Foundation for Local Government Reform
Innovative practices in Bulgaria
Sharing innovations for improving local self-government
Local Healthcare Centre - Town of Rakitovo
Bulgarian National Committee for UNICEF
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Background
The need for health education, free access to qualified health services, active participation of users in the decision making process and citizens control over the resources of the healthcare system is strongly felt in small and medium municipalities in Bulgaria. In the town of Rakitovo, Pazardjik region, the population of Zapad district had for a long time been in need of a healthcare centre and they shared this demand with their local authorities. The Local Healthcare Centre project was initiated within the geographical boundaries of the Roma neighborhood Buntsova Mahala . It started in October 1998 and is to finish in December 2000. The project is supported by the European Union, and implemented by the Bulgarian National Committee for UNICEF in partnership with the Christian Children Fund of the United Kingdom and Ireland, independent charity organizations, which are part of a global network providing support to every child in need, regardless of race, sex or religion, together with the Bulgarian office of the Christian Children Fund of the United Kingdom. The project is implemented with the active support of the Municipality of Rakitovo.
Practice
The goals of the Local Healthcare Centre project are:
- to enhance the healthcare knowledge in the Roma community and to raise awareness of the importance of primary healthcare procedures at home and at school;
- to improve the access to the health services provided for the community;
- to support the long-term sustainability of the project as an initiative jointly owned by the Roma community and the Municipality of Rakitovo;

The project team organizes and coordinates the following activities:

- Providing professional medical services
The Local Healthcare Centre in the village of Rakitovo provides professional health services for the community: pre- and post-natal care (monitoring), supervision of children s immunization and nutrition; gynaecological check up and dentist s services. On being examined at the Centre, patients receive adequate medicines for the initial phase of their treatment.

- Systematically organized health examinations at schools
All Roma children have personal health check-up cards registering their weight, height, nutrition status, physical and dental condition, regularly examined by the medical staff. Nurses visit the school twice a week and give consultations on hygienic, food and family issues. They visit sick children at their homes. The Local Healthcare Centre helps the hospital of the town in the implementation of the immunization procedure for all the children.

- Healthcare workers - connection between the project and the community Ten parents are encouraged to become the core team in developing healthcare skills. They are simultaneously trained and act as healthcare workers in the community: every community healthcare worker is responsible for about 80 families living within the Roma neighbourhood, each family being visited once a month.

- Health education and information campaign
Practical training seminars are organized once a month, intended both for medical workers and the Roma community as a whole. The seminars are led and facilitated by doctors from the Healthcare Centre, the Regional Hospital in Rakitovo, and other specialists, including experts at national level. They discuss themes like baby care, hygiene of the mouth, safe sex, hypertonia, family planning, the healthcare reform, etc. Altogether 70 seminars will be conducted within the project.

Other activities include the publication of a calendar with Roma children drawings and granting an Award for Best Community Healthcare Worker at the Centre.

The Centre is gaining substantial importance for the Roma community and is expected to lose its ethnic focus in the future. Interest towards a four-year continuation of the project after its end in 2000 is really strong and the Christian Children Fund - Ireland is committed to seek funding for this purpose. The Municipality of Rakitovo has undertaken to cover the rent and maintenance costs of the Centre premises.
Results
Since its official opening in February 1999, the Local Healthcare Centre in the village of Rakitovo has accomplished the following:
- 5163 medical examinations and treatment procedures;
- 162 gynaecological examinations;
- 61 home visits;
- over 222 dental examinations and treatment procedures;
- giving away free over 600 toothbrushes and 500 condoms among the Roma community;
- conducting 19 two-hour seminars on various healthcare topics;
- the community healthcare workers have conducted 1295 home visits and disseminated over 900 packs of information materials, sharing the knowledge they have gained at the seminars.
Innovator: Stefan Stoyanov
Publication Date: 04 February 2000
Nominations: 9
Stefan Stoyanov
Project Manager
Rakitovo - 4640
22 Vela Peeva St.
Tel:(03542) 2354
Fax:(03542) 2354

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