Background Sexual and Gender-Based Violence (SGBV) affects women and girls in multiple ways. During migration and within humanitarian settings, migrant women and girls are exposed to different forms of SGBV and to higher vulnerabilities compared with those men encounter. Survivors of this kind of violence face challenges in accessing healthcare for reasons that not only include legal status, language barriers, discrimination, misinformation on the availability of healthcare services, but also the growing spread of conservative views regarding sexual and reproductive health which pose a considerable threat to human rights. This study was guided by the question of how humanitarian emergency preparedness and response initiatives within four cities at the Colombo-Venezuelan border are addressing SGBV. The goal of this research was threefold: first, to explain the level of implementation of the second goal of the MISP, which is to prevent and respond to the consequences of sexual violence; second, to assess the availability of services for migrants who have experienced some type of sexual violence; and third, to understand the perceptions of migrants regarding sexual and gender-based violence. Methods and Findings This study assessed the degree of implementation of the Minimal Initial Service Package (MISP) using a set of tools developed by the Inter-Agency Working Group on Reproductive Health in Crises. This study combined the use of different qualitative methods: i) a literature review; ii) 23 interviews with key informants on sexual and reproductive health; iii) an assessment of 21 health institutions which provide services to migrants; and iv) 24 focus groups with migrants between the ages of 14 to 49 years old (241 participants, of which 121 were women and 120 were men). This research was conducted in four cities at the Colombo-Venezuelan border where there was the highest concentration of migrants. Ethical approval was granted by Profamilia´s Advisory Committee on Research Ethics. Although preventing and managing the consequences of sexual violence is the second objective of the MISP, this study found several barriers for the guarantee of comprehensive healthcare for survivors: Venezuelan migrants do not usually consider that healthcare is a need for them after they have survived sexual violence; SGBV during migration is a common occurrence according to key informants; in three out of four cities there were existing organizations working on SGBV, but not all of them could offer comprehensive healthcare services in response to sexual violence. Conclusions In this study, we observed that migrants tend to be more exposed to Sexual and Gender-Based Violence due to the normalization of such forms of violence in the Colombian and Venezuelan cultures. Findings suggest that Venezuelan migrants are facing complex SGBV issues during the humanitarian emergency at the Colombia-Venezuela border. Recommendations include local health systems response ...

Objectives:To describe the mechanisms of implementation of Zika virus diagnosis, prevention, and management guidelines in Colombia, and to characterize their influence on efforts to defend sexual and reproductive rights. Methods:A qualitative study performed between February and April 2018 in three municipalities in Colombia. We conducted 30 semistructured interviews and five focus groups with key informants who played a role during the epidemic. These included decision-makers, program coordinators, healthcare providers, pregnant women diagnosed with Zika virus, and members of affected communities. Results:We identified barriers to and facilitators for the implementation of the national Zika virus response plan. Barriers included a lack of coordination between vector control efforts and in the realms of sexual and reproductive rights. Facilitators included healthcare providers' response to the epidemic, the development of technical skills, and the establishment of coordination and referral networks across different institutions. Conclusion:A multidimensional approach that considers healthcare services, gender issues, and the environment is crucial. We highlight the epidemic's effects on women's sexual and reproductive rights, mainly related to inequalities in sexual and reproductive health such as the increased risk of sexually transmitted infections experienced by the poorest and most vulnerable women.

SummaryThis study by Profamilia Association focuses on the social response to COVID19 by reporting and analyzing the answers to two surveys carried out between April 16 and 25, and throughout September 2020. The study aims to identify changes in behaviors and immediate expectations after the quarantine was lifted. In general, results show that people have adopted behavioral changes such as wearing face masks, avoiding people with symptoms, and reducing mobility. However, it also shows that people’s concerns have doubled for many reasons, ranging from mental health issues, neglected sexual and reproductive health needs, the burden of care for others, and working from home. Similarly, it was found that some people would accept significant long-term changes such as accepting most children continuing to be homeschooled or employees choosing whether to work or not, targeted quarantines in neighborhoods that show high number of cases; and making the use of face masks mandatory in case a vaccine or treatment for Covid-19 does not become available. This means that during the quarantine and compared to April, many people consider these options to be acceptable in the long term.The survey was filled out online via SurveyMonkey by 1,735 people in Colombia between 1st and 11th September, 2020. Overall, 17% mentioned that they had participated in the previous survey, Estudio Solidaridad I early stage of quarantine (April 2020). The following is a summary of the main findings based on the comparison of the two surveys in hopes to show evidence for changes in behavior, hygiene, levels of measure compliance, unmet needs, and to show peopleś immediate expectations after six months of strict quarantine.The most common concerns among the findings were: a vaccine or treatment for COVID-19 not arriving Colombia soon enough (79%), a vaccine or treatment not being developed soon enough (79%) and also a concern that once the vaccine arrives in Colombia, it will not be accessible (74%). 50% of people think it is likely to get the COVID-19 vaccine once it becomes readily available.62% get information about COVID-19 through social media, 55% through official websites, and 51% through television.43% say that in their neighborhood, community, social group, or town, measures and campaigns have been carried out to prevent the spread of the COVID-19.25% say they would like to support local communities respond to the outbreak.82% agree with most children remaining home-schooled.85% think parents should be able to choose whether or not to send their children to school.95% agree that people should be forced to wear face masks outside the home.90% agree with neighborhoods, districts, or municipalities which experience outbreaks adopting more restrictive measures compared to the country as a whole.86% think employees should choose whether to work in their office or work from home.44% think that people will be able to be vaccinated against COVID-19 in a year or a year and a half.26% think life will return to “normal” in two years or more.

