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Objectives: This study aims to compare selected early childhood health risks and health outcomes of children from marginalized Roma communities (MRCs) in Slovakia with those of the majority. Methods: We obtained cross-sectional data from mother-child dyads from the majority (N = 109) and MRCs (N = 143) via questionnaires and from medical records. Socioeconomic status, health risks and health outcomes were compared using chisquare and Mann-Whitney U tests in SPSS. Results: Mothers from MRCs reported significantly worse socioeconomic status. Air quality in the households in MRCs was significantly worse, affected by heating with stoves, burning fresh wood and indoor smoking. The diet composition of children from MRCs was characterized by shorter breastfeeding and unhealthy diet composition less fresh fruits and vegetables, more processed meat products, and sweet and salty snacks. Children from MRCs more often suffered from respiratory and diarrheal diseases, used antibiotics and were hospitalized. Conclusion: The health and healthy development of children living in MRCs is endangered by various poverty-related factors. Persistent differences in exposures and health in early childhood should be a priority goal of the state's social and health policies. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to compare the early childhood mental health of children from marginalized Roma communities (MRCs) in Slovakia with that of the majority and explore possible mediating pathways of mothers' perceived stress and harsh discipline practices. Methods: We used data from the first wave of the longitudinal RomaREACH study collected in 2021-2022. Two populations were included in the sample: 94 mother-child dyads from MRCs and 79 from the majority population (children aged 14-18months). Data were analysed using linear regression, and mediation was tested using PROCESS Macro in SPSS. Results: Belonging to MRCs vs. the majority, perceived stress of mothers and harsh discipline were found to be associated with early mental health problems in children. Perceived stress of mothers partially mediates the relationship between belonging to MRCs vs. majority and harsh discipline and harsh discipline partially mediates the relationship between perceived stress of mothers and the mental health of children. Conclusion: Mothers from MRCs perceive more stress, which is associated with more frequent use of harsh discipline practices having a negative impact on the mental health of young children. [ABSTRACT FROM AUTHOR]

Objectives:This study aims to compare selected early childhood health risks and health outcomes of children from marginalized Roma communities (MRCs) in Slovakia with those of the majority.Methods:We obtained cross-sectional data from mother-child dyads from the majority (N = 109) and MRCs (N = 143) via questionnaires and from medical records. Socioeconomic status, health risks and health outcomes were compared using chi-square and Mann-Whitney U tests in SPSS.Results:Mothers from MRCs reported significantly worse socioeconomic status. Air quality in the households in MRCs was significantly worse, affected by heating with stoves, burning fresh wood and indoor smoking. The diet composition of children from MRCs was characterized by shorter breastfeeding and unhealthy diet composition less fresh fruits and vegetables, more processed meat products, and sweet and salty snacks. Children from MRCs more often suffered from respiratory and diarrheal diseases, used antibiotics and were hospitalized.Conclusion:The health and healthy development of children living in MRCs is endangered by various poverty-related factors. Persistent differences in exposures and health in early childhood should be a priority goal of the state’s social and health policies.

Objectives: This study aims to compare the early childhood mental health of children from marginalized Roma communities (MRCs) in Slovakia with that of the majority and explore possible mediating pathways of mothers’ perceived stress and harsh discipline practices.Methods: We used data from the first wave of the longitudinal RomaREACH study collected in 2021–2022. Two populations were included in the sample: 94 mother-child dyads from MRCs and 79 from the majority population (children aged 14–18 months). Data were analysed using linear regression, and mediation was tested using PROCESS Macro in SPSS.Results: Belonging to MRCs vs. the majority, perceived stress of mothers and harsh discipline were found to be associated with early mental health problems in children. Perceived stress of mothers partially mediates the relationship between belonging to MRCs vs. majority and harsh discipline and harsh discipline partially mediates the relationship between perceived stress of mothers and the mental health of children.Conclusion: Mothers from MRCs perceive more stress, which is associated with more frequent use of harsh discipline practices having a negative impact on the mental health of young children.

IntroductionLimited access to healthcare services leads to lower vaccination rates in marginalized Roma communities (MRCs). This study aimed to explore health system barriers to HPV vaccination faced by people from MRCs from multiple perspectives.MethodsThe qualitative study was conducted in Slovakia in 2021/22 with 43 community members and health professionals. Data were analyzed using a combination of content analysis and consensual qualitative research.ResultsA substantial barrier to vaccination is limited coverage of vaccination expenses for certain age categories by health insurance. Moreover, Slovakia faces a significant shortage of healthcare personnel, leading to work overload and a lack of capacity and motivation to address HPV vaccination. Impaired relationships between health care providers and people from MRCs lead to the avoidance of healthcare services, which contributes to insufficient delivery of information and a lack of awareness regarding HPV-related diseases and vaccination.ConclusionStrengthening the capacities of health care providers, expanding the age group covered by health insurance and providing tailored information to people from MRCs are necessary prerequisites to increase the availability of HPV vaccination and enable people to make informed decisions about HPV vaccination.

