Health Statistics

Revision of National
Action Plans
For the National Program for Roma /
Decade of Roma Inclusion
Jaroslav Kling, UNDP Bratislava
November 2011
Why revision of NAPs?

New social and economic situation of target group
after few years of implementation of previous NAPs

New external conditions – Decade of Roma Inclusion,
EU Framework for the National Roma Integration
Strategies; financial and economic crisis

Strong push for RESULTS oriented policies and their
monitoring and evaluation
Roma Integration Strategy 2020, Slovakia

Utilized recently finished work on revision of Decade
NAPs in 2010-2011
 1-year
long consultation process including line ministries,
academia and NGOs
 Adopted by the Slovak Government together with the
financial coverage (2011-2014)

Framed in the EC Communication from April 8, 2011
 Based
on evidence (Atlas of Roma Communities in
Slovakia, 2004; UNDP Survey on situation of Roma in
Slovakia, 2005 and 2010; UNDP Regional survey on
marginalized Roma, 2011 and respective analytical pieces
(e.g. by the World Bank))
Roma Integration Strategy 2020, Slovakia

Framed in the EC Communication from April 8, 2011
 Based
on evidence
 Providing broader context and conceptualization (Roma,
Roma communities, marginalized Roma communities)
 Quantifiable objectives (what, by how much and by when)
 Emphasis on M&E (set of indicators; suggested data
infrastructure and researches – EU-SILC, specialized
surveys on Roma, poverty mapping, territorial tagging of
regular/administrative data)
 Wide consultations – thematic working groups on revision
of NAPs; regional consultations with NGOs, state
administration, local self-governments; consultations with
line ministries; consultations with Roma activists;
cooperation of the World Bank, OSI and UNDP
Roma Integration Strategy 2020, Slovakia

3 strategic principles (de-stigmatization; desegregation and de-gethoization)

Specific objectives in 4 priority areas (housing,
education, employment and health) until 2020

NAPs for 2012-2014
Roma Integration Strategy 2020, Slovakia
A:
Foreword to the Strategy
A1. Introduction
A2. Vision of the Slovak republic in including Roma communities
B:
Theoretical framework of the Strategy
B1. Framing of the Strategy - Marginalization and multidimensional
exclusion and poverty
B2. Europe 2020 and EU Roma Framework
B3. Overall principles of the Strategy
C:
Context of the Strategy
C1. Description of the situation of Roma communities in Slovakia
C2. Alternative prognoses for the future and indicators of a change
C3. Description of policies and strategies of the Slovak republic since
1990
C4. Cost of non-inclusion
Roma Integration Strategy 2020, Slovakia
D:
Policies of the Strategy
D1. Dimensions covered by the Strategy
D2. Priority policies of the Strategy
D2.1. Education policies
D2.2. Employment/ employability policies
D2.3. Health policies
D2.4. Housing policies
D2.5. Financial inclusion policies - access to microcredits
D2.6. Non-discrimination policies
D2.7. Roma identity policies - political participation of Roma, culture and
language
D2.8. Other areas/policies – security/anti-crime policies; affirmative
action, especially for participation in public sector jobs and state
administration
D2.9. Gender mainstreaming policies
Roma Integration Strategy 2020, Slovakia
E.
Implementation of the Strategy
E1. Financing of the Strategy and budget impact of the Strategy
E2. Plan of activities
E3. Roles of various actors, including NGOs
E4. Legislative implications
F:
Monitoring and evaluation of the Strategy
F1. Expected outcomes of a government policies
F2. Indicators of the fulfilment of outcomes
F3. Monitoring and evaluation procedures
Control questions when preparing
National Roma Program / NAPs
Results oriented NAPs – goals and targets




Is the goal formulated clearly to address the particular
problem?
Is there a clear link between the goal and sub-goals or
objectives?
Do the goal and/or objectives state the desired
situation? (Do they clearly state what, how much and
until when should be changed/we want to achieve?)
Is there a harmony of a given goal with the goals
present in other places of the same priority area or in
other priority areas?
Results oriented NAPs – goals and targets




