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The first thousand days of a child’s life are vital for their optimal physical and mental development and the realization of their full potential. The lack of adequate nutrition, quality healthcare and prevention services, vaccination, affordable medicines, learning activities, child protection measures, and opportunities for decent housing and safe living influence children’s life trajectories, resulting in social and health inequalities which will affect the rest of their lives. Therefore, early interventions are essential for reducing disparities between population groups and achieve social justice across Europe, especially for Roma – the most marginalized and disadvantaged population in Europe.

Despite the implementation of the National Roma Integration Strategies in recent years, Roma children remain widely exposed to poverty and social exclusion affecting living conditions, mother and children’s health, child safety and early childhood development as a whole. Substandard living conditions, outdated or missing infrastructure, poor access to drinking water, and public services such as waste management and public transportation, are additional barriers for Roma children preventing their healthy growth. Consequently, Roma are highly vulnerable to poor health and health inequalities, which have continued to widen in the wake of COVID-19.

Tackling inequalities in health, education and living conditions from the first years of life must be a priority for the EU’s post-2020 Roma Equality and Inclusion framework as well as the National Strategies which will be developed by EU Member States. They should promote a positive and sustainable change regarding the social and economic situation of Roma population whilst combating the discrimination and social exclusion of Roma children.

The International Step by Step Association, in cooperation with the European Public Health Alliance, the Romani Early Years Network, the Institute for Development Policies (Romania) and Skola dokoran (Wide Open School-Slovakia) have made several recommendations in the strategic areas necessary to ensure every child gets the good start in life they need, and are based on the Nurturing Care Framework for Early Childhood Development promoted by the World Health Organization and aim to address the disparities in access to health, housing, income, social and early childhood development services of vulnerable Roma children, focusing on the crucial period between birth and 3 years of age.

These recommendations are the result of a project implemented in Slovakia and Romania, involving strategic stakeholders, including Roma communities and health mediators advancing a comprehensive and holistic policy approach towards early childhood development. Although the project activities have been implemented in Romania and Slovakia, the project findings provide a strong basis for improving early childhood development services across all EU Member States and make them more inclusive and sustainable by addressing the public health, social, economic, environmental and human rights issues faced by Roma children.