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On 5 April 2011, the European Commission adopted an EU Framework for National Roma Integration Strategies up to 2020, calling on Member States to prepare or revise National Roma Integration Strategies to more effectively address the challenges of Roma inclusion. In April 2014, the Commission presented its third assessment. EPHA provides a preliminary analysis of these recommendations, where they relate to Roma health, for each of the 28 EU Member States, ahead of discussions at the 2014 EPHA Annual Conference on 4 and 5 September.

On 5 April 2011, the European Commission adopted an EU Framework for National Roma Integration Strategies up to 2020, calling on Member States to prepare or revise national Roma Integration Strategies to address more effectively the challenges of Roma inclusion and tangibly improve their situation by the end of the current decade. This EU framework addresses the specific needs of Roma regarding equal access to:

  • employment,
  • education,
  • housing,
  • healthcare.

Member States were requested to prepare or revise their national Roma integration strategies and present them to the Commission by the end of December 2011. The Commission reports annually to the European Parliament and to the Council on progress on the integration of the Roma population in Member States and on the achievement of the integration goals.

The first assessment of the National Roma Integration Strategies was published in May 2012. The document entitled National Roma Integration Strategies: a first step in the implementation of the EU Framework revealed that although progress has been achieved, Member States, especially those with a sizeable Roma population, need in particular to:

  • Continue regular bilateral dialogue with the Commission and relevant stakeholders
  • Involve regional and local authorities
  • Work closely with civil society
  • Allocate proportionate financial resources
  • Monitor transformations and enable policy adjustments
  • Fight discrimination convincingly

In June 2013, the Commission released its second assessment, entitled Steps Forward in Implementing National Roma Integration Strategies. This document provides two main findings: some Member States significantly re-thought or developed their strategies in concrete terms, in particular by seeking to organise horizontal and vertical dialogue, as well as coordinating the implementation of their strategies. However, some of the necessary preconditions for successful implementation are still not in place and progress in practice is therefore very slow.

At the beginning of April 2014, the Commission presented its third assessment. This report looked in particular at the measures that have been implemented, whether guidance provided in previous Commission progress reports has been followed, and whether there has been real impact in practice. It is composed of two documents:

The Report on the implementation of the EU Framework for National Roma Integration Strategies; this general report describes the broad on-going developments in EU Member States and lays down examples of good practices.

– The Commission Staff Working Document (SWD) provides an in-depth analysis and describes the key steps achieved since 2011 and further action that should be developed. For each country, the situation is summarised in a table which addresses each of the five sections:

  • education
  • employment
  • health
  • housing
  • anti-discrimination

Access to healthcare is just one element of the social determinants of health in the Roma framework. The recent 2014 Commission assessment pointed out that in the field of healthcare adequate access to healthcare, social services and preventive measures are still not available for all Roma, especially for Roma children and women. Little or no health coverage often means no access to vaccinations and susceptibility to infectious diseases . Promotion of healthy lifestyles also needs more attention from Member States. The issue of Roma Health Mediators has been mentioned in relation to several Member States: Belgium, Bulgaria, Finland, Romania, Slovakia, Spain, Sweden and the United Kingdom. The Commission recognises that the training of health professionals and the systematic involvement of Roma health mediators could be a way to address the Roma’s access to healthcare issue.

In the following document, EPHA has compiled health-related information for each of the 28 EU Member States.


The Report on the implementation of the EU Framework for National Roma Integration Strategies concludes that in the field of health, healthcare and basic social security coverage is not yet extended to all. There are promising initiatives that have been developed since the launch of the framework, but they need to be mainstreamed and applied in a systematic way. Consideration should also be given to preventive health measures. In addition, particular attention to Roma children needs to be given.

As regards the report itself, it is regrettable that there is a lack of precision in certain sections of the text. Nevertheless, concrete examples described in the general report are constructive, as they provide other Member States with good practice examples to develop new measures. However, sharing good practice is only effective if other stakeholders are willing to listen and consider it. Therefore, demonstrating political will and determination to improve the Roma situation in Europe is essential. Besides the field of health, it is worth highlighting that the report mentions several times the discriminatory practices that happen in the property market. This must also be addressed as the physical environment in which people live also impacts on their health.


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