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Access of Roma to Health Services

Access of Roma to Health Services. Hanna Dobronauteanu, M.D. Counselor of Minister, Ministry of Health, Romania. Remarkable aspects of the issue The number of Roma population *)  A minimal number - by self-identification, in the national censuses

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Access of Roma to Health Services

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  1. Access of Roma to Health Services Hanna Dobronauteanu, M.D. Counselor of Minister, Ministry of Health, Romania

  2. Remarkable aspects of the issue The number of Roma population *) A minimal number- by self-identification, in the national censuses A maximal number - by external evaluations: local authority registrations, local/police statistics, declarations of Roma leaders, partial surveys estimates etc. An “accepted” or “reliable” number - estimated by sociological surveys on national samples, representative researches etc. *) Source: OSCE

  3. Remarkable aspects of the issue Ethnical strata • Roma with self-identification and the maintaining of the traditional characteristics • Roma with partial (only informal) self-identification and the maintaining of the traditional characteristics • Modern Roma with self-identification, without the visible aspects of the characteristic life style • Modern Roma without/with inconstant self-identification, which can or can’t be identified by other persons • Ex-Roma without self-identification, assimilated by the majority population

  4. Remarkable aspects of the issue Statistically insufficient knowledge about the number of Roma population Ethnical strata Different groups/clans/families  The definition of the public health target group: The Roma Community

  5. Ministry of Health Extension of Roma related activities 2003 Health mediators in Roma communities as part of National Program 2002 Strategy for the improvement of Roma Health & start of its implementation (legal framework, data collection etc.) 2001

  6. Ministry of Health Normative planning: List the problems Find solution Problems Social condition of Roma people Public health

  7. Causes of public health problems related to Roma population • The quality of data concerning the health status of Roma population • Insufficient financial, and human resources • Deficiency of collaboration between the different involved parts, Governmental and non-governmental, group and individual level too • Access of Roma to health services

  8. Access of Roma to health services The Romanian legislation guarantees the equal access of the citizens to the health services, but Deficiency of practical access to  GP (Family doctor)  Preventive services Causes:  Lack of identity documents  Cultural barriers  Lack of information

  9. Solution COMMUNICATION  Collaboration with Roma civil society  Health mediators in Roma communities

  10. Concept and words 1997 - Romani CRISS - projectsin Roma communities  Social mediator …Social & Health mediator... 2001 Ministry of Health (MoH)  Health mediator

  11. The Health Mediator • Respected member of the community • Woman /mother/ • Cross-cultural bridge  Information  Communication  Conflict prevention

  12. Health mediators in Romania Selection • Formal partners of the MoH (“Romani CRISS”, “The Party of the Roma”) • Roma NGO • Roma communities

  13. Health mediators in Romania Training  Institution - NGO partnership • First step (basic) training: “Romani CRISS” • Professional training: organized by District Public Health Authorities

  14. Health mediators in Romania Activity • Financed by the MoH /National program for the health of mother and child/ • Coordinated by the District Public Health Authorities • According to the well defined job description

  15. The health mediator system in Romania • Start of implementation: October 2002 • January 2003: 114 Roma health mediators in 33 districts • October 2003: 140 Roma health mediators in 36 districts • Selection of localities: Ministerial Commission for Roma of the MoH, based on proposals of local health authorities & Roma civil society

  16. The health mediator system in Romania Short term results /Intermediate evaluation after 9 month/ • Above 100,000 direct beneficiaries • Above 25,000 Roma - included in the health insurance system • Health staff: positive changes in the perception of the Roma problem • Roma organizations/communities: increased wish to work, and to participate in the social building process

  17. Next steps • Evaluation and development of the health mediator system system • Improvement of the professional training of the health mediators • Extension of the intervention areas (reproductive health, HIV/AIDS, drug user patterns) - in collaboration with the Roma civil society

  18. ’’Emotions will not be denied. Once an emotion is created,it lives as chemicals in your system. You have to use emotions to create the right kind of thinking.’’ Bill Jensen

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