The COVID-19 pandemic has further deepened socioeconomic and health inequities worldwide, especially among populations experiencing social vulnerability, such as international migrants. Sustained lockdowns and social distancing have raised challenges to conducting public health research with hard-to-reach populations. This study aims at exploring strategies to recruit “hard-to-reach” international migrants for qualitative public health research during the pandemic in Chile, based on the authors’ experience. A retrospective qualitative evaluation process was carried out on the recruitment processes of three qualitative research projects focused on international migrants in Chile. All projects were implemented during the COVID-19 pandemic, demanding complementary and flexible strategies: (i) social media; (ii) snowball sampling; (iii) referrals from social workers and pro-migrant and migrant-led organizations; (iv) vaccination centers and healthcare centers; and (v) community-based recruitment. The strategies are qualitatively evaluated around seven emerging qualitative categories: (i) feasibility during lockdown periods; (ii) speed of recruitment; (iii) geographical coverage; (iv) sample diversity; (v) proportion of successful interviews; (vi) ethical considerations; and (vii) cost. Engaging hard-to-reach international migrants in public health research during the pandemic required constantly adapting recruitment strategies. Furthermore, relying on strategies that were not only Internet-based promoted the participation of populations with limited access to the Internet and low-digital literacy.

In parallel to the COVID-19 pandemic, Chile has experienced a significant influx of international migrants, many of whom are Venezuelan women who have entered the country through unauthorized crossing points. In this context, gender and migration intersect as the social determinants of health, leading to their experiencing a range of adverse events. This poses important challenges in terms of short- and long-term health outcomes, the social determinants of health, and access to healthcare. This study aims at describing Venezuelan women’s perceptions of their health needs as they migrate to Chile via an unauthorized crossing point, with a focus on adverse events throughout the migration cycle, self-reported health needs, and responses. A qualitative case study was carried out with 22 participants in the Antofagasta region of Chile, including Venezuelan migrant women, healthcare professionals, and social workers from the public healthcare system, stakeholders from non-governmental and international organizations, and local government officials. The semi-structured, individual interviews were analyzed thematically. The results show that Venezuelan women face a range of adverse events throughout the migration cycle. The perceived health needs that are reported are sometimes linked to these adverse events or existed prior to migration and were exacerbated throughout the migratory cycle. Addressing these physical and mental health needs is essential for short- and long-term individual and public health; however, despite substantial efforts to ameliorate the situation, persisting gaps in access to care are reported.

The sexual and reproductive health of young migrants has not been sufficiently addressed in mobility studies. In this article, we dwell on some aspects of this issue in the migration process of Latin American youth. We conducted a qualitative study in the region of Tarapacá, Chile, carrying out in-depth interviews with key informants, health staff and young migrants between 18 and 25 years old. The results show some motivations to migrate related to sexual and reproductive health: young pregnant women, LGBTQI+ and HIV-positive people seeking access to health care and social contexts of reduced gender discrimination. During the migration process, young people are exposed to various kinds of sexual violence, and in their settlement in Chile, to situations of racism, stigma and discrimination in society as a whole and in access to and during sexual and reproductive health care. Health care for young migrants is mainly focused on maternal care and reproductive issues, while sexual health as a whole is disregarded. We argue that sexual health must be addressed as a central dimension of the lived experiences of young migrants, and that the social, cultural and structural factors that undermine their sexual and reproductive health must be addressed in order to provide culturally competent health services.

