Child Care Research Articles

Purdah:opportunity or Adversity: Fromattia Hosain’s Fictions

In every day language gender refers to the biological differences between male and female which shows as superiority and inferiority. If that is male then he is made for outdoor work and if that is female she will remain at home for her house work course. Since the age of stone women at home does so many things and taking care of children but she never appreciated for that because we suppose she is born to do so. This what society construct the ideology. After observation of this stereotypes feminism moments take its place. Its roots are very undergoing and its stems and branches are exceeding with a never ending fruit full solution. Feminism is just about equality, nothing else. Everyone thinks feminism is about making women stronger but no, she is already very strong. It’s just about changing the way the world perceive their strength. Religion take very countable role of women in society. The myth which is in very lime light that if the women is Muslim and observes Purdah then she must be unfortunate and not able to built her choice for her career and husband. Islam teaches equal treatment and equal rights The glamming example of it is wife of the prophet Muhammad (PBUH) she was a successful businesswoman. Which is a clear massage that women are allowed to go and to do what she wants.

Clinical utility of anti-Müllerian hormone in female children and adolescents.

Anti-Müllerian hormone (AMH) is a dimeric glycoprotein that belongs to the transforming growth factor beta superfamily and plays essential roles in sexual differentiation and folliculogenesis. In the male embryo, AMH is produced by the Sertoli cells and induces the involution of the Müllerian ducts. In females, AMH is predominately produced by the granulosa cells of growing preantral and small antral follicles and regulates follicular maturation. Many recent studies have highlighted the significant role of this hormone in the diagnostic approach to female children and adolescents with various disorders that affect ovarian development and function. AMH is considered a valuable diagnostic tool in the management of female pediatric patients with conditions such as polycystic ovary syndrome, precocious puberty, ovarian tumors, differences in sex development, and premature ovarian insufficiency. Standardization of AMH assays, internationally approved reference values based on age and pubertal stage, and widespread availability of the test could further upgrade the clinical utility of AMH, rendering it a valuable tool in the armamentarium of physicians involved in the care of female children and adolescents, and promote future research.

Rinse aid with bischofite: prevention of caries and gingivitis in adolescents

The frequency of using liquid complementary hygiene products has been increasing significantly in recent years. This trend is typical not only for adults, but also for children. The ease of use of rinses, foams, suspensions largely contributes to the growth of their popularity. As substances having a complex effect, researchers have long been interested in mineral complexes, among which calciumand magnesium-containing compounds are of particular importance [2, 3]. Such natural minerals as carnalite, kieserite, and bischofite are of particular interest. The effectiveness of the anti-carious, anti-plaque and anti-inflammatory effects of preventive drugs was evaluated: irrigator liquid + mouthwash WATERDENT Anti-caries and baby foam for the oral cavity WATERDENT Happy Smile during the rehabilitation period in children with permanent bite. Materials and methods. An open comparative study of the effectiveness of the use of liquid for the irrigator + mouthwash WATERDENT «Anticaries» and baby foam for the oral cavity WATERDENT Happy Smile was conducted. To assess the effectiveness of the hygiene products used, the following clinical indicators were selected: the caries intensity index (KPI), the Green – Vermillion simplified index (IG-U), the PMA index and the Mulleman – Cowell index. Clinical parameters were determined before and after the use of the compared hygiene products in groups after 1 month. During the study, laboratory saliva parameters were monitored: saliva pH, total protein, determination of saliva Ca and Md. 3 groups of participants were recruited from among those who applied for help at the UMMU dental clinic. All volunteers were somatically healthy children aged 12–18 years with different caries activity and catarrhal gingivitis, randomly distributed by gender and age. Statistical data processing was carried out in Microsoft Excel and Statist programs. Results. The evaluation of clinical tests in the groups showed a significant change in the indices of PMA and Grinn – Vermilion (р ≤0,05) in patients of the main group and a statistically significant improvement in the index of Grinn – Vermilion (р ≤ 0,05) in patients using foam (comparison group), while in the control group there were no dynamics of statistically significant changes in clinical indicators. An increase in the level of calcium in saliva in patients who used Irrigator Liquid + mouthwash WATERDENT Anti-caries from 2.30 to 2.95 characterizes the high mineralizing potential of bischofite, which is part of its composition, and its karyoprophylactic property. An assessment of laboratory data in the main and comparison groups at the beginning of the experiment and after 1 month showed a significant change in total protein values from 2.94 to 2.26 and 2.72 to 2.09 g/l, respectively, for these groups (p <0.05), which shows the positive effect of these products on hygiene, on changes in saliva properties and karyoprophylactic potential. Conclusions. Clinical and laboratory studies of the use of Liquid for irrigator + rinse WATERDENT Anti-caries and baby Foam for the oral cavity Waterdent Happy Smile confirm the claimed consumer properties of these products: anti-carious, anti-plaque and anti-inflammatory effects and can be recommended in comprehensive individual hygienic oral care for children.