Abstract Background This study aims to assess which measures could improve the healthy early childhood development of children from marginalized Roma communities and to identify priority measures. Methods Concept mapping approach was used, using mixed methods. In total 54 professionals, including social workers, educators, health care providers, municipality representatives, and project managers participated in our study. Results Four distinct clusters of measures targeting living conditions, public resources, healthcare and community interventions, and 27 individual priority measures of highest urgency and feasibility were identified. The cluster ‘Targeting living conditions’, was rated as the most urgent but least feasible, whereas the cluster ‘Targeting health care’, was considered least urgent but most feasible. Among the 27 priority measures, ‘Planning parenthood’ and ‘Scaling up existing projects’ had the highest priority. Conclusion Our results reflect the public and political discourse and indicate significant barriers to implementation. Reducing inequalities in early childhood needs to be addressed through coordinated efforts.

Recent analysis indicates that the coronavirus pandemic has disproportionately affected Roma people, amplified pre-existing exclusion, poverty, discrimination, and exposed marginalized Roma to vulnerability even more than before. This study explores the securitization and militarized quarantine of Roma settlements during the first wave of the COVID-19 pandemic in Slovakia. The study analyzes who, how and why securitized Roma communities? On what issues and for whom? With what result and under what conditions? The result of securitization, i.e. militarized quarantine of six Roma settlements is investigated in terms of legality, necessity, proportionality, and temporariness. The topic is approached from the perspective of political science. The study deploys a new institutionalism approach, securitization as an analytical frame, and qualitative research design. This includes a case study, elite interviews, and qualitative content analysis. The study concludes that, in the first wave of the COVID-19 pandemic in Slovakia, securitization took place instead of right-based discourse and a humanitarian approach towards the most vulnerable and socially excluded MRCs. Slovakia deployed heavily securitized responses towards Roma, targeting them selectively and collectively with anti-corona measures. Residents of six Roma settlements were exposed to the discrimination and most restrictive measures that the rest of the population did not face. [ABSTRACT FROM AUTHOR]

Roma are the largest and most disadvantaged ethnic minority in Europe often facing generational poverty, and limited access to education, employment, housing, and various types of services. Despite many international and national initiatives, children from marginalized Roma communities face multiple risks and are being disadvantaged as early as from conception onward. We, therefore, aimed to identify measures and/or interventions targeting equity in early childhood health and development in marginalized Roma communities which implementation is considered to be urgent but not feasible. We used a group concept mapping approach—a participatory mixed research method—and involved 40 experts and professionals from research, policy and practice. From 90 measures and interventions proposed to achieve early childhood equity for children from marginalized Roma communities, 23 measures were identified as urgent but not feasible. These concerned particularly measures and interventions targeting living conditions (including access to income, access to housing, and basic infrastructure for families) and public resources for instrumental support (covering mainly topics related to financial and institutional frameworks). Our results reflect the most pressing issues in the area of equality, inclusion and participation of Roma and expose barriers to implementation which are likely to arise from public and political discourses perpetrating a negative image of Roma, constructing them as less deserving. Measures to overcome persistent prejudices against Roma need to be implemented along with the measures targeting equity in early childhood health and development.

Roma living in marginalised communities are among the most disadvantaged groups in Slovakia. Socioeconomic disadvantage is associated with higher hair cortisol concentrations (HCC), including in parents. The aim of this study is therefore to assess differences in HCC, reflecting the levels of stress, between mothers living in MRCs and from the majority population, to assess the association of socioeconomic disadvantage with HCC, and whether disadvantage mediates the MRC/majority differences in HCC. Participants were mothers of children aged 15–18 months old living in MRCs (N=61) and from the Slovak majority population (N=90). During preventive paediatric visits, visits at community centres and home visits, hair samples and data by questionnaire were collected. HCC differed significantly between mothers living in MRCs and mothers from the majority population, with the mean HCC value being twice as high in mothers living in MRCs (22.98 (95% confidence interval, CI, 15.70–30.30) vs. 11.76 (8.34–15.20), p<0.05). HCC was significantly associated with education, household equipment and household overcrowding, but not with billing, socioeconomic stress and social support. The difference in HCC between mothers living in MRCs and mothers from the majority population was partially mediated by poor house equipment, such as no access to running water, no flushing toilet or no bathroom (the indirect effect of B=7.63 (95% CI: 2.12–13.92)). Practitioners and policymakers should be aware of high stress levels among mothers living in MRCs and aim at enhancing their living and housing conditions. • Roma living in marginalized communities are among the most disadvantaged groups. • Socioeconomic disadvantage causes higher hair cortisol concentrations (HCC) in parents. • HCC differed significantly between MRC mothers and majority mothers. • Mean HCC was twice as high in MRC mothers compared to majority mothers. • The difference in HCC was partially mediated by poor house equipment, such as no access to running water or no toilet. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to compare selected early childhood health risks and health outcomes of children from marginalized Roma communities (MRCs) in Slovakia with those of the majority., Methods: We obtained cross-sectional data from mother-child dyads from the majority (N = 109) and MRCs (N = 143) via questionnaires and from medical records. Socioeconomic status, health risks and health outcomes were compared using chi-square and Mann-Whitney U tests in SPSS., Results: Mothers from MRCs reported significantly worse socioeconomic status. Air quality in the households in MRCs was significantly worse, affected by heating with stoves, burning fresh wood and indoor smoking. The diet composition of children from MRCs was characterized by shorter breastfeeding and unhealthy diet composition less fresh fruits and vegetables, more processed meat products, and sweet and salty snacks. Children from MRCs more often suffered from respiratory and diarrheal diseases, used antibiotics and were hospitalized., Conclusion: The health and healthy development of children living in MRCs is endangered by various poverty-related factors. Persistent differences in exposures and health in early childhood should be a priority goal of the state's social and health policies., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 Filakovska Bobakova and Dankulincova Veselska.)

