Mulheres em situação de rua e o direito à saúde: barreiras e invisibilidades

Abstract

INTRODUCTION: The health of homeless women is marked by multiple vulnerabilities, intensified by the context in which they live. This phenomenon has grown in recente decades, reflecting the structural inequality that permeates Brazilian society and the neglect of the basic rights of populations in situations of extreme vulnerability. Health, although constitutionally guaranteed as a right for all, faces significant barriers to its full realization. OBJECTIVE: To understand the health conditions of homeless women, analyzing their specific vulnerabilities, the barriers faced in accessing health services, and the role of existing public policies. METHODOLOGY: This is an integrative literature review conducted between January and February 2025, covering the period from 2014 to 2024. The databases used were Scientific Electronic Library Online (ScIELO), Latin American and Caribbean Literature in Health Sciences (LILACS), CAPES Journals Portal and Google Scholar. Fourteen articles were selected according to defined inclusion and exclusion criteria, resulting in the identification of four main thematic categories: (1) vulnerability and rights violations; (2) barriers to access health services; (3) prenatal care and maternal-child health; and (4) the role of the Street Outreach Office (Consultório na Rua) and public policies. RESULTS: The findings show that, although there are public policies aimed at the homeless population, they fail to adequately meet the specific needs of women, as they do not address the complexity of health-related issues on the streets. Care is mainly provided by the Street Outreach Office teams; however, it is often sporadic and lacks continuity due to the rotation of professionals, the nomadic lifestyle of this population, and the absence of fixed service points. Identified barriers include documentation requirements, unprepared professionals, and discrimination, all of which distance women from healthcare services. Furthermore, care is often limited to the gestational period, neglecting other health needs. CONCLUSION: It is concluded that there is an urgent need to expand and revise existing public policies so they can address homeless women in their entirety, considering their experiences, real needs, and the context in which they live. It is essential that these women are actively heard and included in the process of formulating, implementing, and evaluating the policies that concern them. Only then can quality care be ensured, along with the full exercise of the rights that are rightfully theirs.