Transcript From increased voice to improved health care access

“From the increased voice to the
improved health care access for Roma
women- continuance”
Obstacles to deliver optimal SRH to Roma community
An enormous difference is noticeable in the access to antenatal
services, particularly a low coverage among pregnant women
from rural areas and socially vulnerable groups (mainly among
Romani people and women of poor education).
• Macedonian women receive more often complete check up
during pregnancy comparing to the Romani women actually non
of the Romani women received complete antenatal check up)
comparing to 16,67% Macedonian. (blood pressure
measurement, wait, EHO sound but also other medical check
ups during the pregnancy (NRC research)
• For example 56,67% Macedonian women comparing to 31,15%
Roma had blood and urine analyses as well as PAP smear and
4D EXO (NRC research)
Activities of National Roma Centrum
• In 2007, NRC carried out the project “Prosperity and Health.” In the course of
the project, we interviewed a total of 2,756 Roma women and girls at aged 13
to 75 in Kumanovo, Kriva Palanka, Bitola and Prilep via written questionnaires
to obtain both general data on the socio-economic conditions of the target
group, as well as specific information related to social determinant on health.
• In 2008/2009, NRC carried out a follow up project in the same four cities with
a focus on promoting Roma women's access to gynecological care.
• In 2010/2011, NRC implemented the project “Health inequalities towards
Romani women” analyzing the accessibility of health care from the point of
view of financial affordability, availability of health information and
transparency.
• In 2012, NRC carried out the From increased voice to improved health care
access project aimed at providing women of reproductive age with an equal
access to antenatal services, in fact, women who are social assistance
beneficiaries and, in particular, Roma women.
• From the increased voice to the improved health care access for Roma womencontinuance” project shall continue to strive for an equal access to health care
for Roma and socially vulnerable women of reproductive age through
monitoring and advocacy.
OUTCOMES 2007-2015
• In cooperation with assistants and gynaecological ordinations in
Kumanovo,Kriva Planka and Bitola we managed to encourage 120 women to
take PAP tests.
• We resolved 150 cases of missing personal documentation and 200 cases of
missing health cards in order to enable Roma women's access to medical
facilities.
• Approximately 3000 women were visited in the field and were provided
with information on their health rights and direct assistance in urgent
situations.
• We completed and published in Macedonian and foreign medical journals
two studies on Roma women's health issues. These studies became an
advocacy tool in the NRC work on promoting health rights for Roma women.
• We advocated for the Law on Patient’s right’s , in July 2008, the Macedonian
Parliament adopted the Law for Protection of the Rights of Patients.
• Advocating for revision of the list of medications to be included in the basic
package of healthcare services (especially asthma medicaments), such revisions
were made and since 2009 the state sponsors provision of the required
medications for economically disadvantaged groups;
• Advocacy for a free program of early detection and prevention of gynecological
diseases for uninsured women for the purpose of early detection of the cervical
cancer.
• We realized 10 focus group studies with the total of 102 Roma women in the
cities of Kumanovo, Kriva Palanaka, Kocani, Shtip and Bitola, where we
monitored the access to and quality of health services in the ante-natal, natal
and postpartum period.
• 25 interviews with representatives of public health institutions and GPs who
work in the state-financed health institutions and we had opportunity to
observe how GPs attend and deliver services to Romani women.
• Based on its findings we prepared a Policy Brief with concrete
recommendations to the health authorities. The Policy Brief was presented to
the Ministry for Health (MoH) and its institutions and departments, as well as
to the embassies in Macedonia.
• We resolved over 100 cases of missing personal documentation to enable
Roma women's access to health care, as well as to advocating for the freeof-charge registration of newborn babies of socially and economically
deprived families (social welfare recipients).
• 3 appeals to the government were published urging concrete measures to
improve the access to health services for Roma women and to implement
the Roma National Strategy and the National Action Plan (NAP) for health.
• Financial assessment was made on the basis of the Antenatal Protocol
adopted by the Government of R. Macedonia
• In frame of our advocacy campaign we raise discussion in the Parliament
of R. Macedonia for free of charge antenatal services
• Action Plan to Reduce Maternal and Infant Mortality was made by the Safe
Motherhood Committee (SMC).
• The Programme for Active Health Care of Mothers and Children for 2014
was change and 900.000 denars were allocated for examinations for
Romani women.
• In cooperation we participate with other 7 NGO’s in submission report
for UN Universal Periodical Review
Existing policies in R. Macedonia on antenatal health care:
• Programme for Active Health Care of Mothers and Children in the Republic of
Macedonia for 2014
• Action Plan to Reduce Maternal, Perinatal and Infant Mortality for 2013 and
2014
• Safe Motherhood Strategy
• Action Plan of the Safe Motherhood Strategy 2010 - 2013
• Strategy on Sexual and Reproductive Health for 2013 and the Action Plan
• Law on Patient’s rights
Project goals: ”From the increased voice to the improved health care
access for Roma women- continuance”
1.
Efficient and available antenatal, perinatal and postnatal health services
for Roma women and socially vulnerable women through monitoring of
newly introduced state sponsored antenatal check ups and advocacy for
improved sexual and reproductive health for Romani women.
1.
Raised awareness on free antenatal health care services and patients
rights through INFORMATION AND ADVOCACY campaign on national
level using samples from three municipalities (Kumanovo, Shtip and
Kochani)
Outcomes:
• 1. In the period 2015-2017 the state will introduce sustainable system
for health protection for Roma and social vulnerable women in the
antenatal period, at national level.
• 2. 80% of the project target group (pregnant women from 3 cities in
Macedonia) are informed and introduced with the scope and content
of the envisaged right according to the free antenatal check ups and
their usage.
• The state accepted to provide free of charge antenatal package for
1,900 women on national level who are social assistance beneficiaries
and pregnant women who come from families with low incomes or
who are unemployed envisage in the Programme for Active Health
Care of Mothers and Children for 2014
Results
• NRC succeeded in establishing three info points in Kumanovo, Kochani and
Shtip.
• Formed an expert group whose members are representing Institutions and
CSO’s
• Designed a questionnaire for the needs of the analysis of the situation and
documents for adopted policies
• Published a public release on behalf of the World Health Day
• Published four double issues of the EDNO Magazine
• Implemented ten info points in the three targeted cities
• It was made 3 case studies for Kochani, Kumanovo and Shtip.
• Made a comparative analysis of antenatal care in other countries and
good practices that could be implemented in the Republic of Macedonia
• Draft analysis of a situation
• Established a database of statistical data about the implementation of the
Program for Active Health Protection of Mothers and Children in
Kumanovo, Kochani and Shtip
• Improved network and cooperation with WHO, UNFPA, HERA, ESE,
European Commission, EPHA, ERTF, Council of Europe, UN agencies, local
CSO’s: Hera, ESE.
Needs
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Policies effective implementation
Cooperation between Government and Civil Society
Political will
Information,
SRHR education, Youth sexual and reproductive health needs are not
prioritized in the health system and comprehensive sexuality education is
insufficiently incorporated in the school curricula
• preventive check ups free of charge
• Raising awareness campaign.
www.nationalromacentrum.org
www.ednomagazine.com