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The project is an initiative, which aims to introduce community monitoring of healthcare services provided to minority ethnic communities in Bulgaria, in order to reinforce the” bottom – up” advocacy, which will give the local communities the opportunity to take part in policies and processes of governing on local level, will improve the health services and health status of Roma and other ethnical groups in the long-term plan.

            Goal of the project is to develop, test and evaluate a mechanism for local community mobilization, using the “social audit” method in the municipalities of Veliko Tarnovo, Gorna Oryahovitsa and Pavlikeni.

            An additional aim is to create preconditions for further expansion of the model in other municipalities and regions in the country during the next year of the program, which has started in the beginning of 2011 and is now in its second year of implementation.

Our team has been searching for pro-active people, with potential and ready to work for their community and who believe that things depend on themselves only and their personal involvement and their civil activity.  

            We have visited many towns and villages, talked to the people from the local communities, met local leaders and representatives of the local administration and after a short evaluation period, already for the second year we have been working in Kaltinets (town of Gorna Oryahovitsa), Vodoley and Ledenik villages (Veliko Tarnovo municipality) and Batak, Varbovka Stambolovo, and Byala Cherkva (Pavlikeni municipality)

Our first task was to support small initiatives of local importance, which will lead to community mobilization, which then will make people believe in their own vires and potential. Those was different sport and cultural events on local level.

            From the beginning of the project in 2011, 3 researches on the “community inquiry” method were held. This includes interviews literally from door to door and aims to check the access to healthcare of the people. Some of the questions concern the health insurance status, female and child healthcare, emergency, clinical and medical care.

            In the last research in August – September 2012, 498 respondents participated, women at age between 18 and 60. The inquiry was held by 50 volunteers, who were previously trained on working with the questionnaire cards and the specific problems.

The results show that 52.2% of the surveyed women are not health insured.

21.68% of the respondents gave negative answer to the question if the GP arrives if they call him when necessary. 14% say they do not know or they haven’t called him.

Asked whether they pay check-ups by the GP (besides the user’s tax) 51.6% answered "yes" and 1% did not know whether they are paying for that.

When asked "Do you feel discriminated against because of your ethnic origin by medical personnel?" 30.12% of the respondents gave positive answer.

36.5% of respondents say that their children do not attend annual prophylaxis medical examination, and 3.4% answered that they either do not know the answer to the question, or that the doctor did not tell them that the child has to go to such check-up.

When asked whether their child goes for prophylaxis dental examination, 49% said "no" and 5.8 percent did not know whether this has happened.

When asked "Do you visit a gynecologist regularly (at least 1 time per year), 71% said they do not.

Another disturbing trend that comes as a result of the survey is extremely limited access to emergency care. Study there showed that 23.09% of respondents say that when called, the ambulance arrives at the scene for 10-15 minutes. 37.75% say it takes 20-30 minutes, according to 11.04% - for an hour or more, and 4.01% said that paramedics refused to send an ambulance. When speaking on the topic, some respondents said that in their villages there were fatal cases because the ambulance took too long to arrive, or did not arrive at all.

For the purposes of program Center Amalipe established local centers for Community Development, whose activities are coordinated by two Municipal Center for Community Development, located in Veliko Tarnovo and Pavlikeni. The centers are working on issues of community mobilization and support the process by which the problems of individuals are being identified as community problems, which is the first step in attacking the problem issues.

Another major goal of the Community Monitoring of Healthcare Services is to promote the interaction of local people with health authorities at the local level and that includes GPs and dentists, hospitals, Regional health inspectorate and emergency medical care facilities because citizens are those who have to hold institutions accountable for quality and accessibility of healthcare services.