Gambaran Praktik Pengasuhan Anak Kembar di Kabupaten Gayo Lues

The purpose of this study is to know the image of the practice of child care in gayo lues district. This study uses qualitative methods with a descriptive approach. Number of participants in the study are three subjects. The data is analyzed using thematic analysis techniques. The findings suggest that there are 7 themes illustrating the practice of foster care in gayo lues district, of which 7 include the following sub themes. Parenting stress that covers the subtheme of financial demands, the lack of time for yourself. Support system that includes sub themes of extended family help, husband support, local government assistance. Coping strategies that include the subtheme manage time through other work, not managing emotions in a healthy way. Teaching that includes sub themes that enhance understanding, direction and example. The culture that includes the sub theme educating children firmly, the high tone of voice and educating children independently. The vaforitism consists of the sub theme divide and contrast.

놀이기록 다시보기를 통한 유아교사의 유아놀이 변화 탐색

Objectives The research objectives of this study is to find out the reflection that the researcher as kindergarten early- child care teacher has, in the course of reviewing the individual play records, and changes in the viewpoints of teachers in early-child care on kid plays. Methods In order to achieve this goal, self-study among qualitative research methods is conducted in that one can re-see and reflect on one's beliefs, values, and play records through self-reflection. To achieve such ob-jectives, the researcher collected and analyzed the play records that were prepared through author's own ob-servation in class, the author's self-reflection journal, and any other materials. Results This research has classified changes in the viewpoints of teachers in early-child care on kid plays into six sub-factors, say, understanding kids from a new perspective, expanding and supporting kid plays, participating in plays from a spectator to a player, reestablishing the educational belief system of teachers in early-child care as a supporter, connecting the curriculum in plays, and learning outside. For the final factors as to it, this study has classified into three top factors, namely, understanding plays from the perspective of kids, reestablishing the edu-cational belief system teachers in early-child care, and the operation of play-centered curriculum. Conclusions By reviewing the play records, it was found that changes in the viewpoints of teachers in early-child care on kid plays brought about the significant change in actual kid plays. Given the research results, the play records that are being prepared in the current educational field would be instrumental. It is anticipated that this would con-tribute to implementing the kid play-centered curriculum which requires reinforcing plays, with the focus on kids.

Management of severe traumatic brain injury in pediatric patients: an evidence-based approach.

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. The decision-making process in the management of severe TBI must be based on the best available evidence to minimize the occurrence of secondary brain injuries. However, healthcare approaches to managing TBI patients exhibit considerable variation. Over an 18-month period, a multidisciplinary panel consisting of medical doctors, physiotherapists, nutritional therapists, and nurses performed a comprehensive review on various subtopics concerning TBI. The panel identified primary questions to be addressed using the Population, Intervention, Control, and Outcome (PICO) format and applied the Evidence to Decision (EtD) framework criteria for evaluating interventions. Subsequently, the panel formulated recommendations for the management of severe TBI in children. Fourteen evidence-based recommendations have been devised for the management of severe TBI in children, covering nine topics, including imaging studies, neuromonitoring, prophylactic anticonvulsant use, hyperosmolar therapy, sedation and analgesia, mechanical ventilation strategies, nutritional therapy, blood transfusion, and decompressive craniectomy. For each topic, the panel provided clinical recommendations and identified research priorities. This review offers evidence-based strategies aimed to guide practitioners in the care of children who suffer from severe TBI.

