
Project purpose & Research Questions 2
Significance Statement 3
Definition of Terms 4
Literature Review 5
Political Context and Massive Exodus from Venezuela: How did we get here? 5
The Importance of Access to Reproductive Services 6
Access to Reproductive Health Care in Venezuela 7
Access to Reproductive Health in Emergency Situations 9
Access to Reproductive Health among Venezuelan Migrants in Colombia 10
Gaps in the literature 11
Methodology 13
Data set 13
Data Cleaning 13
Procedures 15
Regression Analysis 16
Ethical Considerations 17
Limitations 17
Results 18
Demographic information and make-up of households 18
Descriptive Analysis of Survey Respondents by Gender 21
Characteristics of Water, Sanitation & Hygiene (WASH) in households 24
Access to Sexual and Reproductive Health Services 26
Regression Analysis 28
Discussion 32
Make-up of households 32
Insecure housing and the risk of inaccessibility 33
Location and access to SRH 34
Other contextual factors 35
Limitations 36
Public Health Implications and Recommendations 37
References 38
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