Background

The Roma population of Bosnia and Herzegovina (BiH) is estimated at around 40,000. Roma are the largest and most vulnerable national minority, scoring below the national average across multiple socioeconomic indicators. Their social exclusion is primarily reflected in the fact that both individuals and entire communities are socially marginalized and therefore prevented from participating according to their full capacity in economic, social and cultural spheres. The lack of appropriate documents by many Roma families restricts their access to health services.

Intervention
The intervention uses outreach activities and creates a supportive environment by involving Roma community members, thus increasing local ownership and building their capacity.  This approach results from  intensive  work  between WV BiH and Roma NGOs, joint strategic planning and the enrollment of Roma women and youth in community work, creation of an outreach system in Roma communities, and sensitization of Roma  leaders, and community members.
Since 2011, World Vision and Roma community leaders have established three HIV Information Centres, and employing 25 outreach workers. The centres offer education, information sharing, promotion, and awareness of HIV and AIDS prevention in selected Roma communities, monitoring of outreach activities, insuring access to Roma communities, empowering and liaising  with other Roma leaders, cooperation with relevant health  institutions regarding health issues and organising public events and round  tables. Outreach workers who have been trained and provided with the necessary information materials and condoms, regularly visit selected Roma communities and provide education to community members. The workers distribute educational materials, condoms and accompany and support their clients to VCT sites for HIV and Hepatitis testing and counselling.

Results
The three HIV centres have reached 26,505 individuals with HIV prevention education; 853 people through VCT (voluntary counselling and testing) services; 40 000 condoms distributed; 54,157 copies of informative educational materials distributed; 211 outreach visits made to most vulnerable families; 41 visits by the nurses to Roma communities; 18visits to the asylum centre Rakovica and 4 visits to a refugee camp Salakovac; 229Roma women participated in 3 workshops and 8 seminars on HIV&AIDS prevention and reproductive health;  25 round tables for promotion and awareness raising around Roma Population organized. Several hundred medical workers, state officials, and community leaders have benefitted from the opportunity to dialogue on health related issues and the broader needs of the integration of Roma into BiH society.

Conclusions

The most frequently quoted successes include: breaking of stigma and taboos around HIV &AIDS issues; shifting towards safer practices related to sexual and other risky behaviors (e.g. tattoo, piercing); increased number of Roma being tested for HIV and Hepatitis B & C; HIV prevention interventions going beyond the health, and achieving greater impact through enhancing dialogue between Roma and ethnic majorities in BiH; promoting better integration of Roma into Bosnian society. Several hundred medical workers, state officials, and community leaders have benefitted from the opportunity to start a dialogue on health related issues and the broader needs of the integration of Roma into BiH society.