If measures are stated in the NAP are they sufficient
for achieving a given objective (in case objectives are
not defined of a given goal)?
If measures are stated in the NAP are they a set of
activities linked together? (Do the activities describe a
step-by-step process leading to implementation of a
given measure?)
Is it clear whether an activity is a one-time event or a
regularly repeated event?
Are the indicators proposed for goals or objectives
outcome or impact indicators? Are the indicators
proposed for measures and activities input or output
indicators?
Results oriented NAPs – indicators and data







Are data for computation of this indicator available?
Can this indicator be calculated on cyclical (annual)
base?
Does this indicator have a substantive meaning?
Does this indicator correspond to the declared priority,
objective and goal?
Is it possible unambiguously to interpret this indicator
Is monitoring accountability and monitoring
independence for this indicator secured?
Can potential gender disparities be measured by this
indicator?
Examples of indicators (in education)
Quantitative
Activity
Input
Measures
Output
Objectives
Goal
Expenditure on
primary education
Qualitative
Adequacy of the
curriculum
Number of primary Quality of teaching
school teachers
atmosphere in the
classroom
Satisfaction with
Outcome Enrolment and
dropout rates
teaching methods
Impact
Literacy
Capacity to participate
in the labour force
Sources of data for M&E

Administrative or routine data
 Population registries (births/deaths)
 Registered unemployment
 Crime registries
 Property registers, fiscal,

social security
Census data
 Population census
 Establishment census

Survey data
 Perception surveys
 Household
 Labor force
 Victimization surveys

Demographic surveillance systems
Example of one data source –
specialized survey on marginalized Roma
Regional survey on marginalized Roma 2011

Survey as part of the EU funded project on evaluation
of two projects (ECEC and microfinance/self-employment)
implemented jointly with the World Bank

Funding: EU and UNDP (partially the World Bank)

Coordination with the survey of Fundamental Rights
Agency (EU countries)
Method and Sample I
Covers all countries of the Decade of Roma
Inclusion in CEE plus the Republic of Moldova
 Allows for comparison with the survey from
2004 (At Risk: Roma and the Displaced in Southeast Europe)
 Representative for Roma living in
municipalities with the over national level
share of Roma population in total population
and non-Roma living in their proximity

Method and Sample II
Face-to-face interviews at the respondent’s
household (male and female interviewers)
 4 modules – Household members; Household;
ECEC (0-6), Perception questions (16+)
 Combination of questions from various surveys
(EU-MIDIS, EU-SILC, HBS, LFS, MICS) and
original value/norms questions
 750 Roma and 350 non-Roma HHs (Sampling error:

