To what extent are Roma disadvantaged in terms of health and access to health care? What policies have been introduced to foster health and social inclusion?

While data and literature on Roma health are scarce, it is becoming increasingly apparent that Roma are disadvantaged in almost all areas of health. Health inequalities experienced by Roma are likely to be caused in part by their relatively poor access to health care services, caused in turn by poverty, lack of documentation, geographical distance from health providers and discrimination on the part of health workers. Initiatives developed under the European Union during the last twenty years have gone some way in providing a policy framework within which countries have attempted to redress these inequalities. CEE countries with large Roma minorities such as Romania, Bulgaria. Hungary and Slovakia have moved from policies of exclusion or forced assimilation to rights based approaches. However, it is not clear that implementation has been successful to date. The recommendations made in this policy brief could provide a broad framework although this would necessarily need to be more tailored to varying local circumstances: to be effective, policy on Roma health has to take into account social and cultural issues and should be multi-sectoral, taking place within the broader context of anti-discrimination legislation and institution building; Roma, particularly women, should participate in all stages of data collection and in policy-making and programme development; there is a need for measures to combat discrimination of Roma in accessing health services; victims of alleged discrimination should be encouraged to come forward with complaints; problems with implementation need to be urgently addressed by allocating sufficient financial resources to programmes and carrying out regular assessments of the impact of policies; and there is an urgent need for more research and dissemination of research. The European Commission could do much to support countries in developing and implementing such policies