Access to health care for Roma children in Central and Eastern Europe: findings from a qualitative study in Bulgaria

Rechel, B; Blackburn, Clare; Spencer, Nick; Rechel, Bernd

doi:10.1186/1475-9276-8-24

Cited by 75 publications

(77 citation statements)

References 14 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, we have no reason to believe that the six communities in the study are markedly different from other Traveller communities of the same descent (e.g. from other English Gypsy communities) either in their acceptance of immunisation 46,74,76,111 or their social contexts which impact on access to immunisation services.…”

Section: Inferential Generalisationmentioning

confidence: 90%

“…[17][18][19][20][21][22]24 However, there is very little research on Travellers' views on, and experiences of, immunisation specifically. 46,74,76,111 Moreover, these studies tend to include a small number of Travellers, often from one community, or immunisation is only part of a larger study exploring health and health care.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…[17][18][19][20][21]24,[73][74][75] Issues particular to immunisation include barriers to accessing primary care services (e.g. the absence of a permanent postal address for recall letters), 45 parental concerns about the safety of vaccines 46,76 and objection to immunisation arising from strongly held cultural beliefs and traditions. 18 A reluctance to 'self-identify' as Travellers for fear of discrimination 77 and the challenge of maintaining reliable health records for transient communities 19 hinder record keeping of immunisation uptake in Traveller communities.…”

Section: Factors Influencing the Uptake Of Immunisationmentioning

confidence: 99%

See 2 more Smart Citations

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

Jackson

Dyson

Bedford

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

Background: Gypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services, including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. Aims: (1) Investigate the barriers to and facilitators of acceptability and uptake of immunisations among six Traveller communities across four UK cities; and (2) identify possible interventions to increase uptake of immunisations in these Traveller communities that could be tested in a subsequent feasibility study. Methods: Three-phase qualitative study underpinned by the social ecological model. Phase 1: interviews with 174 Travellers from six communities: Romanian Roma (Bristol); English Gypsy/Irish Traveller (Bristol); English Gypsy (York); Romanian/Slovakian Roma (Glasgow); Scottish Showpeople (Glasgow); and Irish Traveller (London). Focus on childhood and adult vaccines. Phase 2: interviews with 39 service providers. Data were analysed using the framework approach. Interventions were identified using a modified intervention mapping approach. Phase 3: 51 Travellers and 25 service providers attended workshops and produced a prioritised list of potentially acceptable and feasible interventions. Results: There were many common accounts of barriers and facilitators across communities, particularly across the English-speaking communities. Scottish Showpeople were the most similar to the general population. Roma communities experienced additional barriers of language and being in a new country. Men, women and service providers described similar barriers and facilitators. There was widespread acceptance of childhood and adult immunisation, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough. Cultural concerns about vaccines offered during pregnancy and about human papillomavirus were most evident in the Bristol English Gypsy/Irish Traveller community. Language, literacy, discrimination, poor school attendance, poverty and housing were identified by Travellers and service providers as barriers for some. Trustful relationships with health professionals were important and continuity of care was valued. A few English-speaking Travellers described problems of booking and attending for immunisation. Service providers tailored their approach to Travellers, particularly the Roma. Funding cuts, NHS reforms and poor monitoring challenged their work. Five ‘top-priority’ interventions were agreed across communities and service providers to improve the immunisation among Travellers who are housed or settled on an authorised site: (1) cultural competence training for health professionals and frontline staff; (2) identification of Travellers in health records to tailor support and monitor uptake; (3) provision of a named frontline person in general practitioner practices to provide respectful and supportive service; (4) flexib...

