Health policies on preventing the transmission of Chagas parasite in Switzerland and experiences of migrant pregnant women from Latin America.

• In Event: Social inequalities and health: a case for social justice with a focus on Chagas disease

Abstract

The three modes of transmission of the Chagas parasite in non-endemic Europe are congenital transmission, blood transfusion or organ transplants. In Switzerland there are blood transfusion and organ donation screening protocols, but medical control of Chagas during pregnancy is only practiced in two districts.
The absence of a national screening policy for Chagas disease during pregnancy questions the logic of priorities in public health and implies unequitable access to health care in other parts of Switzerland, particularly for migrant women from Latin America.
This research explores how health policies for preventing Chagas transmission are elaborated in Switzerland. Justice in health promotion does not consist solely in proposing an equal access to screening, but also requires to consider the needs of the concerned population embedded in a context of precarious migration, where maternity that can be seen as a process of constructing parenthood and negotiating a position within a sometimes hostile host society. Pregnant women face a dilemma between being screened for the benefit of their children's health and not wanting to know their own parasitological status, given its stigmatizing implications.
Drawing on semi-structured interviews with Latin American migrants and healthcare providers, I examine two questions: 1) What are the socio-political determinants that influences policy around the prevention of Chagas transmission in Switzerland? 2) How do women experience the screening and monitoring of the Chagas disease during the life-altering transformation of maternity?

Author

• Elise Rapp, University of Lausanne (UNIL) and Haute Ecole de Santé Vaud (HESAV)