To Build a Bridge

Training for Health Professionals and Law Enforcement Officers

Summary Report on the MIPEX Health Strand and Country Reports

Border Management and Detention Procedures: Health Perspective

guidelines

Guidelines

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Migration Health: Better Health for All in Europe

AMAC

Assisting Migrants and Communities

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Improving HIV data comparability

HIV1 

HIV-related data on migrant and ethnic minority populations in EU/EEA/EFTA

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Mobility of Health Professionals

MHD RO Brussels Publications

Implementation of the National Roma Integration Strategy (NRIS) and Other National Commitments in the Field of Health – CZECH REPUBLIC

Full Report available here

The health aspect of the National Roma Integration Strategy (NRIS) in the Czech Republic has not been sufficiently addressed during the Decade of Roma Inclusion (2005-2015) due to lack of political commitment in respect to the healthcare integration of the Roma community. Instead, employment, housing, and social services dominated the NRIS agenda. On the other hand, only one project was specifically dedicated to health aspects of Roma integration, the Roma Health Social Assistance (RHSA), a pilot action equivalent to the Roma health mediation project. However, despite the successful testing and consensus among experts on the need to further implement this initiative, the RHSA project has not been incorporated in the Czech health services system.

The Progress Report, part of the EQUI-HEALTH project – Roma health sub-action, presents the results of the assessments on the relevant developments made in respect to Roma health in the Czech Republic for the period 2005-2014.

Based on desk research, fieldwork and interviews with different stakeholders, including representatives from national authorities, professionals working with Roma, health providers, and civil society organizations, the report provides an analysis on the implementation of the Czech NRIS and other national commitments in the field of healthcare.

The legal framework of the Czech healthcare system is considered as equitable and developed, and Roma and other resident minority communities have guaranteed legal entitlement to healthcare. Nevertheless, socio-cultural obstacles and barriers in access to healthcare services is significantly worse for those Roma living in socially excluded communities. In this context, the Czech Republic has progressed in increasing Roma policy cooperation and developing dialogue between Roma representatives and Czech civil society. Assessment on the country’s effort in fulfilling the NRIS objectives confirms the progress made in important aspects such as the improved national coordination of integration policies. Unfortunately, the health aspects of the NRIS have not been prioritized and only one pilot project specifically dedicated to Roma health integration (RHSA) was implemented within the Czech NRIS 2005-2015.

In addition, another major problem undermining the successful implementation of the NRIS in the Czech Republic concerns the inadequate collection and lack of valid data on Roma health, currently fragmented, often duplicated, and not very representative. Furthermore, there is no consensus about the type of data to be collected and reporting of ethnic origin is not permitted by Czech law. Consequently, accurate data on Roma health in the Czech Republic is currently not available since ethnicity is not monitored in the statistics.

Similarly, existing obstacles and barriers related to the overall situation of the Czech healthcare system constitute a major problem to Roma access healthcare services. Although some barriers are similar to those that the general population deals with, access to healthcare services is significantly worse for the Roma community living in a socially excluded situation. In this case, inadequate healthcare provider network, limited public transport, financial burdens due to co-payment requirements as well as discriminatory practices from health professionals and various communication problems are among the main obstacles concerning access to healthcare services.

In this context, findings from the assessment acknowledge that the health component of the National Roma Integration Strategy in the Czech Republic was not sufficiently addressed and that other areas such as housing and employment dominated the agenda. Despite the flaws and management problems in the RHSA project, findings suggest that it can be implemented successfully in multiple locations and offer an opportunity for progress in Roma inclusion. Consequently, to move this initiative forward remains an urgent task for the near future, and it has to be one of the main objectives of the health component of NRIS 2014-2020.

On the other hand, findings based on interviews conducted stress the need that ethnic data collection should be addressed. According to stakeholders, available data and information on Roma health is not sufficient and constitutes a major barrier to effectively monitor Roma integration into the healthcare system. In addition, consensus should be reach among Roma stakeholders, medical staff and public authorities on the data gathering method.

Finally, in response to identified barriers, obstacles and discrimination practices towards access of Roma and other vulnerable groups to healthcare services, findings lead to the conclusion that more regulatory measures to reduce difficulties should be incorporated into the NRIS 2014-2020. The main measures should consider improving accessibility of healthcare services to socially excluded communities, monitor and eliminate discriminatory practices by raising awareness of the Roma rights and issues, and develop a health mediation programme to overcome barriers related to socio-cultural differences.

The Progress Report was produced under IOM MHD, RO Brussels guidance by Helena Hnilicová, and benefitted from peer reviews and editing by Mariya Samuilova. DJ Krastev copy-edited, proofread, and assist with the general editing.