Exploring Belief Systems in Kinship Fostering Practice in Igbo Indigenous Communities of Southeast Nigeria

ABSTRACTKinship fostering in Igbo indigenous communities is an enduring alternative child care practice that promotes collective responsibility for child care in a family environment. The practice is believed to be fundamental for family and community continuity. Weakening extended family ties and a lack of social work support services in this care arrangement have cast doubt on the continual viability of this alternative child care practice This is an exploratory study using grounded theory. In‐depth interviews with six community leaders and six senior public social welfare officers provided insight on belief systems promoting kinship fostering in Igbo indigenous communities. Findings were thematically analysed to show continuity of lineage, preservation of family name and challenges associated with kinship fostering. Belief systems on kinship fostering provides insights on how children are viewed in Igbo culture, which can help policymakers design intervention programme that are culturally relevant in child‐care formation in Nigeria given challenges in kinship fostering. The study promotes indigenous knowledge that is vital for social work education and practice in Nigeria. Further study suggests exploring the belief of foster children and their experiences in kinship fostering.

Concurrent predictors of behavioral inflexibility in minimally verbal and verbal autistic children.

Behavioral inflexibility (BI) refers to the rigid and inflexible patterns of behaviors that are a core aspect of autism. Few studies have investigated BI in autism separately from other restricted and repetitive behaviors (RRBs). The present study used a relatively new measure, the behavioral inflexibility scale (BIS; Lecavalier, L., Bodfish, J., Harrop, C., Whitten, A., Jones, D., Pritchett, J., Faldowski, R., & Boyd, B. (2020). Autism Research, 13(3), 489-499), to examine the relationship of BI and variables that are both core symptoms in autism as well as symptoms associated with cooccurring mental health conditions, atypical sensory experiences, and adaptive functioning in a sample of 87 children with autism. Additionally, we aimed to understand how these relationships may be related to autistic individuals' verbal status: minimally verbal (MV) or verbal. Results revealed that anxiety, attention deficit/hyperactive, depressive, oppositional defiance problems, and sensory differences were all significantly correlated with BI in the MV group. In contrast, only anxiety, depressive, and oppositional defiance problems were significantly correlated with BI in the verbal group. Linear regression analyses showed that oppositional defiance problems and atypical sensory experiences explained a significant proportion of the variance of BI in the MV group, whereas only depressive problems were significant in the verbal group after accounting for other mental health conditions. Overall, our findings demonstrate that multiple aspects of psychopathology are significantly related to BI and can have broader implications for interventions and mental health care in autistic children.

Key Determinants of Family-Centered Care for Children with Leukemia

This study examines the relationship between health status, parental knowledge, and parental attitudes with the application of family-centered care (FCC) for children with leukemia at Abdul Moelok Regional Hospital, Lampung Province. Using a quantitative approach with a cross-sectional design, 92 respondents were selected from a population of 1,200 leukemia patients treated between 2021 and 2022. Data were collected through a validated questionnaire that measured parental knowledge, attitudes, and health status, with analysis conducted using the gamma correlation test. The results indicate significant relationships between health status, parental knowledge, and parental attitudes with the implementation of FCC. Factors such as age, education, income, caregiving duration, and disease length influenced the health status and FCC application. The study also reveals that caregivers face challenges in providing care, particularly due to financial burdens and physical strain, impacting their quality of life. Additionally, cultural factors affect how parents communicate the diagnosis to children, with some families delaying disclosure based on cultural norms.

Exploring risk and resilience in school environments for students in kinship care

ABSTRACT Kinship care is provided by members of a child’s extended family or friend network when they can no longer live with their parents. This study explores risk and resilience in UK school environments for students in kinship care. Eight professionals experienced in working with students in kinship care and their schools took part in individual, semi-structured interviews. Interviews focussed on kinship students’ needs and how professionals perceive schools respond to those needs. Reflexive thematic analysis generated over-arching themes indicating that: children in kinship care have multiple needs and are looked after by kinship carers who find themselves “between a rock and a hard place”; in some schools kinship care is “under the radar”; other schools respond to kinship families with the attitude of “the apple doesn’t fall far from the tree”; and in some schools kinship care is “on the agenda”. A model is presented that integrates risk and protective factors within schools, generated from this study, with risk and protective factors for kinship students within families, identified by previous literature. Implications for educational psychology (EP) practice are presented, and further research needs discussed.

Navigating Reproductive Care in Patients With Inflammatory Bowel Disease: A Comprehensive Review.

