Access to maternal health services and perinatal outcomes among pregnant migrant and displaced women in Colombia: A mixed-methods study

@article{belloalvarez2026access,
  title = {{Access to maternal health services and perinatal outcomes among pregnant migrant and displaced women in Colombia: A mixed-methods study}},
  author = {Laura Margarita Bello-Álvarez and Dauris Lineth Mejía-Pérez and Jorge Andrés Rubio-Romero and Mercedes Salcedo-Cifuentes and Javier Zamora and Orlando Abonia-González},
  journal = {Journal of Migration and Health},
  year = {2026},
  month = oct,
  doi = {10.1016/j.jmh.2026.100448},
  url = {https://doi.org/10.1016/j.jmh.2026.100448},
  note = {CC BY-NC-ND 4.0},
}

TY  - JOUR
TI  - Access to maternal health services and perinatal outcomes among pregnant migrant and displaced women in Colombia: A mixed-methods study
AU  - Laura Margarita Bello-Álvarez
AU  - Dauris Lineth Mejía-Pérez
AU  - Jorge Andrés Rubio-Romero
AU  - Mercedes Salcedo-Cifuentes
AU  - Javier Zamora
AU  - Orlando Abonia-González
PY  - 2026
DA  - 2026/10/16
JO  - Journal of Migration and Health
DO  - 10.1016/j.jmh.2026.100448
UR  - https://doi.org/10.1016/j.jmh.2026.100448
AB  - Background: Migration and forced displacement pose major challenges for sexual and reproductive health (SRH) systems in Latin America. Colombia hosts more than 2.8 million Venezuelan migrants and a large population of internally displaced persons, offering a unique context to examine inequities in maternal health service access and perinatal outcomes. We aim to assess differences in maternal and perinatal outcomes among migrant, forcibly displaced, and non-migrant women in Colombia; explore barriers and facilitators to SRH access from the perspectives of women, healthcare providers, and stakeholders; and analyze how the Colombian healthcare system has adapted to meet the SRH needs of mobile and vulnerable populations.  Methods: A mixed-methods study with a parallel convergent design was conducted between November 2023 and May 2024 in Bogotá and Cali. Quantitative data from 929 women (250 migrants (26.9%), 134 forcibly displaced women (14.4%), and 545 non-migrants (58.7%) hospitalized for obstetric events were analyzed to compare SRH access and outcomes across migrant, forcibly displaced, and non-migrant groups. Multivariate logistic regressions adjusted for sociodemographic confounders. Qualitative data from 44 semi-structured interviews with women, healthcare providers, and policy stakeholders were analyzed using a multi-framework approach integrating the Tanahashi Coverage Model, Social Determinants of Health, and Complex Systems Theory.  Results: Antenatal care utilization and testing rates were similar across groups (mean 5.8 visits, p=0.15). However, maternal mortality occurred exclusively among migrants (400 per 100,000 live births), and perinatal mortality was highest among migrants (37.3/1,000 vs. 18.7/1,000 in non-migrants). Qualitative findings revealed barriers including legal precarity, fragmented insurance, stigma, and limited cultural competence, reducing effective coverage despite nominal access.  Conclusions: Although formal service availability appears equitable, structural and sociocultural barriers produce inequitable outcomes for mobile populations. Strengthening SRH equity in Colombia requires adaptive, culturally responsive health policies that integrate social protection, insurance reform, and intercultural training.
SN  - 2666-6235
ER  -