Athens , 30 Semptember 2022
Summary of results and policy recommendations of the REACH project
The project “REACH: Roma women’s Empowerment and fighting discrimination in ACcess to Health”, which started in 2020 and was successfully completed in September 2022, is co-funded by the “European Union’s Rights, Equality and Citizenship Programme (2014-2020)” and is implemented under the coordination of CMT PROOPTIKI in collaboration with the University of West Attica – School of Obstetrics of Athens, the Union of Greek Mediators and Their Associates, the Municipality of Halandri and the Municipality of Larissa.
The REACH project’s aim is to promote the heath of Roma women and tackle discrimination in access to health. The improvement of health in Roma communities is one of the social inclusion priorities at European and National level. In the latest National Strategy for the Social Inclusion of the Roma, the empowerment of Roma women is also recognized as a priority.
The REACH project’s innovative methodology is based on a model of capacity building of professionals in Community Centres, sensitization of healthcare professionals and empowerment of Roma women focusing on their right to health and particularly sexual and reproductive health.
To tailor the project’s methodological framework and tools to the current needs and gaps in the provision of healthcare to Roma women, field research was conducted at the early stage of the project. The professionals reported discrimination and stereotypes against the Roma in health and social protection services and gaps in their knowledge regarding legal and cultural issues and the role of mediators. The REACH capacity building programme was designed and implemented using a blended learning methodology. It focused on the right to health and the obstacles that Roma women experience as well as specific issues of sexual and reproductive health that are more prevalent in Roma communities. It was attended by over 230 professionals and its evaluation demonstrated a destabilization of some stereotypes and an increase in understanding the specific needs of the Roma women.
According to the REACH methodology, a community capacity building programme was piloted in the municipalities of Halandri and Larissa. 20 women from the local Roma communities were empowered to act as propagating keys in their community. Following their training, together with women they inspired, they attended information and consultation sessions with sensitised health and social protection professionals coordinated through the local Community Centres. After the pilot was completed, the women reported feeling more comfortable to approach healthcare professionals and gained additional knowledge regarding their rights to health.
Through the implementation of the REACH project, it became apparent and was put forward that Roma women continue to face discrimination in healthcare. The research conducted during the project demonstrated gaps in the women knowledge about their rights, health and the healthcare system as well as the professionals’ difficulties in engaging with and communicating effectively with Roma about their health. The legal matters, particularly relating to identification and legalization documentation, that some members of the Roma communities face, appear to be significant barriers to the provision of services to improve the health and wellbeing of the people affected. The methodology of the REACH project based on the collaboration of Roma women and healthcare professionals that is coordinated through the Community Centres with Roma mediators, that play a critical role in Roma social inclusion, appeared to have positive outcomes on the women’s attitude towards approaching the professionals and in the professionals’ self efficacy in providing appropriate care and support with a common aim to improve former’s health.
Based on the results and the learnings from the project, a set of policy recommendations was developed with the input of key stakeholders in the fields of human rights monitoring and protection, Roma social inclusion, mediation and heathcare. The recommendations followed three main axes of intervention: a) the integration and collaboration among services, b) the capacity building of professionals, and c) the promotion of health mediation.
Reach project’s policy and interconnection proposals
Interconnection and cooperation between actors
•Active mapping under central coordination of the services, structures and initiatives thathave the potential and / or that are active at local / regional level to promote and care for the health of the members of the Roma communities and disseminate the results.
• Recognition of the key role of local government and Community Centers (CC) in promoting the social inclusion of Roma. Update and then communicate the responsibilities of the CCs to the stakeholders.
•Recognition of good practices of systematic cooperation between the health services of the PHC and Public Health in general, CCs, local government, civil society actors and Roma communities and providing incentives for the development of new ones.
•Strengthening sexual and reproductive health services at local level, through the strengthening of the role of midwives in phC, with the aim in particular of prevention and systematic monitoring during the perinatal period.
• Implementation of procedures to ensure the right to equal access to health also forpersons without identification documents.
Development of professional skills
•Broadening and systematising the capacity-building programmes of professionals providing services to Roma, with a focus on human rights and understanding of the specific needs and the involvement of community members, taking into account the gender dimension and enhancing resilience.
• Cooperation of local bodies, services and professionals and Roma communities in awareness-raising and capacity building actions.
•Provision and/or promotion of practical tools tailored to the support needs of members ofthe Roma community for the systematic provision of valid information and the monitoring of relevant actions.
• Recognition and certification of the role and profession of the Roma Mediator, with possibilities for specialisation, for example in health, as well as the definition of their training standards, as well as their duties and fields of activity.
• The placement of health mediators also in hospitals, with the ultimate goal of enhancingthe access of Roma to the structures and services of the PHC.