Which CoHeReNt members are involved?
Daniela Fiľakovská Bobáková (daniela.filakovska@upjs.sk)
Andrea Madarasová Gecková, Peter Kolarčik, Lucia Bosáková, Zuzana Dankulincová Veselská, Shoshana Chovan, Stanislava Kováčová, Jana Plavnická, Emília Gajdošová

What does the team do?
The team researches the pertaining Roma versus non-Roma health disparity from an applied perspective with a specific focus on the most vulnerable, marginalized Roma communities. Our goal is to explore and provide culturally sensitive and practice-informed scientific evidence about health and psychosocial determinants of health in vulnerable groups of population in Slovakia directly applicable in policymaking and designing interventions to solve the discrepancies in health and promote quality of life. We study the disparities in the health outcomes and exposures, and particular mechanisms within the specific context of marginalized Roma communities. Currently, we focus on inequalities beginning in early childhood.

What methods does the team use?
To study the inter-ethnic disparities and to identify potentially involved exposures and social determinants we use mostly mixed-methods participatory designs.

What are the team’s most remarkable projects?
At present, we conduct the RomaREACH study (Research on Early Childhood in marginalized Roma communities) which aims to bring a more comprehensive understanding of the mechanisms influencing the psychomotor development of children from conception to the three years of age in marginalized Roma communities taking into account the broader context of socio-cultural disadvantage and the related exposure to environmental factors endangering the health and healthy development of children. A significant benefit from a methodological perspective is an effort to consider early childhood development and the factors influencing it, in its complex entirety, and by using a longitudinal design, bring a higher quality of findings in comparison with cross-sectional studies. The project is innovative from the perspective of transferring the findings obtained in the basic research into immediate practice, through a unique collaboration with various stakeholders, including the Ministry of education, science, research and sport of Slovak republic, Ministry of Health, The Research institute of child psychology and patopsychology, various non-governmental organizations and others.

This work as a part of the project “Research on early childhood in marginalized Roma communities: contextual factors of psychomotor development in the first 1000 days.” was supported by the Research and Development Support Agency under Contract No. APVV-19-0493 and by the Scientific Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic and the Slovak Academy of Sciences, Reg. No. 1/0593/21.

The team is also involved in the H2020 RIVER-EU project “Reducing Inequalities in Vaccine uptake in the European Region – Engaging Underserved communities” (https://river-eu.org/). 14 renowned institutions from ten countries work together to collect evidence on health system determinants of high and low vaccine uptake in eight specific contexts including marginalized Roma communities in Slovakia, which will be used to identify and/or develop interventions to reduce barriers to vaccine uptake in underserved communities and increase trust in the health system. RIVER EU aims to reduce health system barriers to vaccination against human papillomavirus (HPV) and mumps, measles and rubella (MMR) in different ethnic minority populations in the European region where vaccine uptake is low. Target populations and vaccines studied per country are 1. the migrant community in Greece, where both HPV and MMR vaccinations are studied, 2. HPV vaccination among adolescent females with a Turkish or Moroccan migration background living in the Netherlands, 3. HPV and MMR vaccination among Ukrainian migrants living in Poland and, 4. HPV vaccination among the marginalized Roma communities living in Slovakia. RIVER-EU will design, implement and evaluate interventions to improve access to vaccination using a co-creative and collaborative approach. The lessons learnt will be collected in a set of evidence-based guidelines and implementation recommendations and disseminated to health policymakers and professionals across Europe to improve the performance of vaccine programmes and reduce vaccine inequalities.

RIVER-EU is funded by the European Union Horizon 2020 Research Programme No 964353 called SC1-BHC-33-2020 Addressing low vaccine uptake.

Past projects

Firstly, our team focused on health and health-related behaviours of Roma adolescents in comparison to non-Roma and succeeded to shed more light on various aspects of their lives.

Our HepaMETA project, conducted in 2011, earned a series of rigorous comparative studies which helped to expose for the first time with the use of clinical data the steep health-outcomes disparity between segregated Roma and local non-Roma populations in Slovakia. The project also shed light on many involved exposures and social determinants.

Since 2011 we were engaged in 7FP SHOPHIE Evaluating the impact of structural policies on health inequalities and their social determinants and fostering change, within which we conducted a multi-perspective qualitative study focused on employment of segregated Roma. Based on this study we started to cooperate with the WHO. This cooperation resulted in WHO key publication focused on context, mechanisms and outcomes of Roma employment project and explaining how increased employability results in improved wellbeing and health.

Our applied qualitative research on the health system limitations of Roma health in Slovakia, funded by the WHO in 2013 identified many important whys and hows regarding the existing health-care access barriers for segregated Roma in the country.