Shedding light on governance for Roma health inequities

ABSTRACT

The health inequities suffered by the Roma population in Europe represent an alarming and unacceptable source of injustice. As the main ethnic minority in Europe, the gap between the health conditions of the Roma and the rest of the population poses a challenge to human rights and public health. Many political efforts have been deployed in Europe to tackle these inequities. However, they have fallen short, even causing paradoxical consequences. In this paper, we argue that previous political efforts have failed because they were developed from a neoliberal perspective, which perceives Roma health inequities as isolated ethnic problems for which there is no political accountability. Hence, there is a need for transformative political change that results in the protection of rights and self-governance to address health inequities experienced by Roma people. We propose a framework of health governance guided by the following principles: (a) effective involvement of multiple stakeholders by building collaborative capacity; (b) infusion of health perspectives in all policies and multisectoral actions; (c) transparent monitoring and evaluation; (d) role redefinition of policy promoters; (e) prevention of institutional discrimination; and (f) assuring cultural competence among policy promoters.

KEYWORDS:

• Governance for health
• health inequities
• Roma
• transformative political change

Notes

Decade for Roma Inclusion 2005–2015 http://www.romadecade.org/.

Additional information

Funding

This paper has benefited from the project PROCOMDI, granted by the Spanish Ministry of Science and Innovation (PSI2011-25554); the project Equi-Health, co-financed by the 2012 work plan, within the second programme of Community Action in the field of health (2008–2013) by direct grant awarded to the IOM from the European Commission’s DG SANTE; and from the COST Action ADAPT (IS1103) by a grant awarded to the first author to conduct a Short Term Scientific Mission at Pécs University Medical School (Hungary).