Teodora Krumova
Center Amalipe, Bulgaria
9th European Public Health
Conference
All for Health, Health for All
Vienna, Austria,
12 November 2016
QUALITY of health vs. ACCESS to healthcare
European concept of modern healthcare: high quality health services which should reach the broadest possible range of people – all European citizens (Health for All)
WANTED: a mechanism to reduce health inequalities among key disadvantaged groups:
people in rural areas,
minorities (with special focus on Roma),
migrants and refugees …
CHALLENGES
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This concept could not be applied if the process is not two-sided:
(from) within the communities and
(from) outside the communities involving all stakeholders, including policy-makers, civil society, practitioners, academics, etc
… all of them acting as equal partners
OPPORTUNITY
The community monitoring and social accountability on healthcare service (an initiative, supported by OSF) offers a comprehensive mechanism to activate both communities and stakeholders from outside. Community mobilization and empowerment leads to improving health situation of Roma population and especially among Roma women through:
Raising awareness about health issues, rights and obligations in the field of health care
Improving access to health care
Increasing the quality of health services provided to Roma
Fostering mutual cooperation between communities and health institutions
Overcoming harmful traditional practices
APPROACH
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Do you know thephone of your GP (yes)
When you call to yourGP, does s/he come to
treat you? (yesanswers)
Do you need toprovide illegal
payment to your GP?(No answers)
100%
92% 96%
87%
62% 46%
Access to and quality of health care services for Roma
Ledenik (in the program since 2012) Lesnovo (in the program since 2015)
Initiatives like Community monitoring has been supported so far only by Private donors and non-governmental organizations. They need to be further taken-over by the decision-makers and become an integral element of EU policies for reducing health inequalities among the most marginalized.
STEPS FORWARD
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Providing access to modern healthcare services for all should be based on the active involvement and mobilization of all communities; it is not just a question of medicine and medical institutions, but also a question of mobilization of patients, citizens, clients of the services …
Reducing health inequalities and raising the health status of marginalized groups such as Roma would be an indicator that the European concept of healthcare is in place
Achieving this result is an indicator for political maturity of decision-makers to apply a model for reducing social inequalities and inclusion of all excluded groups: people from rural areas, minorities (including Roma), migrants, refugees, etc.
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TAKE HOME MESSAGE
Thank you for your attention!
Teodora KRUMOVA
Center Amalipe
www.amalipe.com