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Position paper of the European Forum for Primary Care on the provision of primary care for the Roma in Europe: Roma Health Mediation
26.10.2016 IOM

The position paper of the European Forum for Primary Care on the provision of primary care for the Roma in Europe reflection on Roma Health Mediation as per Roma Inclusion Newsletter October 2016:

“In several countries, there have been positive experiences with the Roma Health Mediator (RHM): a person from a Roma community, mostly female, who is trained to liaise and create an understanding between the Roma and (primary) health care services. The report, ”Roma Health Mediators, successes and challenges”, reviews the experiences (32). Official RHM job descriptions vary little by country, although the actual work may vary. In general, for the RHM, training curriculum, certification and conditions of work have gradually been optimized, supported by international studies and exchanges. The funding for this group of workers remains a challenge, since they are between the health system and community, and the final responsibility for their functioning and employment varies between and within countries. In Romania, the RHM was initially employed by an NGO and the Ministry of Health, but currently the municipalities are taking over the responsibility for their employment, emphasising that the RHM is not a health professional, but a member of a Roma community. After more than 10 years of experience with the RHM, a number of lessons learned are worthwhile to quote:

Mediators can be ineffectual if health professionals have an unclear understanding of the mediator’s functions, and when they are:

• delegating all the weight of the intervention to the mediator,

• delegating all activities that healthcare professionals dislike, i.e. community interventions, to the mediator,

• using the mediator’s service exclusively in situations of conflict. Therefore, a number of prerequisites should inform the actions of mediators, namely:

• a clear definition of their role and functions;

• an adequate training;

• a coordination of their work with healthcare professionals. In no country the number of RHMs is sufficient yet to cover at least all larger Roma communities.”

(de Graaf P, Rotar Pavlič D, Zelko E, Vintges M, Willems S, Hanssens L. Primary care for the Roma in Europe: position paper of the European Forum for Primary Care. Zdrav Var 2016; 55(3): 218-224)



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