Inflammatory bowel disease [IBD] is often diagnosed in patients during their reproductive years. It is crucial that both healthcare providers and patients are adequately informed to avoid misguided decisions regarding family planning. One of the most important aspects during conception and pregnancy is to maintain disease remission, as disease activity is associated with adverse pregnancy outcomes. Apart from methotrexate, most conventional drugs used in IBD are considered low risk during conception and pregnancy. For newer agents, evidence is still limited. If needed, surgery must not be postponed and should ideally be performed in specialized centres. In most patients, delivery should be vaginal except for patients with complex perianal disease, with an ileoanal pouch anastomosis, or if there is an obstetric contraindication. In children exposed to biological treatments during pregnancy, the risk of infections appears to be low, and psychomotor development is probably not affected. Regarding immunizations, the standard vaccination schedule for inactivated vaccines should be followed for children exposed to biologics in utero. In the case of live vaccines, such as rotavirus, decisions should be individualized and take into consideration the risk-benefit ratio, particularly in developing countries. In this review, we provide a comprehensive and updated overview of aspects related to fertility, pregnancy, breastfeeding, and the impact on the care of children born to mothers with IBD. Both the available evidence and areas of uncertainty are discussed, with the goal of assisting healthcare professionals caring for IBD patients during this important stage of their lives.

ASARA-A technology-driven maternal and child healthcare model of Araku

Tribal populations form 8.6% of total India’s population. The health indicators of tribal populations lag behind their non-tribal counterparts. Limited access to healthcare services, poor transportation facilities, increased out-of-pocket expenditures for health, distinct cultural practices and remote settlement among many others contribute to the poor health status of the tribal populations. However, to achieve sustainable development goals by 2030, it is extremely important to address the healthcare needs of the tribal population. The current paper is the first part of the model of care working paper series that discusses the components of the ASARA project to highlight the impacts of the decade long efforts towards improving maternal and child care in the region.

Design of a hazard prediction system with intelligent multimodal fusion based on artificial intelligence & internet of things technology: taking a crib as an example

Problem How to design an intelligent multimodal fusion hazard prediction system using AIoT (Artificial Intelligence & Internet of Things) technology to predict some potential dangers. This article will provide some ideas and methods. Introduction This article designs an intelligent multimodal fusion hazard prediction system based on AIoT technology. The system mainly consists of an IoT hardware device and an AI multimodal and multi-dimensional Hazard Prediction Algorithm. Method This article will take baby cribs as an example, using this system to empower traditional baby cribs and transform them into intelligent baby cribs. Results In this example, the system can detect the real-time status of the baby and predict upcoming dangers, including kicking the quilt, wetting the bed, fever, crying, climbing over the crib, and turning over. Hypothesis Assuming that intelligent systems can detect the status of infants in real-time and make predictions before potential dangers occur, to promptly alert parents. Perhaps it can prevent some irreversible dangers from occurring. Background This system solves the pain point problem of parents having to take care of their babies after working hard. Purpose In this scenario, the system provides a design scheme for an intelligent multimodal fusion hazard prediction system with a temporary care function. The application of this system to baby cribs not only reduces the burden on parents but also ensures the safety and comfort of the baby. Transferability At the same time, the system has transferability, and its design concept can be transferred to other application scenarios, such as hospital care for infants, young children, or elderly patients, as well as childcare stations for abandoned children in society. Significance This innovative system design scheme has a positive significance for family harmony and social development.

The Impact of Foster Care on Child Development: The Role of Sibling Separation

This paper explores the impact of sibling relationships on children’s development within the foster care system, focusing particularly on how sibling separation affects children of different ages emotionally, cognitively, and socially. To address this, the study synthesizes existing literature and theoretical models by combining the developmental stages of children with the role of siblings in child development. Findings reveal that sibling separation at different ages leads to distinct developmental challenges: infants experience severe disruptions in attachment and emotional regulation, middle childhood separations hinder cognitive and social skills development, and adolescent separations result in long-term relational and identity challenges. Previous research underscores the importance of maintaining sibling bonds in foster care, highlighting that these relationships can provide crucial emotional support and stability, mitigating the adverse effects of family disruptions. This study emphasizes the necessity for age-appropriate actions and support services in foster care to minimize the detrimental impacts of sibling separation and promote healthy development. Additionally, it calls for further longitudinal studies to track the developmental trajectories of children separated from their siblings and consider variables such as age differences between siblings and the dynamics of step-sibling relationships. This comprehensive understanding is essential for informing policies and practices that enhance the well-being of children in foster care.

