The Roma vaccination gap: Evidence from twelve countries in Central and South-East Europe

Duval, Laetitia; Wolff, François‐Charles; Roberts, Bayard

doi:10.1016/j.vaccine.2016.10.003

Cited by 31 publications

(23 citation statements)

References 19 publications

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“…Nevertheless, international evidence generally points to Roma being subject to greater vulnerability for social exclusion, unemployment, poverty and a low educational level that continue to hinder their access to the social determinants of health [2,5,6,20] despite political commitment to address the problem. In its intersection with ethnicity, gender, age and migration status, limited access to the social determinants of health works to produce a gradient of vulnerability in which women, children and foreign Roma are at greater disadvantage [3,7,[23][24][25].…”

Section: Roma Health In Spainmentioning

confidence: 99%

“…The Roma have considerably poorer health outcomes when compared to non-Roma populations across Europe [1,2]. Studies point to a persistent health gap with Roma experiencing lower vaccination coverage, higher levels of communicable and noncommunicable diseases, higher unmet health needs and higher infant mortality rates, while acknowledging definitional and methodological challenges that limit data comparibility and impact the depth of the evidence base [1,[3][4][5][6][7][8]. In 2005, twelve European countries joined efforts to promote Roma health equity through the Decade of Roma Inclusiona political commitment to tackle the root causes of poor Roma health by enabling the participation of Roma representatives in health governance [9].…”

Section: Introductionmentioning

confidence: 99%

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Taking stock of Roma health policies in Spain: Lessons for health governance

2018

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Roma health inequities are a wicked problem. Despite concerted efforts to reduce them under the Decade of Roma Inclusion initiative, the health gap between Roma and non-Roma populations in Europe persists. To address this problem, the European Commission devised the National Roma Integration Strategies (NRIS). This paper provides a critical assessment of the implementation of the NRIS' health strand (NRIS-H) in Spain and proposes an evaluation tool to monitor Roma health policies - the Roma Health Integration Policy Index (RHIPEX). It also makes recommendations to promote Roma health governance. To achieve these goals, four community forums, 33 stakeholder interviews and a scoping review were conducted. Results show that the NRIS-H implementation is hindered by lack of political commitment and poor resource allocation. This has a negative impact on Roma's entitlement to healthcare and on their participation in decision-making processes, jeopardising the elimination of the barriers that undermine their access to healthcare and potentially contributing to reproduce inequalities. These unintended effects point out the need to rethink Roma health governance by strengthening intersectional and intersectoral policies, enabling transformative Roma participation in policymaking and guaranteeing shared socio-political responsibility and accountability.

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Section: Roma Health In Spainmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Taking stock of Roma health policies in Spain: Lessons for health governance

2018

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“…Scientifically, higher health-endangering exposures among CEE Roma have been corroborated most rigorously, first by comparative studies on material conditions and lifestyle-related exposures in children (Cook et al 2013;Orton et al 2017) and lately also by studies on healthcare access and quality (e.g. Andreassen et al 2018;Arora et al 2016;Duval et al 2016;Földes et al 2012a;McFadden et al 2018;Sándor et al 2018;Stojanovski et al 2017;Tambor et al 2014). Overall, studies focusing on material circumstances and health-related behaviours in Roma adults, including aspects of sexual and reproductive health, support this picture.…”

Section: Figure 12 Health Indicators For Roma and The General Populamentioning

confidence: 99%

“…The poor health status of CEE Roma is co-maintained by poorer care and access to care, but little is known about what drives and supports these care inequalities. In general, poorer health care for Roma, both in terms of access to and quality of services, has been shown to be common across the region (Arora et al 2016;Duval et al 2016;Földes et al 2012a;Kühlbrandt et al 2014). However, differences in socioeconomic and other circumstances related to standard health care access between patients mostly fail to explain all of these care inequalities (e.g.…”

Section: Introductionmentioning

confidence: 99%

The health of segregated Roma: first-line views and practices: a case study in Slovakia using ethnographic methods

