22.01.2017

Picture1The access to health services for Roma can improve trough change in attitudes and quality of mutual communication in the relation patient-health worker, and that is by stressing out the fact that both sides are right holders as well as duty bearers.

At the same time, promoting the free-of-charge services that Ministry if health provides through Preventive and curative programs, can contribute to mutual understanding and engaging in joint activities, where the institutions within their duty will implement them and thus protect the health of families or persons at risk, while the duty of the Roma as a vulnerable category of population will be actualized in the aim of improving and monitoring.

Having in mind the above mentioned, in the period of October-December 2016 were realized various activities with different target groups and topics:

PRILEP:

  • 10.11.2016 – Action for immunization, in collaboration with the Immunization Office at PHI Health home – Prilep.

With this event was pointed out the duty: TAKING CARE OF THE CHILD’S HEALTH IS DUTY OF THE PARENT, through promotion and direct realization of the Program for compulsory immunization of population in RM.

With this action were examined 17 and vaccinated 10 children aged 0-6 years.

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  • 15.11.2016 – Educational workshop on “Early detection of malignant diseases and free services of the Program of Ministry of Health,” in cooperation with PHI Public Health Center – Prilep.

With this workshop was sent the message: BREAST CANCER AND COLON CANCER ARE MALIGNANT DISEASES WHOSE EARLY DETECTION CAN SAVE LIFE! Hence, it was emphasized the duty of each patient to be informed, and the Center for Public Health to educate and include the patients in the programs for free examinations. This was also  promotion of the Program for early detection of malignant diseases, with special emphasis on free services for  early detection of breast cancer (mammography) and colon cancer (FOB test).

At the workshop, for 11 women aged 50 to 60 years who expressed interest in free mammography were scheduled terms by the Centre. The examinations were conducted during the month of January.

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  • 21.11.2016 and 01.12.2016 – Two educational workshop on “Family Planning and use of contraceptives – their implications on women’s reproductive health”, in cooperation with PHI Public Health Center – Prilep and the Department of Obstetrics and Gynecology at PHI General Hospital “Borka Taleski” – Prilep .

With these workshops, which were held separately with men and women, was sent the message: THE NUMBER OF CHILDREN IS A CHOICE OF EVERY COUPLE, NOT A COINCIDENCE! Hence, it was pointed out to the two groups the duty of every couple to inquire about the methods of family planning and care about their reproductive health, and the duty of the Center for Public Health to organize and motivate their applying. This activity made direct promotion and implementation of the Program for active health care of mothers and children in RM.

The workshops resulted with expressed interest of 7 women to realize free gynecological examinations, and other 11 women for inserting intrauterine device – IUD. Gynecological examinations, including preparatory examinations for inserting IUD started with implementation in December. In this process, a significant contribution was given by the Department of Obstetrics and Gynecology at General Hospital – Prilep which provide free gynecological examinations  (ultrasound, taking smear samples) for candidates, and the Center for Public Health who performed free examination of gynecological smears. ROMA S.O.S. in this part, carried out the procurement of IUDs, so these women who belong to socially vulnerable category, were provided with fully free-off-charge process of inserting them.

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  • 20.12.2016 – Educational workshop on “Care of child’s oral health – registration and regular visits to dentist”, in cooperation with the Department of Preventive Child Protection at PHI Health home – Prilep.

With this event, held in the presence of parents and children of school age who are not regularly involved in the education system, was sent the message: FOR A BEAUTIFUL CHILD SMILE, FOR WHITE AND HEALTHY TEETH, THEY HAVE TO REGULARLY BE CHECKED UP AND CURED BY DENTIST – FROM BABY TO PERMANENT TEETH! Through it, was emphasized the obligation of every parent to register personal dentist of their child and regularly take them for checkups. This activity has been implemented in order to raise the rate of registered dentists, and promote the Program for compulsory medical examinations of students in RM.

The workshop also arose interest among parents of all 20 children present for realizing full medical examination of these children who have never had such because of their non-attendance of school. The examinations were conducted during January, 2017.

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  • October-December, 2016 – realized activities of direct and individual mediation in provision of certain free health services, resulting in:

– Realized 20 free gynecological exams and PAP tests among Roma women of reproductive age, according to the Project for free gynecological examination for women from rural areas and Roma women;

– Realized 12 visits to pregnant women and mothers by Polyvalent patronage service in accordance with the project Home visit;

 

GJORCHE PETROV AND KARPOSH

  • November 2016 – mediation for vaccination of 10 children from families returning from asylum, and their return to the system of immunization, in accordance with the Program for compulsory vaccination of the population in Macedonia.
  • 24.11.2016 – Educational workshop on “Folic acid for pregnant women, nutrition and immunization of children”, with representatives from the patronage service of Polyclinic Gjorce Petrov – PHI Health home – Skopje.

