Bosnia-Herzegovina MEC SUMMARY REPORT By Árpád Baráth PhD., for PRIAE © 9 Dec.2004 Launch Supported by EC DG Research 5 th Framework Programme University of Pécs, Hungary

Survey of ME Elders  Minority elders in BiH (Hungarians, Czechs, Roma) were found to represent a rather heterogeneous group regarding historic-cultural background, migration status, and current social standing & health needs as well.  Roma minority elders, most of them residing in sub-urban areas, scored the worse in all self-assessment measures for general health, well being & life satisfaction, as distinct from both Czech and Hungarian elders of comparable age.  A full range of ethnic-specific (differential) morbidity rates were proven statistically significant across the three minority groups.  Regarding services usage, the most commonly used types of services in all surveyed groups were found the GP services (over 90% of regular usage).  The gap between quality expectations and perceptions of services was found statistically significant in all surveyed groups, in suggesting that the quality level of actually received services is far below the users’ expectations, at the time being.  Minority elders, in particular the Roma, feel that health & social services providers - much alike their local (majority) neighbours and other clients - relate to them with social discriminative codes of conduct, including neglect and insensitivity to their special needs. © 9 Dec.2004 Launch Supported by EC DG Research 5 th Framework Programme

Mainstream and Voluntary Sector Providers  Most mainstream service providers are unaware and/or neglecting a full range of specific health & social need of minority as „if were…” non-existent.  Staffing of health & social care services does not match the ethnic composition of users in regions with considerable density of minority elders.  At organisational level, few if any measures were set in action so far to meet specific needs of the minority elders.  Health & social mainstream providers see substantially smaller gap between expected and perceived quality levels of service provision, in general.  Voluntary sector’s active participation in providing health and/or specific social services for minority elders in BiH is marginal or non-existent, due to the traditional dominance of professional (public health & social) services. The exception seems to be the Roma NGO sector, thanks to its rather strong international networking with other Roma civil organizations throughout the country and abroad.  Minority voluntary organizations have not enough share (if any) in providing any specific health and/or social welfare service their elderly members. They have no tradition, neither financial nor human resources to undertake such projects, at the time being. © 9 Dec.2004 Launch Supported by EC DG Research 5 th Framework Programme

Croatia Policy Recommendations  More in-depth (qualitative) research seems badly needed for better understanding the specific health & social needs of minority elders in the Republic of BiH, including both its entities  Students of higher education in medical and health sciences, as well practitioners and policy makers, should be provided with specific teaching-learning modules to learn competency in sensing-, and dealing with specific health and social needs of minorities elders in their close work environment  Policy makers should work out minimum standards for staffing local health services & social welfare institutions serving multiethnic communities with considerable proportion of minority elders (e.g. 20% or above), including both indigenous and “newly” created minorities, such as Bosnians or Croats in Republika Srpska or Serbs in the Federation of BiH.  Planning, implementation, and evaluation of small-scale social programs seem badly needed for mental health promotion of minority elders, particularly for those living in isolated rural settings, involving both traditional and “newly created” local voluntary organizations (NGOs).  Planning of “new”, and facilitating the “old” minority organizations in taking a more active part in health-, mental health, social, spiritual care, and/or cultural care of their minority elders, and their inclusion in local community life. © 9 Dec.2004 Launch Supported by EC DG Research 5 th Framework Programme