Community based approach to address health disparities among Roma in North Macedonia
Bibliographic record
Abstract
Abstract Issue Roma represent vulnerable group regarding health and health outcomes. Most health research and policies perceive Roma as a coherent group, although there are disparities within different subgroups. This is due to social determinants of health and other causes. Perceiving Roma community as monolith group may result in provision of activities for persons that don’t have need and leaving behind the vulnerable. Situation is similar with other marginalized and vulnerable populations. Description In 2016 started community based intervention including social accountability and legal empowerment regarding coverage,quality of health services and health rights violation. Work conducted in ShutoOrizari municipality with estimated 30.000 Roma. In 4 localities where most vulnerable Roma live, each comprised of 200 households. 2 persons from Roma NGOs and 4 community members work as team in 1 locality. Mapping of the community conducted and community inquiry. Findings shared with the community members. Findings used to conduct education of community and toconduct advocacy on local and national level with community participation in 2018for improvement of coverage and quality of services. Results Approach identified disparities among Roma.1256 persons surveyed from 4 localities. 4 localities have high unemployment rate (above 70%),monthly income related to the locality (p < 0.0002). Disparities in health and access to health services among localities noted. Self-reported health status is related to locality(p < 0.002). Coverage with health services also,including having registered gynecologist(p < 0.001),regular gynecological examinations(p < 0.00001),antenatal care(p < 0.0003). Lessons Identifying needs among Roma living in smaller localities enables tailoring of health interventions based on needs. Identification of the problems on micro level is relevant for the community concerned,increasing their involvement in demanding improvement and advocacy. Key messages Working in strictly defined localities/groups from Roma communities provides accurate insight in the health related issues. Working with defined localities/groups enables greater involvement of the community in advocacy for fulfillment of their rights.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.027 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.003 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".