Background People living a trans-life require access to equitable healthcare services, policies and research that address their needs. However, trans people have experienced different forms of violence, discrimination, stigma, and unfair access barriers when dealing with healthcare providers. Therefore, adapting sexual and reproductive health services with the purpose of providing more equitable, inclusive and discrimination-free healthcare services is an urgent need. The article presents an example of how operative research can be used in order to adjust sexual and reproductive healthcare services to trans people’s needs, identities and circumstances. Methods This is a qualitative study written from a constructivist perspective, and it is based on the voices and experiences of trans people in four major cities in Colombia. The research used a combination of focus groups of discussion (n = 6) and in-depth interviews with trans people (n = 13) in Barranquilla, Bogota, Cali and Medellin. This research had two specific objectives: i) identifying the main sexual and reproductive health needs of people living a trans-life; and ii) generating new evidence in order to guide the adaptation of sexual and reproductive health services centered to trans people’s needs, identities, and circumstances. Qualitative data codification and analysis was using NVivo. Results Once access barriers to sexual and reproductive health services, unmet sexual and reproductive health needs were identified, the research helped define strategies to adapt sexual and reproductive health services to the needs, identities, and circumstances of people living a trans-life in Colombia. Amongst the main barriers found were healthcare costs, lack of insurance, stigmatization, discrimination and abuse by health care providers. Perhaps among the most notable sexual and reproductive health needs presented were trans-specific services such as sensitive assistance for the transition process, endocrinology appointments, and sex reaffirmation surgeries. Conclusions The evidence obtained from this research allowed Profamilia, a Colombian healthcare provider, to adapt the sexual and reproductive health services it provides to people living a trans-life in Colombia. Furthermore, it was possible for Profamilia to design and implement an inclusive sexual and reproductive health program that specifically addresses trans people’s needs, identities, and circumstances.

Introducción: Colombia es el principal país receptor de población migrante venezolana. Esto ha implicado identificar las necesidades en salud de esta población, como la atención y tratamiento de enfermedades infecciosas. Objetivo: analizar el uso de servicios de salud relacionados con VIH/SIDA, malaria y hepatitis virales en migrantes y refugiados venezolanos en Colombia durante 2018 y 2019. Metodología: estudio de investigación mixto. Se desarrollaron 12 grupos focales con mujeres y hombres venezolanos y se realizó un análisis del uso de servicios de salud por diagnósticos de VIH/SIDA, malaria y hepatitis virales, durante 2018 y 2019, en seis ciudades con un alto flujo de migración: Barranquilla, Bogotá, Cartagena, Cúcuta, Santa Marta y Riohacha. Resultados: el uso de servicios de salud por enfermedades infecciosas en migrantes venezolanos aumentó de 2018 (n=1.519) a 2019 (n=3.988). Los hombres fueron los que más usaron los servicios de salud por estas enfermedades. Aun así, la situación irregular migratoria, deficiencias en la atención primaria y acceso limitado a protección y detección temprana de enfermedades transmisibles, constituyen las principales barreras para migrantes y refugiados respecto a la atención en salud. Conclusiones: la migración expone a las personas al riesgo de contraer enfermedades infecciosas; así como a desigualdades y exclusión social en el acceso a servicios de salud para el control y tratamiento de enfermedades infecciosas. Por ello, en contextos de migración se debe fortalecer la equidad en los servicios de salud con el fin de asegurar el acceso de las personas a atención primaria, insumos, pruebas diagnósticas y tratamiento de enfermedades infecciosas.