Fifteen years of training courses and implementation of child and adolescent psychiatry in Jimma, South-West Ethiopia: a single site case study

In Ethiopia, as in many other low-and middle-income countries, health professionals, particularly mental health workers, are scarce. The purpose of this case study is to describe the process of establishing training child psychiatry and capacity building to implement clinical care for child and adolescent mental health. We present a case study on training of child and adolescent psychiatry embedded within the master’s degree program in integrated clinical and community mental health at the department of psychiatry in Jimma University, Ethiopia. This program is jointly developed in collaboration between Jimma University and Ludwig-Maximilian-University, Germany. The core elements of the training were to train mental state description, making decisions on possible disorders, perform occupational activities, and design psychosocial interventions. The WHOmhGAP guide is considered as appropriate knowledgebase for our teaching program. Each course was evaluated bidirectional with multiple methods. From 2010 to 2024, twelve trainings were organized. We structured the program in three phases. The initial phase (2010–2014) was to establish collaboration with guest lecturers and to develop, implement, and evaluate the training. The second phase (2015–2019) changed to mentorship and transition from guest lecturers to local trainers and included a refresher course. Phase three (2020–2024) was independent work. An outpatient clinical service for children was implemented by the lead author and now is running at Jimma University. The implementation of the training took place in small steps. A long-term commitment of local and guest lecturers enabled to develop culturally appropriate solutions for the local context. A similar approach can be applied to effectively start and expand child and adolescent mental health care in other resource limited settings.

Competency mapping among Rashtriya Bal Swasthya Karyakram nurses in Kerala

Background: In India, birth defects, nutritional deficiencies, disabilities, and developmental delays among children cause significant public health challenges. The Ministry of Health and Family Welfare, aims to address these issues through the Rashtriya Bal Swasthya Karyakram (RBSK) program. RBSK nurses are the crucial part of this program. They screen the children between zero to eighteen years as a part of early intervention. This study mainly aimed to map the competencies among RBSK nurses from randomly selected districts of Kerala. Methods: This qualitative study employed key informant interviews with the state nodal officer, district early intervention centre managers, and district coordinators; and in-depth interviews (IDIs) with RBSK nurses, as well as report and document review. Inductive coding was applied to two selected interview transcripts from each district, followed by deductive coding with the rest of the transcribed data to derive themes. Results: The findings are presented using the ‘core competencies of public health professionals’ as revised and adopted by the council on linkages between academia and public health practice in 2021. RBSK nurses in Kerala exhibited proficiency in multiple domains, including knowledge of child health issues, clinical skills, communication, patient education, care for vulnerable population, organizing activities, electronic health record usage, multitasking, teamwork, and problem-solving skills. Conclusions: This dedication and proficiency demonstrated by RBSK nurses in Kerala, serve as a global model for emphasising the importance of early intervention and comprehensive care for children.

What challenges exist within the child welfare system in meeting the health needs of children in care?

Abstract From society’s perspective, the goal of societal care is to protect disadvantaged children and provide them with improved opportunities. In the realm of social care, the child welfare system takes the place of parental responsibilities to safeguard children’s well-being and developmental needs, including their health. However, while holding child welfare agencies responsible, national legislation often lacks specific methods for fulfilling this mandate. Over the years, evidence has shown that limited health care access and unmet health needs often endure in care. In Sweden, efforts to address the issue include mandatory health assessments upon entry into care and collaborative agreements between social services and health care sectors. However, recent studies reveal that only one-third of children undergo these assessment, and collaborative agreements remain lacking in many local authorities. This suggests that additional legal requirements do not offer a straightforward solution. Dr Forsman, with a background in social work, will discuss the child welfare system’s responsibilities and the traditional reliance on social workers and foster carers to address health needs and coordinate care. What are the underlying barriers to successful advocacy and comprehensive health care coordination within the child welfare system? How can the system better respond to the health needs of children in care?

