Integrating Venezuelan Migrants into the Colombian Health System during COVID-19

Bowser, Diana; Agarwal-Harding, Priya; Sombrio, Anna G; Shepard, Donald S.; Roa, Arturo Harker

doi:10.1080/23288604.2022.2079448

Cited by 12 publications

(16 citation statements)

References 23 publications

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“…Since Venezuelan migrants are a mixed flow that shares many characteristics with forced migrants, studying this groups reminds us of how the association between human mobility and health depends on the causes and context of mobility. Secondly, while this study of a south-south migration replicates what has been shown for south-north migration, in the sense that settlement can be beneficial for health and access to health care, the fact that only 16.3% of the participants who were followed had sought to regularize their migration status, despite the policy of the Colombian government of promoting regularization [ 37 ], hints to barriers that may be particular of this context.…”

Section: Discussionmentioning

confidence: 57%

Longitudinal health survey of women from Venezuela in Colombia (ELSA-VENCOL): First report

et al. 2023

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Background Colombia is currently the world’s main recipient country for Venezuelan migrants, and women represent a high proportion of them. This article presents the first report of a cohort of Venezuelan migrant women entering Colombia through Cúcuta and its metropolitan area. The study aimed to describe the health status and access to healthcare services among Venezuelan migrant women in Colombia with irregular migration status, and to analyze changes in those conditions at a one-month follow-up. Methods We carried out a longitudinal cohort study of Venezuelan migrant women, 18 to 45 years, who entered Colombia with an irregular migration status. Study participants were recruited in Cúcuta and its metropolitan area. At baseline, we administered a structured questionnaire including sociodemographic characteristics, migration history, health history, access to health services, sexual and reproductive health, practice of early detection of cervical cancer and breast cancer, food insecurity, and depressive symptoms. The women were again contacted by phone one month later, between March and July 2021, and a second questionnaire was applied. Results A total of 2,298 women were included in the baseline measurement and 56.4% could be contacted again at the one-month follow-up. At the baseline, 23.0% of the participants reported a self-perceived health problem or condition in the past month and 29.5% in the past 6 months, and 14.5% evaluated their health as fair or poor. A significant increase was found in the percentage of women who reported a self-perceived health problem during the past month (from 23.1% to 31.4%; p<0.01); as well as in the share who reported moderate, severe, or extreme difficulty working or performing daily chores (from 5.5% to 11.0%; p = 0.03) and who rated their health as fair (from 13.0% to 31.2%; p<0.01). Meanwhile, the percentage of women with depressive symptoms decreased from 80.5% to 71.2% (p<0.01). Conclusion This report presents initial information on the health status of Venezuelan migrant women in Colombia, and is a starting point for further longer longitudinal follow-ups to assess changes over time in health conditions.

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Section: Discussionmentioning

confidence: 57%

Longitudinal health survey of women from Venezuela in Colombia (ELSA-VENCOL): First report

et al. 2023

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“…As evidence, the study’s telephone survey component found that Venezuelans were less likely to report flu-like symptoms related to COVID-19 than Colombians [ 10 ]. Similarly, the mobility component of this family of studies found that weekend mobility (when patrons might visit bars and clubs) appeared to be a greater contributor to COVID-19 transmission than mid-week mobility (presumably for work and necessary errands), Venezuelans may have been less mobile due to lower disposable income or less confidence, and thus less exposed [ 10 – 12 , 15 , 16 ]. Finally, Venezuelans may have become more resilient as they were forced to adapt to the stresses of discrimination, adverse economic conditions, and a foreign environment [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…This study is part of a family of studies examining Colombia’s health system performance for citizens and displaced Venezuelans [ 10 – 12 , 15 , 16 ]. A previous publication from this family of studies, a telephone survey of 8,130 Venezuelan migrants and Colombian nationals, focused on the most frequently used health service, consultations [ 10 ]. By using Colombia’s extensive administrative data, the present study also examined less frequent services, such as hospitalizations.…”

Section: Methodsmentioning

confidence: 99%

“…The aforementioned household survey found that 97.0% of Colombians across 60 municipalities reported being enrolled in an EPS (a key measure of insurance coverage) compared to only 26.4% of Venezuelans. However, after controlling for self-reported EPS enrollment, the analysis found that Colombians’ and Venezuelans’ self-reported access to health services was comparable [ 10 ]. We wished to examine this relationship further with RIPS data.…”

Section: Methodsmentioning

confidence: 99%

“…Consultations are formal contacts with a medical professional, such as a physician, for diagnosis and possible treatment in a non-emergency, ambulatory setting. For Venezuelans, enrollment required authorization, documentation, and mastery of the necessary administrative steps [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of COVID-19 on healthcare utilization, cases, and deaths of citizens and displaced Venezuelans in Colombia: Complementary comprehensive and safety-net systems under Colombia’s constitutional commitment

et al. 2023

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Objective Colombia hosts 1.8 million displaced Venezuelans, the second highest number of displaced persons globally. Colombia’s constitution entitles all residents, including migrants, to life-saving health care, but actual performance data are rare. This study assessed Colombia’s COVID-era achievements. Methods We compared utilization of comprehensive (primarily consultations) and safety-net (primarily hospitalization) services, COVID-19 case rates, and mortality between Colombian citizens and Venezuelans in Colombia across 60 municipalities (local governments). We employed ratios, log transformations, correlations, and regressions using national databases for population, health services, disease surveillance, and deaths. We analyzed March through November 2020 (during COVID-19) and the corresponding months in 2019 (pre-COVID-19). Results Compared to Venezuelans, Colombians used vastly more comprehensive services than Venezuelans (608% more consultations), in part due to their 25-fold higher enrollment rates in contributory insurance. For safety-net services, however, the gap in utilization was smaller and narrowed. From 2019 to 2020, Colombians’ hospitalization rate per person declined by 37% compared to Venezuelans’ 24%. In 2020, Colombians had only moderately (55%) more hospitalizations per person than Venezuelans. In 2020, rates by municipality between Colombians and Venezuelans were positively correlated for consultations (r = 0.28, p = 0.04) but uncorrelated for hospitalizations (r = 0.10, p = 0.46). From 2019 to 2020, Colombians’ age-adjusted mortality rate rose by 26% while Venezuelans’ rate fell by 11%, strengthening Venezuelans’ mortality advantage to 14.5-fold. Conclusions The contrasting patterns between comprehensive and safety net services suggest that the complementary systems behaved independently. Venezuelans’ lower 2019 mortality rate likely reflects the healthy migrant effect (selective migration) and Colombia’s safety net healthcare system providing Venezuelans with reasonable access to life-saving treatment. However, in 2020, Venezuelans still faced large gaps in utilization of comprehensive services. Colombia’s 2021 authorization of 10-year residence to most Venezuelans is encouraging, but additional policy changes are recommended to further integrate Venezuelans into the Colombian health care system.

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Migration Status and Utilization of Healthcare Services Among Venezuelan Immigrants in Peru

Hernández-Vásquez,

Bendezu-Quispe,

Azañedo

2023

J Community Health

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Integrating Venezuelan Migrants into the Colombian Health System during COVID-19

Cited by 12 publications

References 23 publications

Longitudinal health survey of women from Venezuela in Colombia (ELSA-VENCOL): First report

Longitudinal health survey of women from Venezuela in Colombia (ELSA-VENCOL): First report

Impact of COVID-19 on healthcare utilization, cases, and deaths of citizens and displaced Venezuelans in Colombia: Complementary comprehensive and safety-net systems under Colombia’s constitutional commitment

Migration Status and Utilization of Healthcare Services Among Venezuelan Immigrants in Peru

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