Supplementary file 1_Challenges and facilitators to sexual and reproductive health care for undocumented in-transit migrant women in Mexico: a qualitative study.pdf

BackgroundThe number of international migrants has steadily increased over the past decade. Among them, undocumented in-transit migrant women (UITMW) face heightened vulnerability to gender-based violence and complex sexual and reproductive health (SRH) needs. However, limited evidence exists on the challenges state and non-state actors face in delivering SRH services to this population. This qualitative study explores the barriers encountered by service providers and decision-makers in Mexico when addressing UITMW's social and health needs through an SRH lens, and identifies facilitators that may support more effective service delivery.
MethodsBetween August and November 2023, we conducted 31 in-depth interviews with 36 service providers, migration experts, and local and federal decision-makers in Ciudad Juárez, Chihuahua City, and Mexico City. Guided by McLeroy et al.'s socioecological model, we examined challenges and facilitators at individual, institutional, community, and structural levels. Data were analyzed using a framework analysis approach.
ResultsParticipants identified 11 challenges and 9 facilitators influencing SRH service provision for UITMW. Key challenges included: (1) policies and resource allocations are shaped by the perception of migration as temporary; (2) growing anti-immigrant sentiment undermine community-level service delivery; (3) religious restrictions in faith-based shelters limit access to certain SRH services; and (4) biases among healthcare providers affect quality of care. Notable facilitators included structural reforms such as strengthened migration and health governance and improved multi-level collaboration to enhance service access.
ConclusionThis study underscores the complex, multi-level barriers to delivering SRH care to UITMW in Mexico. Findings point to research and policy priorities, including examining the long-term impacts of migration and health policies on SRH service availability, evaluating alternative delivery models, analyzing the role of media in shaping public opinion, and involving UITMW and local stakeholders in policy development. Addressing these gaps could improve SRH outcomes for UITMW and strengthen the broader health system response for both migrant and local populations.