Abstract
BackgroundHalf of the people living in social exclusion in the Czech Republic are of Roma origin. The worse health of Roma could be partly explained by numerous barriers to accessing health care. Therefore, our study aimed to explore the perceptions of various stakeholders and experts who may have an impact on the inclusion of Roma and/or their access to health care on how to improve health care access for Roma living in social exclusion in the Czech Republic.MethodsWe conducted a concept mapping study and obtained data from 32 participants from health and social services, policymakers and others who were involved in different study phases (brainstorming, sorting, rating, interpretation).ResultsOut of 64 proposed measures sorted into six distinct clusters, 20 were rated as the most urgent and the most feasible and should be implemented with a priority to improve access to health care for Roma living in social exclusion. The proposed measures covered various topics, such as education and awareness of the target group as well as education and supervision of helping professionals, strengthening capacities and streamlining the health care system, health promotion and associated services and increasing the local and financial accessibility of health care. Overall, measures concerning the education and supervision of helping professionals were rated as both the most urgent and the most feasible. Individual priority measures targeted, for example, the health needs assessment of Roma living in social exclusion to set up interventions or to include topics such as participation, empowerment, cultural competence and communication training in the curricula of health care and helping professionals in postgraduate and continuing studies.ConclusionsStakeholders proposed a set of relevant and acceptable measures that may help improve access to health care for Roma living in social exclusion. The way they rated the proposed measures reflects both the current unfavourable mainstream and public discourse concerning Roma living in social exclusion and the most acute policy issues identified by several European and national bodies.
Highlights
Health systems play an important role in mediating the differential consequences of illness in people’s lives [1]
Our study aimed to explore how to improve access to health care for Roma living in social exclusion in the Czech Republic and on priority measures, based on their urgency and feasibility, using the concept mapping approach
The aim of this study was to explore how to improve access to health care for Roma living in social exclusion in the Czech Republic using the concept mapping approach involving stakeholders from various fields of policy and practice
Summary
Health systems play an important role in mediating the differential consequences of illness in people’s lives [1]. Its accessibility is an important factor of the social determinants of health [3], bringing disparities in health outcomes when not accessible [4]. Addressing the social determinants of health [3], including health care accessibility, is significant for reducing longstanding health disparities. According to the WHO, universal access to health care is a priority that could be guaranteed and with acceleration extended to all countries in the EU region [5]. Half of the people living in social exclusion in the Czech Republic are of Roma origin. Our study aimed to explore the perceptions of various stakeholders and experts who may have an impact on the inclusion of Roma and/or their access to health care on how to improve health care access for Roma living in social exclusion in the Czech Republic
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