461 Elevating access to health care for unaccompanied migrant boys in Zimbabwe: the confluence of gender, agency and best interest determination

Abstract EP1.3, e-Poster Terminal 1, September 4, 2025, 10:05 - 10:25 Aims Using data from my PhD work, this study examines how the sociocultural configurations around gender intersect with agency and best interest determination (BID) to shape how unaccompanied migrant adolescent boys (UMABs) access health care. I problematise the relationship between gender (masculine aspirations) and agency, as well as gender (sociocultural expectations) and best interest determination (BID), intersecting to shape UMABs access to health care. UMABs often engage in agentic actions (acts of resistance) to navigate their daily lives, yet this can be constrained by BID that is protectionist, vulnerability oriented and incongruous to their unique needs and gendered lived realities. This curtails access to health care, rendering it ineffective and harmful. Framed within the Social Determinants of Health approach, I conceptualise health care as encompassing the non-medical factors that contribute to positive health outcomes. Methods I shall make use of a qualitative methodological foundation. Data will be collected using in-depth interviews, focus group discussions and key informant interviews. Thematic analysis, as described by Braun and Clarke (2020), will be used to synthesise and analyse the rich data. The study site will be the migration corridor comprising of two districts, Beitbridge and Chipinge, that border Zimbabwe with?South Africa and Mozambique respectively, where irregular cross-border migration is rife, including that of unaccompanied children. Results It is anticipated that that the results will speak to the incongruities between BID framed within a protectionist, vulnerability-oriented lens, and the lived realities of UMABs. The latter has a bias towards return and negates the agency of these migrant children, yet this agency is central to how these children make decisions daily and navigate a harsh livelihood terrain. Conclusions The study shall make evidence driven conclusions, underscoring the gender, agency and BID intersection in shaping access to positive determinants of health for UMABs.