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Hanna Dobronauteanu, M.D. Counselor of Minister, Ministry of Health, Romania

Health Mediators in Roma Communities 3 Years on a New Way. Hanna Dobronauteanu, M.D. Counselor of Minister, Ministry of Health, Romania. REMEMBER OBSERV IMPROVE. REMEMBER. ACCESS OF ROMA TO HEALTH SERVICES Deficiency of practical access to  GP (Family doctor)

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Hanna Dobronauteanu, M.D. Counselor of Minister, Ministry of Health, Romania

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  1. Health Mediators in Roma Communities 3 Years on a New Way Hanna Dobronauteanu, M.D. Counselor of Minister, Ministry of Health, Romania

  2. REMEMBER OBSERV IMPROVE

  3. REMEMBER ACCESS OF ROMA TO HEALTH SERVICES Deficiency of practical access to  GP (Family doctor)  Preventive services Due to:  Lack of identity documents  Cultural barriers  Lack of information

  4. REMEMBER Number of Roma population Ethnical strata Different groups/clans/families  The definition of the public health target group: The Roma Community

  5. REMEMBER Romani CRISS 1997 Ministry of Health 2001 HEALTH MEDIATORS IN ROMA COMMUNITIES

  6. REMEMBER THE HEALTH MEDIATOR • Respected member of the community • Woman /mother/ • Cross-cultural bridge  Information  Communication  Conflict prevention

  7. REMEMBER THE HEALTH MEDIATOR SYSTEM =Jobs for Roma women in their community =Active creation of profound changes = Opportunity to fight discrimination

  8. REMEMBER OPERATING TERMS Of the functioning of Health Mediator System • Declared respect for the Roma culture & tradition • Commitment of the Roma Representatives (in planning, implementation, and evaluation; at central & local level too) • Offer of solutions for the problems of  Roma people  Health care system • Monitoring • Flexibility

  9. HEALTH MEDIATORS IN ROMANIA • Selectionof candidates for training:  Local Roma NGO Roma community leaders •Training: Institution – NGO partnership  First Step/Basic/Training: Romani CRISS  Professional Training: organized by County Public Health Authorities

  10. HEALTH MEDIATORS IN ROMANIA • 2002: 112 Health Mediators in 32 counties 2005: 222 Health Mediators in 40 counties /Romania: 42 counties/ •Coordination: County Public HealthAuthorities •Activity: well defined job description •Finance: Ministry of Health /National Program/

  11. Works for • 916 • Beneficiaries • Can be contacted by • 1560 • Beneficiaries 1 HEALTH MEDIATOR 2003/2004 • Helps • 219 • Roma to be included in • the Health Insurance System Holds 34 37 Health Education Sessions Helps 19 40 Pregnant Women to access health services Accompanies 53 114 Children to vaccination

  12. HEALTH MEDIATORS IN ROMANIA Public Health Indicators of communities with health mediator  Vaccination coverage rate  68%95% Bihor  45% 90% Maramures  20% 90% Dambovita  100% Brasov, Mehedinti Infant mortality  46,2 %o  6,8 %o Ialomita  47,6 %o  0 Sibiu  0 – Braila, Dambovita, Dolj, Maramures, Mehedinti Addressability to reproductive health services   with 50% of therapeutic abortion - Harghita

  13. HEALTH MEDIATORS IN ROMANIA CHALLENGES TO FACE: • To complete the external evaluation process (started in 2004) •To identify the place of health mediators in the reformed Romanian health system • To improve  Professional training of health mediators  Program management and monitoring Networking

  14. Emotions will not be denied. Once an emotion is created, it lives as chemicals in your system. You have to use emotions to create the right kind of thinking. Bill Jensen /Simplicity: The New Competitive Advantage In a World of More, Better, Faster/

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