In the framework of PE2 of the ‘’REACH’’ project, research has been conducted for the health state of Roma women to depict the state of access to health facilities in Greece by Roma women. Alongside, the research’s aim was to track the needs that professionals have during their contact with the Roma and especially Roma women. The problems and challenges that they face were registered, the Roma attitude towards them, the stereotypes that professionals have towards Roma, communication issues, health issues for which the Roma approach the Primary Healthcare facilities, and issues for which they visit the social services.
In the first stage desk research has been conducted, during which the European and National institutional framework has been explored. A review of European policies/reports/related documentation and a bibliographic review of scientific papers, reports from important organizations and journals on the provision of health care to the Roma. The bibliographic review was the base of assembling the research tools (questionnaire and interview guides), as well as the development of the handbook and the educational material, which will become available to health care and Community Centers professionals.
National and international reports seem to agree that Roma often live excluded from the general population, and they face multifaceted discriminations (foremost Roma women), particularly in the sectors of: housing, education, employment and health. The bibliography shows that the Greek Roma population suffers in general from big exposure to crucial factors for the configuration of health, such as a less healthy lifestyle and low access to Primary Healthcare Facilities. The Roma tend to use health services less frequently than the general population due to health illiteracy, cultural differences but also from insufficient knowledge for their rights.
Moreover, the way of access to healthcare services and often the areas in which they reside, are being presented as obstacles in accessing Primary Healthcare Facilities. Especially for the Roma women, it is argued that the state of their health is worse in comparison with Roma men and women from the general population. The sexual and reproductive issues are common between women, including the premature pregnancies, sterilization, and it is also mentioned that they don’t often receive gynecological and obstetric services.
For the primary research a mixed methodology of both quantitative and qualitative methodology has been applied, in order to explore the access to health services by Roma women in Greece and also the challenges that are being faced by Roma women and professionals respectively.
For the quantitative research, two questionnaires have been created (one for healthcare professionals and one for the healthcare proffessionals that provide services to Roma people), which have been distributed through email and social media. 145 people from Greece have answered the questionnaire. The sole criterion for participation was the past or current experiences with Roma people.
Moreover, interview guides have been drafted and two online semi-structured interviews and two focus groups with professional representatives (general doctors, social workers, midwives, nurses), the Ombudsman and Greek Mediators representatives.
During the interviews, the researchers aimed to cover issues relevant to those from the questionnaire while they investigated the views of the participants regarding Roma people.
The participants in the qualitative research came from regions of Attica and Larisa, firstly because of the concentrated Roma community’s presence in these regions, and secondly because the Municipalities of Chalandri and Larisa have participated in the ‘’REACH’’ program.
Qualitative research findings
The qualitative research aimed to provide the chance to professionals to share their views with the project’s researchers and analyze issues that have not been included in the questionnaire from the quantitative research. After analyzing the interviews and the focus groups, six interesting thematics emerged, which conform with the findings of the bibliographic review, but at the same time completes the findings of the quantitative research. Specifically
- Administrative documents and health care services
The professionals have highlighted the issue of lack of identification documents, such as birth certificates, social security number etc. The lack of those documents seems to cause serious problems which then long term bothers the infant, the family and the hospital staff. It is recommended that the official state practices can solve these issues
- Stereotypes between professionals and Roma women
Contrary to the quantitative data, the qualitative data have shown the existence of stereotypes against Roma people, in the views of professionals. Even though the professionals attribute the stereotypical views to the illiteracy of Roma people and in their difficulty to cope with the guidelines that professionals give them, the professionals reproduce the stereotypes through their behavior.
- Cultural differences
It seems that there is a cultural hap between the professionals and the Roma, which has a consequence the meaningful communication, by blocking the seamless support for Roma people by the professionals and the reproduction of stereotypes which contribute to the defective access of Roma people to Primary Healthcare Facilities.
- Contraception and family planning
the professionals have reported specific problems regarding sexual and reproductive health that Roma women are facing. The professionals have reported that they do not trust that the women will follow their advice, while the trust issues between professionals and Roma women seem to affect the contraception methods that the latter choose. At the same time Roma women are resorting to contraception methods such as sterilization, due to the reproduction of stereotypes and also due to incomplete information that they receive regarding the methods of contraception, health promotion and protection.
- Midwifery and gynecological monitoring and breastfeeding
According to the experience of the participants, most Roma women are facing problems with frequent monitoring by a gynecologist. From one side, this is a result of their difficulty to comprehend how the health system works. On the other hand, as professionals admit, Roma people don’t receive appropriate and accurate information on how to deal with certain issues such as this of breastfeeding and smoking stoppage etc.
- The role of woman and the empowerment of Roma women
Finally, another issue that emerged was the need to emancipate women, especially through other Roma women. Even though most women seem to have a secondary role in the Roma community, they receive more social power as they grow older. The grandmothers, as the participants observed and explained, have influence on their daughters and the latter try to become like them. In this framework, the grandmothers, or other Roma women, could empower young girls and young children in general in order to promote their health