Romani CRISS
Roma Center for Social Intervention and Studies
HEALTH MEDIATOR
Best practice on Roma health?
Georgiana Mihai
Programs Coordinator
Romani CRISS experience in health mediation
The programs implemented by Romani CRISS on HEALTH aim to
improve the Roma’s access to public health services, as well as the
health condition of Roma community’s members in Romania.
The health program’s action lines focus on improving
communication between the medical authorities and the Roma
community and on training women with moderate level of
education in the field of health mediation.
Due to the organisation’s involvement in the Roma health issue,
Romani CRISS is the Ministry of Health’s partner in the health
mediation’s implementing process. The partnership is regulated by
the Agreement signed between Ministry of Health, OSCE/ODIHR
– Contact Point for Roma and Sinti Issues and Romani CRISS in
2001 and renewed in 2005.
As per Ministry of Health Order no. 619/2002 regarding the
functioning of the health mediation system, Romani CRISS is
responsible for training the health mediators and for monitoring and
evaluating the mediators’ activity.
The health mediator - A chance for Roma communities?
Through their work in the Roma communities, the health mediators
contribute to the harmonising of social conditions, by providing Roma
community members the opportunity to improve their health condition.
The mediator plays the role of “linking bridge” between the community
and local authorities as they cultivate mutual trust of persons from different
worlds.
The health mediator’s mission is to prevent unpleasant socio-health
situations that might appear in Roma communities. Therefore, the health
mediators are social workers and, by their work, contribute to the process
of improving the socio-health condition of Roma in Romania.
Romani CRISS is the organisation that proposed this health mediation
model as an answer to the issue of Roma’s access to public health services.
The inclusion of the mediators in the health system is a first important step
made by the Government in applying GD 430/2001, the Strategy for
Improving the Roma Condition in Romania. In addition, by involving the
health mediators in the health system, the Romanian Government,
indirectly acknowledge that Roma are a minority which face complex health
issues.
Romani CRISS has trained 450 health mediators, out of which 223
work in the Ministry of Health network, within the County Public
Health Directorates (DSP), as per Order 619/2002.
Barriers
The health mediators’ working partners don’t know the
mediators’ job description
The health mediators are perceived incorrectly by some Roma
community members (thinking they bring humanitarian aid)
Some Roma leaders are not satisfied with the health mediators’
activity, as they refuse to get involved in the political process
The DSP co-ordinaters do not monitor the health mediators’
activity in the field
In some counties where the mediators work, there are not
allocated enough funds for reimbursing the transportation and
communication expenses, necessary to deploy the health
mediation activities.
Evaluation of the health mediation system
The evaluation of the health mediators’ activities should focus on
two approaches: qualitative and quantitative.
After 3 years of intense activity of the health mediators, Romani
CRISS, as initiator of the program, requested a qualitative evaluation
of the health mediation system. To this end, a team of researchers (a
Romanian and a French researchers) drafted an evaluation
methodology that would reflect the qualitative aspects of the health
mediation system. In order to evaluate the health mediators, Romani
CRISS sought for CCFD support in view of writing down a health
mediators’ activity evalution report.
At present, the team of external evaluators are realising the evalution
report of the health mediation program.
Conclusions and recommendations:
The health mediator is the experiment of Romani CRISS – Roma Center
for Social Intervention and Studies and the result of collaboration with the
Ministry of Health, following the signing of the Agreement.
The health mediator aims to make an inventory of Roma health condition
to be brought before the health authorities. The health mediator
contributes to the improvement of Roma situation.
The health mediators and Roma NGOs become aware of the fact that the
health mediator is an important factor in relation with the Roma
community. The health mediator is not the community’s leader, but a
person paid to improve the relation between the local authorities and
Roma community, in order to ameliorate the community’s health
condition.
The health program’s co-ordinators at Romani CRISS are in permanent
connection with the health mediators employed in the public health
system, as well as with the mediators’ co-ordinators in DSPs. Romani
CRISS ensure the training courses for the health mediators and technical
assistance in the health mediation process.
The health mediator represents a positive practice in the context of
maintaining the specificity of their work.
The working partners of the health mediators do not know the
provisions of Order 619/2002.
The evaluation of the health mediation system should focus on the
qualitative aspects of the health mediator’s activity and especially on
the impacts of the health mediation work in the Roma communities.
The evaluation of the health mediation system should answer to the
following questions:
Is the health mediator a necessity for the public health system?
Does the health mediator contribute to the improving of Roma
communities’ members?
Thank you!!