RESEARCH ARTICLE Lessons learned from cross-sectoral collaboration to protect migrant farmworkers during COVID-19 in Spain Miquel U ´ beda 1☯ , Vanesa Villa-Cordero ID 2☯ , Agustı ´n Gonza´ lez-Rodrı ´guez 1,3 , Sergio Andre´ s-Cabello 4 , Iratxe Perez-Urdiales ID 5,6 *, Marı ´a del Mar Jime´ nez- Lasserrotte ID 7 , Mar Pastor-Bravo 8 , Erica Briones-Vozmediano 1,9,10 1 Department and Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain, 2 Department of Health Sciences, Gimbernat University Schools, Barcelona, Spain, 3 Grup de Recerca Anàlisi Social i Educativa (GR-ASE), University of Lleida, Lleida, Spain, 4 Department of Human Sciences, University of La Rioja, La Rioja, Spain, 5 Department of Nursing I, University of the Basque Country (UPV/EHU), Biscay, Spain, 6 Biocruces Bizkaia Health Research Institute, Biscay, Spain, 7 Department of Nursing, Physiotherapy, and Medicine, University of Almerı ´a, Almerı ´a, Spain, 8 Department of Nursing, University of Murcia, Cartagena (Murcia), Spain, 9 Consolidated Research Group in Society, Health, Education and Culture (GESEC), Lleida, Spain, 10 Research Group in Healthcare (GRECS), Biomedical Research Institute (IRB), Lleida, Spain ☯ These authors contributed equally to this work. * iratxe.perez@ehu.eus Abstract In Spain, the agricultural sector relies heavily on migrant workers, especially during sea- sonal seasons. However, these workers face significant challenges related to precarious working conditions and structural vulnerability, which have become more acute since the outbreak of the COVID-19 pandemic. This descriptive qualitative study was based on 87 personal interviews with health and social professionals from sectors such as NGOs, social services, trade unions, local institutions, and health services to promote compliance with these measures in four Spanish regions. It explored the difficulties faced by migrant agricul- tural workers in complying with prevention measures during the COVID-19 pandemic, the measures taken by organizations and public institutions and the health consequences of the pandemic on this group. After a reflexive thematic analysis, the results show how to mitigate the pandemic’s impact, both local authorities and NGOs implemented extraordinary mea- sures to care for migrant farm workers. Responses to the pandemic included temporary housing, mass testing, and stricter labor regulations. Working conditions, constant mobility, precarious housing, and language barriers contributed to the difficulty of implementing pre- ventive measures. Covid-19 intensified inequalities and highlighted the lack of prepared- ness of institutions to deal with this group. The conclusions suggest that intercultural competence in health professional training and the creation of inclusive approaches to health and social care are critical to addressing health disparities and ensuring the well- being of all migrant farm workers, regardless of their migration status or mobility. PLOS ONE PLOS ONE | https://doi.org/10.1371/journal.pone.0307578 January 3, 2025 1 / 22 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: U ´ beda M, Villa-Cordero V, Gonza´lez- Rodrı ´guez A, Andre´s-Cabello S, Perez-Urdiales I, Jime´nez-Lasserrotte MdM, et al. (2025) Lessons learned from cross-sectoral collaboration to protect migrant farmworkers during COVID-19 in Spain. PLoS ONE 20(1): e0307578. https://doi.org/ 10.1371/journal.pone.0307578 Editor: Sanjit Sarkar, CUK: Central University of Karnataka, INDIA Received: January 17, 2024 Accepted: July 8, 2024 Published: January 3, 2025 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0307578 Copyright: © 2025 Villa-Cordero et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: The data that support the findings of this study contain potentially identifying participant information, so data will be