{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T20:12:57Z","timestamp":1775160777562,"version":"3.50.1"},"reference-count":51,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundo para o Asilo, Migra\u00e7\u00e3o e Integra\u00e7\u00e3o","award":["PT\/2021\/FAMI\/693"],"award-info":[{"award-number":["PT\/2021\/FAMI\/693"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The COVID-19 pandemic put pressure on health systems, affecting populations\u2019 use of health services, especially those experiencing increased difficulties in healthcare access, as some migrant groups. This study aimed to investigate access and use of health services during the COVID-19 pandemic among migrants in Portugal. A mixed-methods approach was used. A community-based cross-sectional survey was conducted involving migrant communities residing in the Lisbon Metropolitan Area. Analyses of a subsample of participants (n = 929) examined factors associated with perceived worsening of access to health services during the pandemic. Semi-structured interviews with 14 migrants were conducted and thematically analyzed to further understand experiences and difficulties in health services\u2019 use. Around 44% of surveyed participants reported worsening of access to health services since the pandemic, more frequently women, those with lower income, and those who perceived being at moderate or high risk for COVID-19 infection. Digital change in services and lack of formal and informal support during lockdowns were highlighted by interviewers as main barriers in access to healthcare for migrants. The pandemic renewed concerns about inequalities in healthcare access among migrants. It is key that in following years health systems are able to address the potential accumulated burden of disease.<\/jats:p>","DOI":"10.3390\/ijerph192013201","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T20:55:11Z","timestamp":1665694511000},"page":"13201","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["\u2018I Didn\u2019t Know Where to Go\u2019: A Mixed-Methods Approach to Explore Migrants\u2019 Perspectives of Access and Use of Health Services during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-6159","authenticated-orcid":false,"given":"Ana","family":"Gama","sequence":"first","affiliation":[{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"}]},{"given":"Maria J.","family":"Marques","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8660-490X","authenticated-orcid":false,"given":"Jo\u00e3o Victor","family":"Rocha","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4655-4987","authenticated-orcid":false,"given":"Sofia","family":"Azeredo-Lopes","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"},{"name":"Statistics and Operational Research Department, Sciences Faculty, University of Lisbon, 1749-016 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8475-4066","authenticated-orcid":false,"given":"Walaa","family":"Kinaan","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"}]},{"given":"Ana S\u00e1","family":"Machado","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5085-0685","authenticated-orcid":false,"given":"S\u00f3nia","family":"Dias","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"McCabe, R., Schmit, N., Christen, P., D\u2019Aeth, J.C., L\u00f8chen, A., Rizmie, D., Nayagam, S., Miraldo, M., Aylin, P., and Bottle, A. 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