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Title: Taking stock of Roma health policies in Spain: lessons for health governance
Authors: Escobar-Ballesta, M.
García-Ramirez, M.
Freitas, C.
Keywords: Roma
Health policy
Policy assessment
Migration and health
Wicked problem
Issue Date: 2018
Publisher: Elsevier
Abstract: Roma health inequities are a wicked problem. Despite concerted efforts to reduce them under the Decade of Roma Inclusion initiative, the health gap between Roma and non-Roma populations in Europe persists. To address this problem, the European Commission devised the National Roma Integration Strategies (NRIS). This paper provides a critical assessment of the implementation of the NRIS’ health strand (NRIS-H) in Spain and proposes an evaluation tool to monitor Roma health policies – the Roma Health Integration Policy Index (RHIPEX). It also makes recommendations to promote Roma health governance. To achieve these goals, four community forums, 33 stakeholder interviews and a scoping review were conducted. Results show that the NRIS-H implementation is hindered by lack of political commitment and poor resource allocation. This has a negative impact on Roma’s entitlement to healthcare and on their participation in decision-making processes, jeopardising the elimination of the barriers that undermine their access to healthcare and potentially contributing to reproduce inequalities. These unintended effects point out the need to rethink Roma health governance by strengthening intersectional and intersectoral policies, enabling transformative Roma participation in policymaking and guaranteeing shared socio-political responsibility and accountability.
Peer reviewed: yes
DOI: 10.1016/j.healthpol.2018.02.009
ISSN: 0168-8510
Accession number: WOS:000434748400015
Appears in Collections:CIES-RI - Artigos em revista científica internacional com arbitragem científica

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