Interview with Sebihana Skenderovska, coordinator at the National Roma Centrum


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“From increased voice to the improved health care access” is a project of the National Roma Centrum which aims to help pregnant women who are beneficiaries of social welfare, and are unable to afford the participation for antenatal check-ups. spoke with the coordinator of the project – Sebihana Skenderovska about the activities undertaken by the National Roma Centrum in order to help this vulnerable category. Respected, first of all, can you explain briefly what does the Association National Roma Centrum represent, and what are its goals and activities?

Sebihana Skenderovska, coordinator of the health program in the NRC: NRC is an association established in 2005 and which works and acts in the field of human rights through advocating, providing free legal aid, researches, and direct field work. As the name suggests, NRC’s target group is the Roma population, but in no way do we exclude other citizens who need our help. Our vision is an integrated and a prosperous society for every citizen. At the moment, the NRC is well known through the project “From increased voice to the improved health care access”. Can you tell us something more about this project and the reasons which inspired you to realize it?

S. S.: The project “From increased voice to the improved health care access” aims to help the women in the Republic of Macedonia, who receive social welfare, and face financial difficulties and can’t afford the participation for antenatal check-ups. In 2011, the NRC conducted a research through focus groups in five cities in Macedonia: Kumanovo, Kriva Palanka, Stip, Bitola and Kocani. Using the method of a structured questionnaire we analyzed the use of antenatal and postnatal services of women who gave birth in the past 5 years and are aged 15 – 49. We interviewed 103 women who voluntarily took participation in the focus groups and shared the experiences of their pregnancy and delivery, as well as of the services provided by the patronage nurses. Most of them told us that they experienced discrimination, and the biggest barrier for not having regular antenatal check-ups was the financial participation, which must be paid for most of the check-ups during the antenatal period. Do you have any information how much this participation costs?

S. S.: According to the Guideline for antenatal controls, established by the Ministry of Health, every woman should have 10 antenatal check-ups. According to the established prices by the Health Insurance Fund, every healthcare insured woman who is a recipient of a social welfare should has average expenses of 300 – 500 MKD per month for gynecological check-ups during her pregnancy. Calculating the percentage for participating in the payment, established by the Health Insurance Fund (up to 20%), every woman must pay 2.240 MKD for the check-ups. For the women who receive a social welfare of 1.000 – 3.000 MKD, that sum is a fortune for their survival. According to you, how can the socially endangered women be helped?

S. S.: The state should provide an unobstructed access to the antenatal services for all women, social welfare users, without participation fee. Because of this, we directed our activities in advocating for the lifting of the participation by the state for the healthcare insured women who are recipient of a social welfare. We ask of the state to cover to cover the participation of 2.240 MKD. We calculated that the total cost for antenatal check-ups for 32.222 women would be 3.1 million MKD, or about 50.500 EUR per year, which is not a huge sum, and would help the women who receive social welfare. Which activities are undertaken by the NRC for the realization of the project “From increased voice to the improved health care access”? Do you believe in the achievement of your goal?

S. S.: Besides the institutions, which are familiar with the financial estimation and legal analysis, regarding the project, we’ve had many media appearances in order to raise the awareness of the population. We’ve realized 5 projects and interviewed 100 women, with the aim for them to use their rights as patients. In every city in which we worked, we had a media appearance. We organized two roundtables from which we have conclusions which should be act upon. We had meetings with Macedonian MPs in order to promote the idea and to get the state to adopt it and cover this sum for the women who have economic problems. We had meetings with the Committee for safe motherhood, the Commission for health in the parliament, the Commission for labour and social politics, the Commission for education, etc. The NRC strongly believes that this project will receive big support from the public and from the state structures, and by realizing its goals we will help many pregnant women to have a free access to the antenatal check-ups, which will help reduce the number of infant mortality and underweight newborns. The prevention means a qualitative life and a more economical expenditure in the healthcare system, rather than the curing, which is of great importance for every country in these times of crisis. Respected, we wish you a successful realization of the project.

S. S.: Thank you.


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