Access and right to health for Bolivian migrants in a Brazilian metropolis

Abstract

This paper analyzes the health care accessibility conditions afforded Bolivian immigrants to the Brazilian health system and their perception of the right to health. A cross-sectional, quantitative and qualitative study was carried out from 2013 to 2015. Data were collected by a questionnaire with closed questions answered by 633 Bolivian individuals; questions regarding access to health were answered by 472 immigrants over 18 years old. Semi-structured interviews conducted with 55 subjects (Bolivians, health professionals, representatives of Health Departments, Consulate of Bolivia, Public Defender’s Office, Federal Public Prosecutor’s Office and Non-Governmental Organizations) underwent content analysis. Most Bolivian immigrants know the Unified Health System (SUS) and often use Primary Health Care; however, they described structural and systemic barriers to health accessibility, such as lack of documentation, working conditions, medium and high complexity procedures, language barriers, among others. The national health card (CNS) is an important gateway to access health care, playing a role of social integration. Interviewees recognize Health as a Social Right, pointing it out as a human and solidary value. Ensuring this recognition, when not based on the consolidation of social policies aimed at strengthening universal social protection, is threatened.