show abstract

Section: Inferential Generalisationmentioning

confidence: 90%

Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Factors Influencing the Uptake Of Immunisationmentioning

confidence: 99%

See 1 more Smart Citation

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

Jackson

Dyson

Bedford

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

show abstract

“…Many researches are done regarding European Roma populations. However publications on the health status of Roma people are very limited in number (8). Besides most of them are on genetics or phylogenetics.…”

mentioning

confidence: 99%

Health and Roma People in Turkey

Ekmekçi¹

2016

Balkan Med J

View full text Add to dashboard Cite

Background:The research and published literature on Roma health in Turkey is much more limited than in other European countries. Among these, there are hardly any published literature focusing on the health status, health indicators and health behaviors. Aims: The aim of this research is to describe the perceptions of health-related concepts and access and the use of health services and social determinants of the health of Roma people in Turkey. Study Design: Descriptive qualitative survey. Methods: The participants were chosen by random sampling. The semi-structured interview topic guide was developed from sources such as advice from the Romani community leaders, published evidence and personal experience from previous work with Roma communities.Non-directive open-ended questions allowed the exploration of their health status, how they conceptualize health and disease, their level of awareness on the impact of social determinants of health, on their health status and the access and use of health services. The data analysis was based on grounded theory. Analysis proceeded in four steps: 1. Reading and examining the transcripts separately using open coding, 2. Extracting the key words and codes from the transcripts and sorting them into categories, 3. Rereading the transcripts by using selective coding, and 4. Examining the categories derived from the open coding systematically and determining the concepts summarizing the material. Results:The survey results are compatible with the existing literature on Roma health and reveal that 1) there is a tight link between the lack of social determinants of health and the poor health status of Roma people 2) socioeconomic factors and cultural norms of the ethnic minority are suspicious factors 3) comparative and systematic research is needed to illuminate the actual health gaps and causal factors for them. Conclusion:The research proves that the need for comparative and systematic research in Turkey to determine the actual health status of Roma people and develop policies to combat the health disparities is profound.

show abstract

“…A great proportion of Europe's largest minority group, the Roma of Central and Eastern Europe, continue to be deprived of access to healthcare, 7 experiencing much worse health outcomes than any other distinct population in Europe. 8,9 As Central and Eastern European countries (CEE) began "returning to Europe" following the collapse of the Soviet Union in 1989, 10 the health of its peoples began to converge with their neighbours in Western European countries. However, rapid economic reforms in the former Soviet Union, 11 which often benefi ted the few at the expense of the many, resulted in over 3 million excess deaths.…”

Section: Introductionmentioning

confidence: 99%

Public Health in Europe: Power, Politics, and Where Next?

2010

View full text Add to dashboard Cite

Health policy in Europe is at a crossroads. Longstanding challenges, such as persisting social and geographical inequalities, ageing populations, and rising burdens of chronic diseases, are being compounded by new, global threats, such as pandemic infl uenza and crises in the world's fi nancial markets. Signifi cant improvement in the health of Europe's population has been driven by factors both inside and outside the health sector. Key obstacles to improving population health in Europe result from underlying failures to overcome political and economic issues, including those shaping healthcare fi nancing and delivery systems. How can the public health community respond to these challenges? This paper discusses three examples of how power and politics have shaped the world in which public health works. The focus on individual risk factors diverts attention from underlying determinants, such as the dominance of the market in healthcare, and the political decision to favour a rapid transition from communism in the 1990s. Effective public health policy requires addressing these political forces, seeking to understand the dominant paradigms, how they have been defi ned and shaped, and how they might be changed. Their effects are often subtle but powerful, shaping the language that is used, the assumptions that are made, and the rules that are implied. We can formulate key policy options to help improve health outcomes by reshaping the critical forces that affect public health risk factors among those populations currently most burdened by signifi cant disease in Europe today.

show abstract

Access to health care for Roma children in Central and Eastern Europe: findings from a qualitative study in Bulgaria

Abstract: Background: Despite the attention the situation of the Roma in Central and Eastern Europe has received in the context of European Union enlargement, research on their access to health services is very limited, in particular with regard to child health services.

Cited by 75 publications

References 14 publications

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

Health and Roma People in Turkey

Public Health in Europe: Power, Politics, and Where Next?

Contact Info

Product

Resources

About