Roma child participation in public health policy and practice across Europe

Abstract

Roma teenagers are often excluded from participation opportunities, when they could be informing a wide range of law, policy and practice. CoE and EU recommendations make it clear that improvements in living conditions can only be achieved through active participation of Roma people. The 2018 Roma Civil Society Monitoring report reinforces that 'it is essential for Roma to be involved not only in narrowly defined 'Roma issues', but also in a wider range of topics and policies'. We address the question of what methods enable Roma children to become involved in influencing health policy and service design, focusing on the case of Bulgaria. A qualitative European survey (Feb - June 2020) in English, French, Spanish and Bulgarian identified professional perspectives on the impact of COVID-19 on children, with a focus on Roma families. Case studies of Roma children's experiences, and examples of their participation, were analysed of these case studies was conducted by the authors (combining sociological, public health and community perspectives). Accuracy of emergent findings were assessed through dialogue with survey participants. Preliminary results indicate that participatory practices that enable Roma children's participation in designing public health policy, services and responses are limited and pre-existing inequalities are deepening. However relevant isolated examples of inclusive participation were identified: information design, peer-administered questionnaires, arts-based activities, dialogue events, and campaigning in Bulgaria and beyond. Inclusive methods that enable Roma teenagers' engagement in health policy and service design are closely tied to methods used with other communities facing discrimination. However, significant structural barriers, related to economic inequalities and anti-gypsyism are additional barriers faced by some Roma children. International exchange of examples of such practices could inform future health promotion practice.