Healthcare access, quality and financial risk protection among displaced Venezuelan women living in Brazil: A cross-sectional study

Abstract: 

Background
Millions of Venezuelans have been displaced because of the deteriorating socio-economic conditions in their country. Women and girls are especially vulnerable in this displacement context. We examine key domains of universal health coverage among migrant Venezuelan women in Brazil: healthcare access, care quality received and financial risk protection.

Methods
We collected primary data on 2,012 Venezuelan women aged 15-49 who migrated to Brazil between 2018 and 2021, in the cities of Boa Vista and Manaus, along with secondary data for Brazilian women. We estimate associations between migrant status and healthcare spending, utilisation and quality indicators, for general health and sexual and reproductive health services, using linear regression with entropy balance matching.

Results
Overall, compared to Brazilian women, migrant women had lower household out-of-pocket health spending but higher catastrophic health expenditure incidence. Migrant women were more likely to receive healthcare when sought and free medicines from the Brazilian public health system, but less likely to have had a pap smear in the last three years. Migrants were more likely to have received antenatal consultations according to guidelines. We find differences among migrants depending on the city of residence and time since migration.  

Discussion
The relatively good healthcare access and care quality outcomes among migrant women in Brazil constitute reassuring evidence. Yet a potential backlog of unmet sexual and reproductive healthcare needs and inadequate financial risk protection among migrants require policy attention.