Objectives: This study aims to compare the early childhood mental health of children from marginalized Roma communities (MRCs) in Slovakia with that of the majority and explore possible mediating pathways of mothers' perceived stress and harsh discipline practices. Methods: We used data from the first wave of the longitudinal RomaREACH study collected in 2021-2022. Two populations were included in the sample: 94 mother-child dyads from MRCs and 79 from the majority population (children aged 14-18 months). Data were analysed using linear regression, and mediation was tested using PROCESS Macro in SPSS. Results: Belonging to MRCs vs. the majority, perceived stress of mothers and harsh discipline were found to be associated with early mental health problems in children. Perceived stress of mothers partially mediates the relationship between belonging to MRCs vs. majority and harsh discipline and harsh discipline partially mediates the relationship between perceived stress of mothers and the mental health of children. Conclusion: Mothers from MRCs perceive more stress, which is associated with more frequent use of harsh discipline practices having a negative impact on the mental health of young children., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 Filakovska Bobakova, Chovan and Van Laer.)

Introduction: Limited access to healthcare services leads to lower vaccination rates in marginalized Roma communities (MRCs). This study aimed to explore health system barriers to HPV vaccination faced by people from MRCs from multiple perspectives., Methods: The qualitative study was conducted in Slovakia in 2021/22 with 43 community members and health professionals. Data were analyzed using a combination of content analysis and consensual qualitative research., Results: A substantial barrier to vaccination is limited coverage of vaccination expenses for certain age categories by health insurance. Moreover, Slovakia faces a significant shortage of healthcare personnel, leading to work overload and a lack of capacity and motivation to address HPV vaccination. Impaired relationships between health care providers and people from MRCs lead to the avoidance of healthcare services, which contributes to insufficient delivery of information and a lack of awareness regarding HPV-related diseases and vaccination., Conclusion: Strengthening the capacities of health care providers, expanding the age group covered by health insurance and providing tailored information to people from MRCs are necessary prerequisites to increase the availability of HPV vaccination and enable people to make informed decisions about HPV vaccination., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Filakovska Bobakova, Plavnicka, Urbancikova, Edelstein, Jansen and Dankulincova Veselska.)

Roma are the largest and most disadvantaged ethnic minority in Europe often facing generational poverty, and limited access to education, employment, housing, and various types of services. Despite many international and national initiatives, children from marginalized Roma communities face multiple risks and are being disadvantaged as early as from conception onward. We, therefore, aimed to identify measures and/or interventions targeting equity in early childhood health and development in marginalized Roma communities which implementation is considered to be urgent but not feasible. We used a group concept mapping approach-a participatory mixed research method-and involved 40 experts and professionals from research, policy and practice. From 90 measures and interventions proposed to achieve early childhood equity for children from marginalized Roma communities, 23 measures were identified as urgent but not feasible. These concerned particularly measures and interventions targeting living conditions (including access to income, access to housing, and basic infrastructure for families) and public resources for instrumental support (covering mainly topics related to financial and institutional frameworks). Our results reflect the most pressing issues in the area of equality, inclusion and participation of Roma and expose barriers to implementation which are likely to arise from public and political discourses perpetrating a negative image of Roma, constructing them as less deserving. Measures to overcome persistent prejudices against Roma need to be implemented along with the measures targeting equity in early childhood health and development., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Filakovska Bobakova, Chovan, Bosakova, Koky, de Kroon and Dankulincova Veselska.)