Margin error n=750 +/- 3.74%; n=350 +/- 5.49%)
Poverty Statistics
Income-based Poverty Rates $2.15 / $4.30 (PPP)
Percentage of people living in households with a per capita income
below $2.15 / $4.30 (PPP)
$2.15
$4.30
27%
17%
23%
27%
21%
23%
14%
10%
2%
N-R
R
ALB
23%
7%
19%
7%
R
N-R
BIH
7%
2%
R
4%
1%
N-R
CRO
R
MAC
6%
8%
6%
N-R
R
4%
1%
N-R
MNE
38%
10%
7%
1%
N-R
R
SRB
21%
7%
R
N-R
MLD
Poverty Statistics
Expenditure-based Poverty Rates $2.15 / $4.30 (PPP)
Percentage of people living in households with a per capita expenditure
below $2.15 / $4.30 (PPP)
$2.15
$4.30
30%
28%
21%
15%
8%
R
ALB
3%
5%
N-R
R
20%
20%
15%
21%
21%
4%
0%
N-R
BIH
5%
0%
R
1%
0%
N-R
CRO
8%
4%
3%
5%
R
N-R
R
MAC
4%
1%
N-R
MNE
5%
4%
0%
N-R
R
SRB
3%
R
N-R
MLD
Labour Statistics: Unemployment
Labour Statistics: Unemployment
Labour Statistics
Education Statistics
Adult Literacy Rate (15+)
Percentage of persons that answered "Yes" when they were ask whether
they could read and write
99%
97%
95%
83%
85%
99%
96%
86%
83%
73%
69%
66%
ALB
BIH
CRO
MAC
Roma
99%
98%
Non-Roma
MNE
SRB
MLD
Education Statistics
Highest Attained Education (ISCED 1)
Population between 25 and 64 years of age having attained at least primary
education (ISCED 1)
98%
98%
97%
98%
97%
78%
78%
65%
63%
99%
98%
63%
60%
52%
ALB
BIH
CRO
MAC
Roma
Non-Roma
MNE
SRB
MLD
Education Statistics
Highest Attained Education (ISCED 2)
Population between 25 and 64 years of age having attained at least lower
secondary education (ISCED 2)
92%
89%
83%
93%
88%
52%
44%
37%
29%
ALB
26%
BIH
97%
91%
38%
25%
CRO
MAC
Roma
Non-Roma
MNE
SRB
MLD
Education Statistics
Highest Attained Education (ISCED 3)
Population between 25 and 64 years of age having attained at least upper
secondary education (ISCED 3)
70%
69%
69%
67%
60%
59%
35%
11%
10%
12%
12%
7%
4%
ALB
BIH
CRO
MAC
Roma
Non-Roma
MNE
SRB
7%
MLD
Education Statistics
Dominant ethnicity of classmates
Share of people ...
Mixed
Roma ethnicity
Majority ethnicity
90%
86%
78%
76%
75%
69%
70%
66%
59%
58%
53%
48%
51%
45%
40%
ALB
BIH
17%
10%
10%
3%
10%
10%
MNE
Non-Roma
Non-Roma
Roma
Non-Roma
MAC
10%
3%2%
1%
Roma
Non-Roma
CRO
28%
SRB
11%
2%
Non-Roma
11%
Roma
Non-Roma
Roma
2%
6%
13%
6%
Non-Roma
12%
24%
23%
Roma
21%
15%
Roma
23%
17%
31%
Roma
34%
MLD
Education Statistics
Average number of years in Education
12
Roma
Non-Roma
10.8
10.3
10
9.2
9.2
9.2
9.3
9.4
9.8
9.6
9.2
8.9
8.6
8.0
8
7.5
7.0
6.0
5.5
6
4.2
4
5.1
4.9
4.5
3.8
3.6
3.5
2
0
ALB
BIH
CRO
MAC
MNE
SRB
MLD
BLG
CZE
HUN
ROM
SVK
Health Statistics
General Health Assesment
People who stated to be in a "very bad" or "bad" health situation
33%
30%
26%
24%
17%
14%
8%
3%
ALB
BIH
25%
3%
1%
CRO
MAC
Roma
Non-Roma
5%
MNE
4%
SRB
4%
MLD
Health Statistics
Access to Health Services
Share of HHs having access to health services when needed
94%
99%
93%
94% 95%
86%
75%
ALB
97%
91%
86%
91%
75%
73%
BIH
89%
CRO
MAC
Roma
Non-Roma
MNE
SRB
MLD
Health Statistics
Limited Access to Basic Needs
Share of population not having access to essential drugs
73%
66%
66%
65%
57%
50%
45%
37%
32%
29%
31%
19%
14%
8%
ALB
BIH
CRO
MAC
Roma
Non-Roma
MNE
SRB
MLD
Health Statistics*
Access to Health Services
Share of people who did not consult a doctor when needed
66%
58%
45%
36%
36%
36%
30%
28%
24%
17%
ALB
45%
42%
BIH
13%
CRO
MAC
Roma
* 16+ randomly selected HH member
Non-Roma
8%
MNE
SRB
MLD
Health Statistics*
Access to Health Services
