Acesso aos serviços de saúde pelas populações migrantes: revisão sistemática

Abstract

This research studied the access to health services by migrant populations, with an analysis of articles related to migrants in Brazil and/or Brazilians in a migrant situation. The value of this study is supported by its worldwide relevance: in 2015, it is estimated that there were already 244 million international migrants in the world, with unquestionable impact on the health of these populations and on public health. Objectives: It was researched about the access to health services by the migrant populations, also trying to identify the possible barriers in this access and the main problems related to the quality of care. Methodology: Systematic review of articles published in the PubMed, BVS and SciELO databases, between 2003 and 2018. This search resulted in 776 items, with a selection of 32 articles for analysis and qualitative synthesis. Results: Migration is indicated as an important risk factor for infectious diseases due to its association with environmental, occupational, socioeconomic and cultural risks. Due to the intense exposure to insecurities and inequities, they are also more susceptible to chronic diseases. Most of the articles pointed out a relevant association between migratory processes and impacts on mental health, with vulnerabilities for mental suffering, psychopathologies and harmful use of alcohol and other drugs. Women, due to greater risks for violence and suffering related to the loss or separation of their children, added to the daily adversities and the accumulation of responsibilities at home and at work, face greater difficulties in accessing services and taking care of their own health, expressing high levels of diseases. Regarding refugees, experiences during the migratory phases can expose the various levels of challenges, violence, suffering and specific demands, which are often improperly addressed. Correlations between migration and work are cited in most articles. In large proportion, work is associated with an important risk factor for health, due to unhealthy occupational conditions, propitiating the development of suffering and illness. Conclusion: The main difficulties in accessing quality services are related to: cultural and linguistic barriers; lack of knowledge of their rights and the functioning of the services; lack of adequate structure, articulation and resolution actions in the services; racism and discrimination; institutional and professional unprepared care; and lack of government policies and actions that fully guarantee the rights of migrants and ensure access to health services, adequate working conditions, housing and education.