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A Citizen’s Guide to Greece 2015


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February 17, 2016

Barriers to healthcare access for Roma women in Thessaloniki

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Written by: Politis

As part of the Social Science 399-Service Learning class during the Fall 2015 semester at the American College of Thessaloniki, study abroad student Megan Yuan, a Public Health major from Rutgers University, undertook primary research among one of the most marginalized and disenfranchised demographics: Roma women. Through the Service Learning class, co-taught by Ruth Sutton and Maria Patsarika, Megan met Roma women from two communities in Thessaloniki over a period of four months to experience first-hand the issues they face in accessing healthcare and medical advice and to suggest practical, feasible ways to overcome these. The research was undertaken with the support of the Michael and Kitty Dukakis Center for Public and Humanitarian Service at ACT.

by Megan Yuan

This research strives to identify barriers to healthcare access for Roma women in communities in Thessaloniki, and propose an intervention that will support Roma women’s knowledge on healthcare and healthcare access.

The Roma community in Europe is considered one of the most major ethnic minorities in the world, characterized by a nomadic lifestyle, social exclusion, and poverty. Ioanna Petraki writes “Health Status of Roma People” (2012) that altogether, the Roma have shown greater prevalence of health issues such as communicable diseases, low birth rate, malnutrition, and preventable injuries. The Roma community in Thessaloniki, Greece, is no exception. Existing research, such as EUMC’s “Breaking the barriers – Romani Women and Access to Public Health Care” (2003), has described Roma women as particularly vulnerable due to socio-economic cultural barriers, oppression, illiteracy, and rigid gender roles in the community. The report also suggests that they are often the health mediators for their own families, so it is particularly important that they are given health education on caring for themselves as well as their families. According to one of the European Union’s reports called “Health and the Roma Community, analysis of the situation in Europe” (2009), several examples of Roma women’s health disparities include: lack of knowledge about pap and mammography screening, limited visits to the gynecologist, limited use of contraception, and high prevalence of miscarriage. In light of such existing findings, there is value in investigating the causes of these issues, exploring the contexts in which they occur, and identifying the specific health barriers of Thessaloniki’s Roma women so that the Dukakis Center, as well as other parties interested in improving Roma health, can utilize this knowledge to improve health interventions in Thessaloniki.

Research was based on open-ended interviews conducted with 6 Roma women from the Aghia Sofia settlement aged 35 to 70, a focus group of 4 teen girls from the Roma community of Dendropotamos, aged 14 to 15, and overall observational research that added valuable contextual and background data.

Interviews were conducted with the help of the Roma community’s gatekeeper, who was an interpreter and mediator between the interviewer and participants. Due to the intermediary and interpretivist nature of the interviews, questions were often rephrased, repeated and simplified, thus impacting the data received. This participative approach allowed participants to identify their own salient issues, as well as helped to contextualize their health issues into broader social problems. Questions of both the interviews and the focus group focused on 3 categories: 1. the female gender role in the context of Roma culture; 2. doctor- patient interaction; 3. pregnancy and motherhood. The responses of the participants were analyzed and specific barriers were categorized.

Based on anecdotal and observational data, specific health barriers of the Roma women were identified and categorized: 1. illiteracy; 2. language and communication; 3. transportation; 4. financial issues; 5. discrimination; and 6. generational and cultural norms. Though discrimination from the Greek healthcare system was a common theme, differences were clearly seen from the disparity in education levels and degree of social integration; the women of Agia Sofia, who are unregistered and illiterate, encountered far more health barriers and communication issues than the girls of Dendropotamos, who are registered citizens and literate. Furthermore, 5 of 6 women in the Aghia Sofia settlement mentioned that doctors did not advise them on diet and lifestyle changes during pregnancy, and 4 of 6 women mentioned that they did not change their diets during their pregnancies.

Though six different barriers were brought up, it is clearly seen from the responses that all of these barriers are interrelated. For example, one can not address communication without addressing illiteracy. Likewise, one can not address illiteracy without addressing transportation and financial issues. However, from comparison with the girls of Dendropotamos, it is safe to say that the addressing of these complexity of issues need to start with literacy and social engagement. Despite facing similar stereotypes and discrimination as the women of Agia Sofia, the girls of Dendropotamos show that because the social environment have supported them more, and because they have been exposed to more knowledge, they can be assertive in claiming their societal rights. A mentoring program between the girls of Dendropotamos and the girls of Aghia Sofia will be suggested to interested parties as a possible intervention plan to alleviate the effects of illiteracy and promote future social integration. A sense of empowerment will also hopefully break the cycle of dependency on the men and husbands of the community.

Furthermore, 5 of 6 women interviewed responded that an educational pamphlet about lifestyle change and diet behaviors during pregnancy would be helpful to them. A pamphlet with pictures rather than words, given their illiteracy, will serve as an educational tool for the Roma women of Aghia Sofia. Since the women share information and general knowledge, information from such a pamphlet can be integrated into their pool of general knowledge. The majority of the women also mentioned that they were the main health mediators of the family, thus enforcing the claim and findings of existing literature. Therefore, it is even more pertinent that they are given health education on caring for themselves as well as their families.






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