Reproductive health services use by the Roma minority women in Romania

Abstract

health services in Cork and Kerry so that this research may inform how future policies and service provision can be targeted towards addressing these specific needs. Specifically, the objective is to determine the perceived barriers and facilitators to accessing sexual health services among asylum seekers, and to get an understanding of the overall lived experiences of asylum seekers when accessing these services. Methods: This is a qualitative study which utilised data from 14 semi-structured interviews conducted with asylum seekers between May and June 2019. Participants were over 18 and living in direct provision in Cork or Kerry. This study used a content analysis to interpret the data and develop categories which produced the results. Results: Participants demonstrated varying levels of understanding of sexual health and sexual health services. Several barriers and facilitators were identified which can be grouped into socioeconomic , political/legal, systemic, and social/cultural/reli-gious barriers and facilitators. Conclusions: The findings from this study highlighted several areas for improvement in the provision of information and services relating to sexual health for asylum seekers and revealed the importance of addressing these issues to fulfil the purpose of public health by promoting health, preventing disease and prolonging life for all members of society. Key messages: There are varying levels of knowledge around sexual health and access to services among asylum seekers in direct provision. There are several barriers and facilitators to sexual health and access to services among asylum seekers and these highlight the areas of improvement that can shape future policy and service provision. Backgound: In Romania Roma women are vulnerable to pregnancy-related events, unwanted pregnancies, stillbirth, abortion and cervical cancer. This paper aims to analysis the use of reproductive health services, family planning, prenatal care and screening for cervical cancer by Roma women. Methods: A secondary analysis was performed on the data of the Reproductive Health Survey in Romania 2016, of a subsample of 314 Roma women, aged 15-44 years. Results: 2/3 of Roma women had their first pregnancy in adolescence, 66.9% between 15-19 and 8.4% under 15 years of age. 65.4% Roma adolescent girls had their first child at 15-19 years, and 2.8% at ages under 15 years. During pregnancy, 24.1% of Roma women do not use prenatal care services, three times more than the women from the reference population (7.1%) (p < 0.01). 73% of Roma women have never benefited from cervical cancer screening compared to 42.7% in the general fertile female population. 46, 7% of Roma women use any type of contraceptive method and 38.1% modern methods, a closed prevalence of contraception in the general population of fertile women (48.4% of any method and 38.7% modern methods) Conclusions: Roma women have their first pregnancy in adolescence. There are inequalities in the use of preventive services for prenatal care and cervical cancer screening of the Roma female population compared to the reference female population in Romania. Public health policies should include specific active measures for Roma women to improve their access to preventive services. In order to prevent unwanted pregnancies, public health policies in Romania should include family planning measures addressed towards all women, but using methods culturally adapted to the Roma population. Key messages: There are inequalities in sexual reproductive health services use of Roma minories women I Romania. Services and active preventive mesures should be adressed to Roma populationtion. 9.A. Workshop: The contribution of Environmental Impact Assessments to better health objective is to consider ethical, legal and methodological issues raised by the requirement for health to be considered in the EU Environmental Impact Assessment (EIA) Directive. This roundtable will cross-examine the advice that EUPHA wrote with the International Association for Impact Assessment (IAIA) to guide health authorities through the EIA process. See https://eupha.org/section_page.php?section_page=200. We contend that human health in EIA cuts across many aspects of public health and that public health must up its game. The EIA Directive provides a high level of protection to the environment and health on land and at sea. It applies to a wide range of projects in all EU Member States, including those co-financed by the EU through its Cohesion, Agricultural and Fisheries Policies. It applies to projects funded by the financial institutions of the EU which operate globally. The directive explicitly requires human health to be considered and yet gets little input from health authorities. EIA is a forward-looking instrument. EIA provides information to a decision-maker before effects occur. This allows for environment and health to be hard-wired into the design of a project. It places public health at the heart of deliberations about the future of infrastructure and the built environment. Format: the roundtable will open with an introduction to the process of EIA and the EUPHA/IAIA reference paper. Panellists will then question the speakers. The chairperson will invite questions from all participants. The organisers will generate debate on social media. Areas of inquiry are provided below: Ethics: The construction and operation of projects can have good and bad effects on communities, and these effects can go beyond the current generation. What ethical principles should guide the design of these projects? How can an ethical EIA be iii236