‘I Didn’t Know Where to Go’: A Mixed-Methods Approach to Explore Migrants’ Perspectives of Access and Use of Health Services during the COVID-19 Pandemic

Abstract

The COVID-19 pandemic put pressure on health systems, affecting populations’ use of health services, especially those experiencing increased difficulties in healthcare access, as some migrant groups. This study aimed to investigate access and use of health services during the COVID-19 pandemic among migrants in Portugal. A mixed-methods approach was used. A community-based cross-sectional survey was conducted involving migrant communities residing in the Lisbon Metropolitan Area. Analyses of a subsample of participants (n = 929) examined factors associated with perceived worsening of access to health services during the pandemic. Semi-structured interviews with 14 migrants were conducted and thematically analyzed to further understand experiences and difficulties in health services’ use. Around 44% of surveyed participants reported worsening of access to health services since the pandemic, more frequently women, those with lower income, and those who perceived being at moderate or high risk for COVID-19 infection. Digital change in services and lack of formal and informal support during lockdowns were highlighted by interviewers as main barriers in access to healthcare for migrants. The pandemic renewed concerns about inequalities in healthcare access among migrants. It is key that in following years health systems are able to address the potential accumulated burden of disease.

COVID-19 Vaccination among a Population Experiencing Homelessness: A Survey in Italy

“…The reason for the lack of using this source might be that homeless people may have more difficulty in accessing a primary care physician or preventive healthcare services and in obtaining health information; therefore, there is a lack of opportunity to improve their level of knowledge. This is consistent with the broader literature showing that the physician-patient relationship acts as a barrier for underserved communities, and such individuals may access healthcare services less often [47][48][49] as well as the observation that the COVID-19 pandemic has negatively affected access to health-related information and sources of healthcare worldwide [50][51][52][53]. On the other hand, the surveyed respondents indicated that the most common information resources used were mass media and the internet.…”

Examining the Challenges and Opportunities of Managing Public Services in a Complex and Interconnected World

“…Quantitative surveys of citizens and government workers will complement qualitative interviews with public administrators in this study (Gama et al, 2022). The study's results, as well as the policy and practice implications, will shed light on the main difficulties and potentials of managing public services in today's complex and interconnected world (Pascaris et al, 2020).…”