Community Monitoring of Healthcare Services in Bulgaria
The Amalipe Centre for Interethnic Dialogue and Tolerance has initiated Community Monitoring with community mobilization and follow up advocacy of healthcare services delivered at grassroots level in Roma community across 7 municipalities in different regions. The main aim of the community monitoring has been to empower the local Roma communities and improve the health care service delivery at grassroots level.
- Community local club for community development were formed at the local level and this volunteer club brought together young people, women, informal leaders to discuss certain community issues and together with the community moderator to implement volunteer activates on community interest.
- Community Development Centres were formed at municipal level: municipal coordinators worked in them in order to coordinate and support the activities of the local clubs for community development, to moderate the processes within the community and to facilitate the contacts with the healthcare and other institutions.
During the recent years, the community monitoring exercise has been able to achieve its goal to create, test, and evaluate a mechanism for mobilizing the local community in seven different towns and villages of Veliko Tarnovo, Gorna Oriahovica and Pavlikeni. The results show that the method of mobilizing the local communities for solving issues in the field of healthcare works successfully.
The combination of social audit with advocacy efforts has improved the access to healthcare services and health culture of the local community in many aspects. In the municipality of Pavlikeni (the first one to be included in the community monitoring exercise), the illegal payments in the GP cabinet decreased from 32% to 18% while in the hospital they decreased from 24% to 2%. As a result, there is an increase in the regular medical checkups for children from 36.62% to 92.13%. The delay of emergency care showed a decrease from 40% to 17%.
| Roma People in Bulgaria The Roma are the biggest European minority counting more than 12 million citizens in the European Union. Within the EU, in Bulgaria the Roma are the two big ethnic minorities. According to population Census of 2011, nearly 3, 26,000 people declared themselves as Roma. Health status of Roma Community in Bulgaria The health status of the Roma community in Bulgaria is significantly lower than the majority of the Bulgarian population. The national figures from Census 2011 in Bulgaria show that the life expectancy of ethnic Roma is 10 years shorter than the ethnic Bulgarians. In addition, 12.6% of the entire Roma population in Bulgaria including children has some kind of disabilities or suffer from a chronic disease. One third of the male Roma population and two fifths of the female population in the ages between 45 to 60 years have either partially or fully lost their full capacity owing to the poor health.atus. | AMALIPE Amalipe Center for Interethnic Dialogue and Tolerance is a leading Roma organization, working for the equal integration of Roma in Bulgarian Society.The organization plays a central role in organizing a Roma civic movement and advocating for Roma integration within the state institutions.Currently Amalipe runs nine projects within the sectors of: education, health care, social services and advocacy. Within these domains Amalipe works with a network of 170 schools all over the country to decrease the dropout rate of the Roma population, introduce intercultural education, promote life-long learning in the Roma community and raise the educational status of Roma. To know more about Amalipevisit: http://amalipe.com/index.php?nav=home&lang=2 |
Roma people meet serious health problems both in access to healthcare and in the quality of health care services. The access to health of Roma people in Bulgaria remains poor due to high levels of discrimination, prejudices that the health service providers have, low health education and awareness people have. This aspect has also surfaced in the Health Strategy for Persons belonging to the Ethnic Minorities and in the National Roma Integration Strategy (NRIS- that is one of the steps of European Union legislation to wards comprehensive European Roma integration policy). Another reason for the poor access to health infrastructure of the health system is the inadequate infrastructure of the health system that is not suited to the needs of the Roma population, especially people living in rural areas. The illegal payments made to the medical staff is a widespread practice where the vulnerable groups are required to pay for the services that should be free.
A short film on Community Monitoring practice in Bulgaria showcases the results of community monitoring through ‘community inquiry’, including periodical consultation (twice in the year) with the local communities about the health services they receive and their quality.
This film developed by NeVo and Foundation Open Society Institute presents the process of Community monitoring on healthcare services implemented by Center Amalipe in Bulgaria with the financial support of Open Society Foundations.
To watch the film visit: