The health condition of Roma shows some specific features that differ from the general national picture of the health condition in Macedonia. Namely, according to research by UNDP 27% of Roma men and 31% of Roma women suffer from chronic diseases (compared with 23% of non-Roma living in close proximity to Roma).

Poor living conditions, hard physical work, the lack of a clean living environment, combined with poor nutrition, contributes to the poor health of Roma. All these factors result in a shorter life expectancy of Roma in comparison with non-Roma. Additionally, unemployment and a poor economic situation, substandard living conditions in small homes unsuitable for the number of people living in them significantly affects the health of Roma. Unequal treatment by medical staff is an additional obstacle to timely and regular medical examinations of the Roma.

According to the recommendations from the Strategy for Roma and Health Action Plan – Decade of Roma Inclusion, preventive health care, institutional cooperation between relevant institutions and Local Self Government, and constant cooperation and consultation with the Roma community, are the primary actions that may allow improvement of the health situation of Roma. Opening Health Advising Centers in each community where Roma would be provided preventive health education and culture, parallel with the provision of free basic health services, is seen as the most effective initiative that would achieve improvement of the health status of Roma. As stated, prevention is the most efficient and cost-effective way to maintain the health of the population, followed by educational activities.

The health situation of Roma in Prilep is constistent with the national situation or perhaps worse because of the underdeveloped sector of representatives who promote health at the local level, in parallel with the central management of the health system in Macedonia which specifically and directly prevents the removal of barriers faced by patients.

In December 2007 the association ROMA S.O.S from Prilep launched the initiative Health Advising Centre, financially supported by Roma Health Project, OSI-Budapest, whose main goal is to improve the health status of Roma in Prilep through the identifying of barriers in access to the health care system.

Within this initiative direct cooperation was established with the following local institutions:

– Local Self Government – Prilep;

– P. H. I. Hospital “Borka Taleski” – Prilep;

– P.I.I. Center for social affairs – Prilep;

– Centar for employment – Prilep;

– Fund for health insurance – Prilep;

– Primary Health Institution – Prilep;

– P. H. I. Centar for Public Health – Prilep.

The successful implementation of planned programs and activities of the initiative resulted in the preparation of a Local Action Plan for the Health of Roma (in the period from February to September 2009), a document which summarizes identified health barriers and needs of the Roma community from Prilep and proposes actions to overcome them.

With the adoption of this document the Local Government – Prilep assumes responsibility for local implementation of public policy under which the health status of Roma citizens and the provision of better conditions for their integration into social processes comprehensively and concisely will be targeted. The Initiative is part of the efforts to implement the Decade of Roma Inclusion through the support of government measures to close the gap that exists between Roma and non-Roma population in Macedonia.

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Conclusion of the local government