Table 5 Policy Recommendations

   1. Until such a time as political will to legalize informal settlements exists, the current settlements should be equipped with temporary house numbers. In addition households should register with the local authorities to confirm their residence status.

   2. An integrated strategy at the national level that allows Roma to register their permanent address as a local community centre needs to be implemented as an interim solution.

   3. Standardization and training to guide administrators on when to reduce fees would help maintain consistency and minimize discrimination.

   4. Review the registration procedure in order to determine where the process is arduous and implement administrative processes that overcome these barriers. For example, representatives within the settlements could be hired to assist in Roma the completion of necessary forms as well as educate on the application process.

   5. An evaluation of the Roma health mediator program should be conducted in order to determine whether the program is working. This should be completed in conjunction with a publication of best practices from the evaluation.

   6. The number of unregistered persons needs to be determined so that registration processes undertaken by the UNHCR and Praxis may be monitored as they continue to persevere with the registration of chronically unregistered Roma.

Availability of Physicians

   7. Although the availability of physicians is not an issue that disproportionately affects the Roma, research into the root causes of why persons do not have a chosen practitioner should be undertaken. With this knowledge, an integrative plan that takes into account the recommendations from the 2006 World Health Report and Global Health Workforce Alliance should be developed.

Geographical Accessibility

   8. Geographical accessibility for rural Roma should be made a priority and evaluation of the feasibility of identified interventions would be helpful within the Serbian context.

Affordability

   9. Out-of-pocket payments for both services and medications should be reduced or eliminated as rapidly as possible.

Discrimination

   10. A comprehensive sensitivity training program aimed at all levels of health workers needs to be implemented; this includes training in the medical and nursing schools as well as sensitivity training in the workplace. In addition, internships in Roma settlements for medical and nursing students may improve relations.

   11. The continued assistance to individual Roma persons to help realize their rights is important as this creates a culture of empowerment.

   12. Public campaigns educating Roma on their rights, including the right to healthcare need to be implemented as a priority.