ATUAÇÃO DA ENFERMAGEM À CRIANÇA COM LEUCEMIA E EM CUIDADOS PALIATIVOS

Introduction: Cancer in pediatrics is always a challenge. Palliative care is a difficult discussion to be dealt with the family and the role of the nurse in this matter is essential. Objective: To describe the nursing practice in children with leukemia and in palliative care. Materials and methods: This is an integrative literature review that took as a research question "what is the role of nursing in children diagnosed with leukemia and in palliative care?". To this end, the search for articles took place through the Virtual Health Library, using the following inclusion criteria: publications between the years 2019 and 2023, in Portuguese and English. Results: A total of 20 articles were included in this review, 13 of which were developed in Brazil. Discussion: To facilitate the understanding of the findings, three topics were established: the implications of leukemia in children and caregivers; nurses' role in the care of children and families with leukemia and in palliative care; Importance of the nurse's role as a health educator. Conclusions: The results emphasized an important participation of the nurse in palliative care, being part of the reception of both the child and the family members/guardians. However, there is a limitation regarding specific studies that relate to the work of nurses, palliative care and children with leukemia.

System-wide health needs segmentation: innovating integrated care for complex needs households

Abstract Background Health needs segmentation is increasingly used in healthcare delivery and health policy planning to cater for diverse population groups and develop effective and equitable health policies. But existing models often lack a systemic approach, focusing instead on single conditions or settings. This leads to fragmentation, gaps and inefficiencies in service provision and inequities in health outcomes, particularly when addressing complexity, and specifically for children, as adversity clusters in families. Aims To develop a household health needs segmentation model to identify those households with children with high levels of complex cross-sectoral needs, to plan for integrated care services. Methods Data linkage of primary, secondary, mental, community and social care services, mortality records, residential information, and small-area multiple deprivation measures was used to design a rule-based model to identifying households with children with the most complex needs in the UK region of Cheshire and Merseyside (C&M), with large variation in demography, (human) geography, and deprivation. Results Of 2,645,329 individuals in C&M (97% of the registered population in 2021), 1,022,840 lived in 266,939 households with children aged 0-16: 21,527 households had complex needs. This 8% of families accounted for an estimated 34% of health and social care costs for families, £362 million in total, 42% of which spent on children in care of local authorities. Implications The model identified a specific group of families with complex service use patterns, high mental and physical comorbidity and socioeconomic vulnerabilities. These exhibit potential for improved outcomes through better integration of services and targeting of community building and family support resources. Conclusions Our model represents a significant innovation in health needs segmentation. By using whole system linked data, it provides a pragmatic way of profiling complexity for proactive care. Key messages • Complex health and social problems in children cluster in families with adults also having complex needs, so we need to transform fragmented services to support the whole family to improve outcomes. • Household level segmentation using cross-sectoral, whole system data is an innovation to identify households with complex needs with respect to their locality to improve integration of support.

Roma mothers of infant children in the health system - a qualitative study

Abstract Background The Roma in Bulgaria constitute the third largest group - 4% of the population. Data on demographic processes by ethnicity are scarce. A national survey in 2003 found significant differences in infant mortality - 9.9‰ for Bulgarian, 18‰ for Turkish, and 28‰ for Roma infants. Poverty among Roma children, risk of poor education, especially for girls, barriers to accessing health services remain high. We aim to reveal the cultural specificity in prenatal behavior and infant care among Roma mothers in the context of the role of the Bulgarian health service. Methods In-depth interviews with Roma mothers of infants up to 1 year were utilized for data collection. To ensure heterogeneity among the interviewees, several “nests” with varying socio-cultural status in the Varna district were identified in advance for participants recruitment. A list of interview themes concerning respondents’ relationships with the public health system with an emphasis on the experiences of mothers was drawn up. Results Ten interviews with mothers having between 1 and 7 children were conducted in 2023. The mothers recounted discriminatory experiences during their interactions with certain health facilities (maternity wards), which act as barriers to accessing and utilizing health services. Maternity and infant counselling services are highly esteemed with favorable influence on child health outcomes. There has been a positive shift away from early marriage and childbirth towards prioritizing education for Roma girls. Mothers prioritize their children, and there is no neglect in their care. Family relations and support are being upgraded, with Roma fathers becoming involved in child care. Respondents express their educational needs and hopes for community-based support to better cope with their roles as mothers. Conclusions Ethno-cultural factors shaping the mother’s role maintain traditional family support, while also reflecting significant modernization that needs societal support. Key messages • A glimpse into people’s experiences of the healthcare system - a clue to its effectiveness. • Тhe ethno-cultural factors in Roma are subject to modernization.