Pre-Implementation Evaluation of a Community-Based Surveillance System for Migrants’ Sexual Health in Chile

The increasing migration phenomenon and its impact on sexual health highlight the urgency of improving access to preventive services and developing responsive surveillance mechanisms. This study aims to describe the context and define the implementation circuits of a Community-Based Surveillance System (CBSS) focused on social epidemiological aspects related to sexual health in Chile’s migrant population. A two-phase qualitative design was employed: Phase 1 involved formative research, and Phase 2 focused on the design of CBSS implementation circuits. The formative phase led to the selection and characterization of three community-based organizations (CBOs)—two in Santiago and one in Antofagasta—and two primary healthcare centers (PHCs). Findings revealed heterogeneity in institutional capacities, limited coordination between CBOs and the health system, and a high level of willingness to participate. PHCs showed comparable profiles. Based on this, differentiated operational circuits were co-designed and adapted with stakeholders, and formalized through site-specific implementation manuals. This pre-implementation evaluation helped identify critical contextual barriers and generate tailored strategies for CBSS deployment. The active involvement of local actors is essential to ensuring the contextual relevance, institutional acceptability, and future sustainability of the proposed model. These insights offer transferable learning for the design of health interventions in underserved and structurally constrained settings.