 |
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2024, vol. 30, issue4
Subject Area: Public Health
-
DOI: 10.5272/jimab.2024304.5873
Published online: 22 November 2024
Original article
J of IMAB. 2024 Oct-Dec;30(4):5873-5877
HEALTH SERVICES CONSUMPTION AND BARRIERS IN THE HEALTH CARE OF PERSONS OF ROMA ORIGIN IN BULGARIA
Mariela Kamburova1
, Borislava Ivanova1, Radoslava Tihomirova1, Eleonora Mineva-Dimitrova1, Ana Ivanova1, Dimitar Dimitrov1, Zornitsa Yordanova1, Emil Simeonov2, Tsevelina Vitkova3,
1)Department of Social Medicine and Health Management, Faculty of Public Health, Medical University, Pleven, Bulgaria.
2)Department of Orthopedics and Traumatology, Faculty of Medicine, Medical University, Pleven, Bulgaria.
3)Department of Hygiene, Medical Ecology, Professional Diseases and Disaster Medicine, Faculty of Public Health, Medical University, Pleven, Bulgaria.
ABSTRACT:
Introduction: Persons of Roma origin often face serious inequities concerning their state of health and their access to good quality health services.
The purpose of the study is to analyze the health services consumption and barriers in the health care of persons of Roma origin in Bulgaria.
Material/Methods: The cross-sectional study was conducted, and a semi-structured face to face interview were applied in 2018. Adult citizens of Roma origin were covered as follows: residents of Knezha - a total of 59 people and households from the towns of Kneja and Kotel - 18 families (50 persons). The cities are representative of settlements of medium size with separate neighborhoods of Roma origin. Data processing was performed by SPSS v.24.
Results: Over two-thirds of the covered persons of Roma origin do not have health insurance. Due to a lack of health insurance, 14% of the households were reported a refusal to provide health care by general practitioners (GPs) and specialists in out-hospital care. 82.1% of Roma women have never had a mammography, and 71.4% a smear test. 83.3% of the households required direct payment for the provision of health services, which corresponds to the high share of informal payments in health care in Bulgaria (34 % in 2023), but among the Roma population, this share is significantly higher.
Conclusion: The Roma population in Bulgaria is characterized by an unfavourable health profile, and the health services provided to the persons of Roma origin are inadequate to their needs.
Keywords: Roma's health, health insurance, health inequities, access to health care,
- Download FULL TEXT /PDF 559 KB/
Please cite this article as: Kamburova M, Ivanova B, Tihomirova R, Mineva-Dimitrova E, Ivanova A, Dimitrov D, Yordanova Z, Simeonov E, Vitkova T. Health services consumption and barriers in the health care of persons of Roma origin in Bulgaria. J of IMAB. 2024 Oct-Dec;30(4):5873-5877. [Crossref - 10.5272/jimab.2024304.5873]
Correspondence to: Mariela Kamburova, Department of Social Medicine and Health Management, Faculty of Public Health, Medical University – Pleven; 1, Kliment Ohridski Str., Pleven 5800, Bulgaria; E-mail: mariela_kamburova@yahoo.com
REFERENCES:
1. Orton L, de Cuevas RA, Stojanovski K, Gamella JF, Greenfields M, La Parra D, et al. Roma populations and health inequalities: a new perspective. Int J Hum Rights Healthc. 2019 Nov 28;12(5):319-327. [PubMed]
2. WHO releases new guidance on monitoring the social determinants of health equity. WHO. 19 February 2024. [Internet]
3. Fésüs G, Östlin P, McKee M, Adány R. Policies to improve the health and well-being of Roma people: the European experience. Health Policy. 2012 Apr;105(1):25-32. [PubMed]
4. Bosakova L, Geckova AM, van Dijk JP, Reijneveld SA. Increased Employment for Segregated Roma May Improve Their Health: Outcomes of a Public–Private Partnership Project. Int J Environ Res Public Health. 2019 Aug;16(16):2889. [Crossref]
5. IOM MHD RO Brussels. Health Mediation models in the EU: Examples of good practices. MHRP. 2017; 50. [Internet]
6. Early Childhood Care and Education Regional Report – Europe and North America (Draft). UNESCO. 27 Aug. 2010. [Internet]
7.Masseria C, Mladovsky P, Hernández-Quevedo C. The socioeconomic determinants of the health status of Roma in comparison with non-Roma in Bulgaria, Hungary and Romania. Eur J Public Health. 2010 Oct;20(5):549-54. [PubMed]
8. The health situation of Roma communities: Analysis of the data from the UNDP/World Bank/EC Regional Roma Survey. UNPD. 2012. [Internet]
9. Wörz M, Foubister T, Busse R. Access to health care in the EU Member States. Euro Observer. 2006 Summer;8(2):
10. Kasabji F, Alrajo A, Vincze F, Kőrösi L, Ádány R, Sándor J. Self-Declared Roma Ethnicity and Health Insurance Expenditures: A Nationwide Cross-Sectional Investigation at the General Medical Practice Level in Hungary. Int J Environ Res Public Health. 2020 Dec 3;17(23):8998. [PubMed]
11. Belak A, Filakovska Bobakova D, Madarasova Geckova A, van Dijk JP, Reijneveld SA. Why don't health care frontline professionals do more for segregated Roma? Exploring mechanisms supporting unequal care practices. Soc Sci Med. 2020 Feb;246:112739. [PubMed]
12. Nesvadbová L, Sandera J, Haberova V. [Roma population and health, the Czech Republic, National report 2009] [in Chech] [Internet]
13. Sándor J, Kósa Z, Boruzs K, Boros J, Tokaji I, McKee M, et al. The decade of Roma Inclusion: did it make a difference to health and use of health care services? Int J Public Health. 2017 Sep;62(7):803-815. [PubMed]
14. Escobar-Ballesta M, García-Ramírez M, Miranda D, Petrova-Benedict R. Shedding light on governance for Roma health inequities. J Prev Interv Community. 2018 Jan-Mar;46(1):84-99. [PubMed]
15. Kósa K, Katona C, Papp M, Fürjes G, Sándor J, Bíró K, et al. Health mediators as members of multidisciplinary group practice: lessons learned from a primary health care model programme in Hungary. BMC Fam Pract. 2020 Jan 28;21(1):19. [PubMed]
16. Roma Health Mediators: Successes and Challenges Report. Open Society Foundations. October 2011. [Internet]
17. Baev M, Manov R. Access to healthcare of Roma women in Bulgaria and Roma paramedics in the Emergency care units. Eur J Public Health. 2018 Nov;28(suppl4):cky218.193. [Crossref]
18. State of Health in the EU Bulgaria Country Health Profile 2019. OECDiLibrary. [Crossref]
19. Krumova T, Ilieva M. [The health status of Romani Women in Bulgaria.] Astarta, Veliko Turnovo. 2008. [in Bulgarian]
Received: 02 August 2024
Published online: 22 November 2024