This workshop emphasized the duty of Roma women for registering gynecologist and do  regular checkups especially in pregnancy, and the duty of patronage service for informing and enabling patients the use of all benefits provided with the programs of the Ministry of health. Through this event was promoted the Program for active health care of mothers and children and the Program for participation in using health care for certain diseases among citizens and health care for mothers and infants with special emphasis on services for free folic acid for pregnant, free gynecological examinations and free laboratory tests for pregnant women.

At the event 3 women with risk pregnancies were identified, for which direct mediation will be conducted in obtaining health services.

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  • 25.11.2016 – Educational workshop on “The importance of registering personal dentist and oral health,” in cooperation with the dentist from a private medical institution.

Through this event was emphasize the duty of registering personal dentist for children and care for their oral health. At the workshop, a group of children aged 4 to 9 years was formed, in order to perform mediation in access to regular dental services.

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  • 22.12.2016 – Educational workshop on “Importance of choosing a family GP and importance of knowledge and learning about the administrative procedures in the secondary and tertiary care” in cooperation with the Polyclinic Gjorce Petrov – PHI Health home – Skopje.

This workshop emphasized the duty to register a GP and follow the procedures for obtaining health care at different levels. Also, it promoted the Program for prevention of cardiovascular diseases and the Program for early detection of malignant diseases.

Through this activity were identified 10 women who have not registered family GP and were referred immediately to do so. 5 of them have already registered by the end of December. Additionally were identified 5 women interested in using the services provided with the programs.

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  • 23.12.2016 – Educational workshop on “Improving the health status of people with mental disorders”, in collaboration with a doctor-psychiatrist of Polyclinic Gjorce Petrov – PHI Health home – Skopje.

Through this activity was sent a message for the duty of taking care for one’s mental health and overcoming the prejudices against it. Also, the Program of health care for persons with mental disorders was promoted. At the activity 5 people showed interest for including in the free activities offered by the program.

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⇒As a result of all defined messages and identified key topics of interest, a calendar for 2017 was prepared, that is intended for distribution in Roma communities and between public health institutions of the two municipalities.

WHAT CHANGE WAS NOTED?

→Preventive and curative programs of MH for 2016  have been seriously promoted in Roma communities and thus used the provided free services. PHI are fully involved in understanding and implementation of their duties in the realization of the programs in Roma communities, that is the individual interviews with health workers showed that in 2015 health facilities had no record of whether Roma were involved at all in the programs because there was a lack of Initiative aimed at the Roma community, and the Roma themselves had no information that there is a possibility of free examinations (mammograms, Pap tests, etc.)

→The attitude of health workers about the lack of funds and lack of interest for regular visits to the doctor by the Roma patients, which seriously affect stereotypes and negative perceptions about their “disregard for their health” or going to the doctor in the “last minute” changes through proper and continuous implementation of these programs that is beginning to be recognized as a problem by the health workers in terms of their lack in mutual cooperation and communication, and lack of knowledge about medical innovations, which affects the inability of Roma to use the provided services and thus pay more attention to their health.

→Gynecologists from the Department of Gynecology and Obstetrics in Prilep voluntarily asked to hold a workshop on the use of contraceptives of Roma women and consequently they continued to perform free examinations and inserting of IUD to women who expressed an interest for it. Although this is not part of their responsibilities they still felt an obligation to it while performing their job, following the uncontrolled births, especially among young Roma women, which often result in infant mortality, as well as frequent performing of abortions. Gynecologists from the department thought they should contribute to overcoming these problems, bearing in mind that inserting an IUD is one of the most economical and most effective ways of helping couples to control the issue of “many children” and thereby change the public perception about the community and show that they  can make decisions about having a baby and that “God does not give children or” one can not be pregnant by accident. ” Additionally, further discussion and counseling of the husbands on the same subject was held, initiated by the fact that women on the first workshop were afraid to agree on their own i.e. without the permission of their husbands. It is noted that gynecologists were more than satisfied given the opportunity to discuss openly with women and especially men on this topic out of the health institution, because they had more freedom to speak  and exchange opinions, questions and answers of a problem that they have currently and for years noticed, but except through short, professional and specific advice for specific diagnosis given at the examination, have not managed in a broader sense to review the problem and impact its reducing. Men from Roma community accepted contraception as a way to protect against uncontrolled birth which opened space for use of IUD and understanding that abortion is unacceptable in circumstances where there are other means of protection useful for the reproductive health of spouses. Roma men finally realized and changed their negative attitude towards contraception i.e. that it will not interfere them but on the contrary will reduce financial costs that women make with abortions.

→The patronage service in Prilep took over the role in this project in mediation for providing a free Pap test by the gynecologists for registered Roma women from our side, which indicated their seriously strengthened role and readiness to cope with the challenges of patients in the use of services, that is fulfilling their obligations under the programs and projects of the Ministry of Health.


* The project is implemented in the period August 2016-July 2017 entitled “Humanity does not know about differences 2″, funded by the Foundation Open Society  – Macedonia, in partnership with the association LIL Skopje.