Background: The COVID-19 pandemic has had an impact on the mental health of international migrants globally. Chile has managed its response to the pandemic in an ongoing context of social unrest and combined regional migratory and humanitarian crisis. The country’s population presents a high prevalence of common mental disorders and a high suicide rate, with limited access to mental healthcare. International migrants in Chile represent 8% of the total population, and although a socioeconomically heterogenous group, they face social vulnerability, a range of mental health stressors and additional barriers to access mental healthcare. This study describes the mental health outcomes, stressors, response, and coping strategies perceived by international migrants during the COVID-19 pandemic in Chile.Methods and findings: A qualitative case study was carried out through individual online interviews to 30 international migrants living in Chile during the pandemic and 10 experts of the social and health care sectors. An inductive content analysis was carried out, a process during which the researchers sought to identify patterns and themes derived from the data. Participants experienced mainly negative mental health outcomes, including anxiety and depression symptomatology. Stressors included the virus itself, work, living and socioeconomic conditions, discrimination, fear for their family and distance caring. Institutional responses to address the mental health of international migrants during the pandemic in Chile were limited and participants relied mainly on individual coping strategies.Conclusions: The pandemic can represent an important opportunity to strengthen mental health systems for the general population as well as for population groups experiencing social vulnerability, if the issues identified and the lessons learned are translated into action at national, regional, and international level. Promoting the mental health of international migrants means recognising migration as a social determinant of mental health and adopting a cross-cultural as well as a Human Rights approach.

This article analyzes the results of a descriptive, qualitative study carried out in 2018 on the mental healthcare needs of Latin American refugees and asylum seekers in Chile, through the perspectives of refugees and asylum applicants (n=8), healthcare professionals responsible for delivery of care (n=4), and members of civil society organisations involved in this area (n=2). Our findings indicate that despite Chile’s commitment to international treaties in this regard, little has been achieved in safeguarding the right to access to mental health care, understood as part of the universal right to health care access. This article documents barriers to mental health care access for migrants applying for asylum and refugee status. Post-migration stress factors may also increase the risk of emotional disorders within this group of people. Mental healthcare providers and teams are often not equipped with the tools to deal with the psychological consequences arising from the situations of violence and persecution associated with forced migration. Our study discusses the need to strengthen the link between mental health care – as a fundamental human right – and the right to international protection. El presente artículo analiza las necesidades de atención de salud mental de refugiados y solicitantes de asilo de origen latinoamericano en Chile, por medio de un estudio cualitativo descriptivo, realizado en 2018, desde la voz de las personas solicitantes de refugio y asilo (n=8), profesionales de salud que los atienden (n=4), y miembros de organismos e instituciones dedicados en la temática (n=2). Los hallazgos evidencian que las obligaciones asumidas por Chile, a través de la adhesión a tratados internacionales, no han logrado garantizar el ejercicio del derecho a la salud mental, entendida como parte del derecho universal de acceso a la salud. En lo particular, el artículo documenta la presencia tanto de barreras de acceso a la salud mental en migrantes solicitantes de refugio y asilo, como de factores de estrés posmigratorios que pueden acentuar el riesgo de estos grupos a sufrir trastornos emotivos. También se reporta la insuficiente instalación de capacidades de atención en los equipos de salud mental para abordar las consecuencias psíquicas de los episodios de violencia y persecución que están a la base de la migración forzada. Finalmente, el artículo discute la necesidad de estrechar la vinculación entre la salud mental –como derecho humano fundamental– y el derecho a la protección internacional.

Pasados más de 30 años desde el fin de la dictadura cívico-militar, pocas investigaciones han abordado el rol que la categoría de víctima ha asumido en las estrategias que el Estado chileno puso en marcha desde 1990 en adelante para abordar las violaciones a derechos humanos acaecidas entre 1973 y 1990. A partir del análisis documental y etnográfico de las políticas de reparación simbólica y de las normativas asociadas con programas de beneficios sociales y sanitarios, este artículo explora la forma en que el Estado chileno ha administrado las violaciones a derechos humanos, la tortura y la desaparición, basándose en dos principios: la narrativa de la victimización y la adopción de una perspectiva individualizada en el abordaje del trauma. A partir de un análisis de material documental y etnográfico, la investigación evidencia cómo este tratamiento ha marcado la agenda pública en materia de derechos humanos permitiendo soslayar, por una parte, la demanda por el esclarecimiento del destino de los cuerpos de los detenidos desaparecidos y, por otra, el reconocimiento del rol que tuvo el Estado en la perpetración de violencia durante la dictadura cívico-militar. Este análisis demuestra que, si bien la utilización de la figura de la víctima ha contribuido a aislar a las personas que sufrieron vejaciones y despolitizar su actuar, es necesario aún problematizar la potencialidad de acción colectiva que posee la victimización y sus posibles diálogos con los movimientos sociales contemporáneos.