Share of persons not consulting a doctor when needed due to cost contrains
86%
84%
80%
76%
73%
67%
66%
63%
56%
49%
40%
38%
27%
21%
ALB
BIH
CRO
MAC
Roma
* 16+ randomly selected HH member
Non-Roma
MNE
SRB
MLD
Health Statistics*
Medical Insurance
Share of people who have a medical insurance
97%
95%
92%
99%
97%
89%
93% 93%
83%
75%
70%
54%
40%
32%
ALB
BIH
CRO
MAC
Roma
* 16+ randomly selected HH member
Non-Roma
MNE
SRB
MLD
Health Statistics*
Incidence of specific medical checks
Share of people who had a dental check-up in the last 12 months
53%
45%
37%
36%
34%
41%
37%
38%
27%
20%
36%
30%
21%
14%
ALB
BIH
CRO
MAC
Roma
* 16+ randomly selected HH member
Non-Roma
MNE
SRB
MLD
Health Statistics
Access to services
Share of HHs living in defined distances from closest general practitioner
Less than 1 km
6%
7%
25%
19%
11%
70%
60%
51%
40%
46%
16%
7%
7%
9%
13%
17%
42%
49%
59%
43%
43%
47%
42%
50%
40%
40%
60%
20%
20%
24%
43%
18%
21%
48%
47%
50%
Non-Roma
10%
Non-Roma
35%
44%
Roma
47%
20%
Non-Roma
71%
68%
Roma
30%
6%
19%
22%
Over 10 km
Non-Roma
80%
5-10 km
8%
90%
23%
3-5 km
Roma
100%
1-3 km
ALB
BIH
CRO
MAC
MNE
Roma
Non-Roma
Roma
Non-Roma
Roma
Non-Roma
Roma
0%
SRB
MLD
Health Statistics
Malnutrition
Share of households, which experienced at least once in the last month that
somebody went to bed hungry because they could not afford the food
roma
63
66
non-roma
62
54
47
39
35
24
15
10
7
ALB
BIH
6
6
CRO
13
MAC
MNE
SRB
MLD
Living conditions
Limited Access to Basic Needs
Share of population not having access to improved sanitation
85%
73%
65%
54%
52%
51%
44%
43%
32%
16%
4%
ALB
BIH
6%
15%
6%
CRO
MAC
Roma
Non-Roma
MNE
SRB
MLD
Living conditions
Limited Access to Basic Needs
Share of population not having access to a improved water source
61%
46%
34%
28%
21%
17%
10%
ALB
7%
BIH
13%
9%
4%
3%
CRO
0%
MAC
Roma
Non-Roma
1%
MNE
SRB
MLD
Living conditions
Living Conditions
Rooms per household member
1.51
1.24
1.20
1.15
1.10
0.69
0.65
1.08
0.63
0.48
0.44
ALB
0.66
0.62
1.13
BIH
CRO
MAC
Roma
Non-Roma
MNE
SRB
MLD
Living conditions
EU Deprivation Index
Share of people living in HHs which face at least 3 out of 8 deprivations
98%
96%
96%
93%
93%
90%
86%
86%
78%
67%
64%
68%
61%
42%
ALB
BIH
CRO
MAC
Roma
Non-Roma
MNE
SRB
MLD
...but also*...
Plans to move to another country, by source country (%)
45
Roma
40
40
42
Non-Roma
36
35
30
25
20
26
25
23
19
18
16
15
14
14
10
10
10
10
5
0
MAC
ALB
* 16+ randomly selected HH member
BIH
CRO
MNE
SRB
MLD
...and

Questions on experience with discrimination in:
 Looking
for job
 At
work
 When looking for a dwelling
 When seeking a health services
 In education

... AND MANY MORE
to conclude...National Roma Program should



Be results oriented (clearly stated goals and objectives)
Have quantified objectives (what by how much until when)
Be prepared in widely participative manner (state
administration, local self-government, NGOs, academia, etc.)

Be transformed into local level actions (local development
strategies)

Be regularly monitored and evaluated (progress and
effects; internally & externally)

Have at disposal regularly collected data on situation
of Roma communities (administrative data, surveys – regular(EUSILC, LFS) or specialized)
THANK YOU
[email protected]
UNDP Bratislava Regional Centre
http://europeandcis.undp.org/go/vulnerability
* 16+ randomly selected HH member