Adherence to sexual and reproductive health programmes among migrant women residing in the Basque Country: protocol for a mixed-methods study on implementation and influencing factors
Isabel Artieta Pinedo, Maria Jesus Mulas-Martin, Carmen Paz-Pascual, Maite Espinosa Cifuentes, Amaia Maquibar, Itziar EstalellaIntroduction
The increased resources available to improve the population’s sexual and reproductive health do not always reach migrant women equally. This is relevant in a context where 26.6% of births in 2024 were to foreign-born mothers. The objective of this study is to analyse the adherence among the migrant population in the autonomous region of the Basque Country (Spain) to the established protocols for pregnancy, childbirth and postnatal care, as well as their use of health services. In addition, it aims to identify the barriers and facilitators that influence their access to and continuity of care.
Method
This mixed-methods study comprises two phases: (a) a population-based, descriptive, retrospective study using data from the routine monitoring of health programmes for women who gave birth during 2024 in the Basque Country. Variables related to the women’s characteristics, healthcare utilisation, and the course of pregnancy, childbirth and the postnatal period will be analysed. The analysis will include descriptive statistics, bivariate techniques and multivariate modelling; (b) a qualitative study using focus groups. At least five focus groups will be organised to ensure representation by continent and country of origin. These groups will explore experiences and perceived barriers related to the adaptation of sexual and reproductive health self-care practices to the healthcare system among migrant women. The sessions will be audio-recorded, transcribed verbatim, coded and categorised to develop a conceptual framework that will later be analysed with the text.
Ethics and dissemination
The study has been approved by the Basque Country Ethics Committee. Informed consent will be obtained from all participants for the collection of primary data, and participants may withdraw from the study at any time without consequence. Authorisation has also been granted by the Basque Health Service Directorate to access recorded data, which will be provided in anonymised form, ensuring that individuals cannot be reidentified. Findings will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals.