Local action plan to promote access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus, Brazil: Analysis of the plan´s development, experiences, and impact through a mixed-methods study (2020)

BACKGROUND: The provision of care and monitoring of health are essential for indigenous Venezuelans from the Warao ethnic group, who are at risk of decimation. OBJECTIVE: Analyze a Local Action Plan (LAP) to promote access to the health system of indigenous Venezuelans from the Warao ethnic group (IVWEG) in Manaus, Brazil. METHOD: A mixed-methods study was performed. Quantitative data were collected to assess the provision of care and monitoring of health conditions in IVWEG through a survey that was self-completed by healthcare providers. Qualitative narrative data were collected to gain insight into IVWEG that seek care. We applied descriptive statistics, grouping analysis (GA) by hierarchical levels, and multiple correspondence analysis (MCA). Content analysis was applied to qualitative data. RESULTS: 106 healthcare providers participated in the study, with the following characteristics: 94 (88.7%) females, 67 (63.2%) pardo race/color, 40 (37.7%) working in primary healthcare, and 49 (46.2%) nurses. In addition, 43 (40.6%) of the healthcare providers reported providing care to IVWEG. Among the providers, 89 (84%) had received training for assisting IVWEG. Additionally, 30 IVWEG were enrolled for interviews in the qualitative phase. The barriers to seeking care were language, distance to health units, and lack of money for transportation. The LAP proved to facilitate access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus. The study contributed to knowledge on a LAP addressed to IVWEG and helped improved their access to the health system, providing appropriate training for healthcare providers and other relevant actors by implementing a coherent and consistent public health policy at the local level.