Community of Practitioners on Accountability and Social Action in Health
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Association for Emancipation, Solidarity and Equality of women in Macedonia - ESE

Context

Association ESE provides technical support and training for a group of CSOs working on community monitoring on local level with the Roma minority communities in seven municipalities in Macedonia. The community monitoring work is conducted regarding the coverage of Roma children with immunization and preventive health care services and currently we have started expanding the work on the issue of coverage of Roma women with preventive gynaecological services. ESE provides technical assistance to partner Roma CSOs in following issues:
  • Development of methodology and relevant materials for empowering the Roma communities for their rights regarding health, with special emphasis on the right to immunization and preventive health care services for their children,
  • Development of methodology for the community inquiry in Roma communities, including development of the tools for the inquiry and methods for conducting the inquiry on the field,
  • Development of methodology and direct assistance in preparation of the community score card,
  • Assistance in preparation of the requests for access to information,
  • Assistance in preparation of different documents for the needs of the ongoing work of the partner Roma CSOs,
  • Assistance in preparation of the local level advocacy plans for each municipality where partner CSOs work,
  • Enabling ongoing communication and experience sharing among the partner CSOs
  • Ongoing consultancy in the everyday work, according to the needs of the partner CSOs.
Website
http://www.esem.org.mk/
Area of Work
Eastern Europe
Contact Person
Jasminka Friscik
Despite of that ESE is coordinating the advocacy efforts on national level. In course of this work ESE facilitates the process of development on national level advocacy strategy, develops the needed documents for national level advocacy and coordinates the advocacy activities on national level.
Adjacent to the community monitoring work, ESE is conducting applied budget work in order to promote transparency and accountability of the Government on the issues of Roma health (immunization and gynaecological services). Through the applied budget work we are monitoring the implementation of the policies and activities aimed for improved coverage of Roma children with immunization and preventive services, as well as policies for increased coverage of women with preventive gynaecological services. Both findings from community monitoring and applied budget work are used in the national level advocacy in order to improve coverage of Roma minority with these services.

Approaches to implementing Community monitoring/accountability

Macedonian Government has adopted several policies and measures aimed for improvement of Roma health, including specific measures for increased coverage of Roma children with immunization and preventive health care services (including community nurse visits, outreach activities, health education, regular medical check-ups etc.). Despite of the commitments by the Government there are still gaps in coverage of Roma children with immunization and preventive services.

Through the continuous monitoring on the implementation of these measures within the Roma communities from one side, and monitoring on the national level implementation from the other side we provide clear evidence where are the gaps and obstacles in the implementation of these policies. Evidence gathered on local level is used by our partner Roma CSOs, with our technical assistance in order to hold the local health authorities accountable for implementation of these policies and measures. Evidence gathered on national and local level are used in order to hold the national level health authorities for continuous non proper implementation of the provided policies and measures.

In our advocacy activities we are constantly reminding the Government on the obligations that are undertaken regarding the Roma health and the continuous lack of implementation of these services.

Results and lessons

  • The strength of the type of community monitoring undertaken by Amalipe is its ability to transform the relationship between communities, service providers and decision-makers at the local level. It focuses on community experience as the central indicator for assessing both access to and quality of services. Strengthening community mobilisation as well as establishing sustainable community structures (such as Local Community Development Groups, Community Development Centers)appears as an essential element of the model. 
  • Amalipe is now leveraging their monitoring efforts to promote the validity of community experiences to inform policy and practice and secure additional space for civil society and community participation. For example, in early 2012, the Bulgarian national Roma strategy and action plan was approved by the Parliament, but it did not contain provisions for the inclusion of civil society participation and/or community perspectives in monitoring or specify ways to strengthen government’s own monitoring mechanisms. In June 2012, Amalipe organised an European Commission Hearing on the monitoring components of the national Roma strategies and action plans. By influencing the monitoring aspect of the national strategies and action plans, we hope to complement our community monitoring work and create additional space for advocacy based on community experiences. 
  • In the future, Amalipe proposes to expand the community monitoring work throughout Bulgaria using a network of community and health-social centers we have established with EU funds. We hope that this strategy will help ensure that the results of multiple monitoring efforts are relevant for national advocacy.
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