Belák¹

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Segregated Roma are also being oppressed through their self-exclusionary hopes and tastes. Chapter 3 of this thesis 2. Pushed and pulled towards the so-called margins, most segregated Roma become skilled at escaping the relative disadvantages of life standard in the so-called centers. Chapter 4 of this thesis 3. Many people who happen to serve segregated Roma feel that such position gradually forces them to choose between useless burnout and cynical neglect. Chapter 5 of this thesis 4. Trusting segregated Roma with more decision power and resources causes many of them to challenge the local structures that oppress them. Chapter 6 of this thesis 5. It would require a rather explicit selection process to make any risky genes concentrate in any Roma group-much more selective than Roma history could lead to. Chapter 7 of this thesis 6. Antigypsyism drives the poor health status of the Roma, mostly because most people involved, including segregated Roma, do not understand that it is so. Discussion of this thesis 7. We cannot claim to have formulated a convincing denial of the inequality of the human races, so long as we fail to consider the problem of the inequality-or diversity-of human cultures, which is in fact-however unjustifiably-closely associated with it in the public mind. Claude Levi-Strauss 8. We're all going to die, all of us, what a circus! That alone should make us love each other but it doesn't. We are terrorized and flattened by trivialities, we are eaten up by nothing. Charles Bukowski 9. We live in a world where we have to hide to make love, while violence is practiced in broad daylight. John Lennon 10. We are lost, but other animals point to the right road. They are the right road.

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“…However, numerous studies across Europe have found vaccination uptake to be lower amongst Roma compared to non-Roma communities across Europe [21][22][23]. Vaccination uptake has also been reported as lower in Romania compared to other European countries but has not been examined amongst Romanian communities in the UK.…”

Section: Several Of the 2017-18 Measles Outbreaks In England Specificmentioning

confidence: 99%

What have we learnt from measles outbreaks in 3 English cities? A qualitative exploration of factors influencing vaccination uptake in Romanian and Roma Romanian communities

Bell

Saliba

Ramsay

et al. 2020

Preprint

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Background: Since 2016, large scale measles outbreaks have heavily affected countries across Europe. In England, laboratory confirmed measles cases increased almost four-fold between 2017 and 2018, from 259 to 966 cases. Several of the 2017-18 measles outbreaks in England particularly affected Romanian and Roma Romanian communities, with the first outbreaks in these communities occurring in Birmingham, Leeds and Liverpool. This study explored factors influencing vaccination behaviours amongst Romanian and Roma Romanian communities in these three cities. Methods: Across Birmingham, Leeds and Liverpool, we conducted semi-structured interviews with 33 key providers to explore their experience in delivering vaccinations and managing the outbreak response. We also interviewed 9 Romanian women in one of the cities to explore their vaccination attitudes and behaviours. To categorise factors affecting vaccination we applied the 5As Taxonomy for Determinants of Vaccine Uptake (Access, Affordability, Awareness, Acceptance and Activation) during data analysis. Findings: Factors related to access and acceptance, such as language and literacy, ease of registering with a general practice, and trust in health services, were reported as the main barriers to vaccination amongst the communities. Concerns around vaccination safety and importance were reported but these appeared to be less dominant contributing factors to vaccination uptake. The active decline of vaccinations amongst interviewed community members was linked to distrust in healthcare services, which were partly rooted in negative experiences of healthcare in Romania and the UK. Conclusion: Access and acceptance, dominant barriers to vaccination, can be improved through the building of trust with communities. To establish trust providers must find ways to connect with and develop a greater understanding of the communities they serve. To achieve this, cultural and linguistic barriers need to be addressed. Better provider-service user relationships are crucial to reducing vaccination inequalities and tackling broader disparities in health service access.

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The Roma vaccination gap: Evidence from twelve countries in Central and South-East Europe

Abstract: Our findings point out a large difference in vaccination coverage between Roma and non-Roma and support the need for better understanding of factors influencing vaccination among Roma as well as policies that might improve services for Roma in Central and South-East Europe.

Cited by 31 publications

References 19 publications

Taking stock of Roma health policies in Spain: Lessons for health governance

Taking stock of Roma health policies in Spain: Lessons for health governance

The health of segregated Roma: first-line views and practices: a case study in Slovakia using ethnographic methods

What have we learnt from measles outbreaks in 3 English cities? A qualitative exploration of factors influencing vaccination uptake in Romanian and Roma Romanian communities

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