The project “Initiative for Health and vaccination” is implemented under the patronage of the Parliamentary Committee on Health and the Council of Ministers

(National Council for Cooperation on Ethnic and Integration Issues). The Initiative partners include the Ministry of Health, Ministry of Labor and Social Policy, StateAgency for Child Protection, the National Association of GPs in Bulgaria, the Bulgarian Association for vaccination, "National Network of the mediators in Bulgaria" and GlaxoSmithKline.The Initiative began in March 2010, regarding the epidemiological situation with the measles outbreak in Bulgaria that affected mainly the hard to reach communities in Bulgaria due to gaps in their immunization coverage. For 12 months there are more than 24,000 registered cases and 24 deaths. 92% of the reported cases of infection are in the roma population. During 2010 and 2011 four national and eighteen regional meetings were organized to explain the role of the Initiative and to educate the Health mediators, the GPs and the RHIs (Regional Health Inspectorates are part of the Ministry of health’s structures on regional level). ObjectivesTo facilitate the access of the hard to reach communities to the healthcare system by improved cooperation between GPs, health mediators (representatives fromthe hard to reach communities) and the RHI representatives. One of the main goal of this collaboration is to extend the vaccinated population among theminorities To improve the vaccination process among the vulnerable groups To increase the Health mediators’ public health educational abilities and to raise awareness for the benefits and safety of the vaccines Achievements:

minorities To improve the vaccination process among the vulnerable groups To increase the Health mediators’ public health educational abilities and to raise awareness for the benefits and safety of the vaccines Achievements:

• For the first time in Bulgaria government, non-government and private organizations work in cooperation for the initiation of the project Vaccination ofhard to reach communities.• Legislative changes were made by the Council of Ministers in the Regulation for Application of the Social Assistance Act – additional measures are taken for thesocial benefits obtaining ( one of them is to decrease the guaranteed monthly benefit with 70% per child) and deprive the child allowances for unvaccinatedchildren;• Sustainability of the project – the concrete need of common actions is realized and the Health mediators’ network continued their work on health educationalprojects;• The health mediators’ best practices are shared and multiplied by two other countries in the region – Serbia and Macedonia. Their representatives participated in one of the regional meetings that aimed to educate the network.• Education of the Health mediators – over 100 prepared people from the minority groups;• Improved health awareness – improved health awareness – participation in educational meetings on VoV, networking with GPs in the region• 188 000 vaccinated. Measles incidence is minimized.• In the end of 2011 – new immunization campaign is launched – against poliomyelitis

• Better vaccination coverage 

In May 2010, in Hisarya the First National Meeting under the “Initiative for health and vaccination” project was provided. Over 250 participants – health mediators, Regional health inspectorates’ representatives and GPs shared their experience and best practices regarding the measles outbreak common work, as well as the further measures for infectious diseases’ control. Among the special guests were institutions, NGOs and private sector’s representatives. Due to improving the further communication between the participants an educational modules were provided, including information of the infectious diseases’ dissemination and the specificity of the vulnerable groups. 

In October 2010, in Plovdiv the Second National Meeting was provided. The event confirmed that the good cooperation between the key stakeholders in campaigns for the vaccine-preventable diseases prevention among the vulnerable communities will be essential part of the further activities. During the meeting were also identified different ways of expanding the immunization coverage, increasing health awareness and improving the level of prevention among vulnerable groups. Medical experts and specialists in infectious childhood diseases have conducted training for the participants on issues related to vaccine prevention. During the meeting interest was shown from a delegation from Macedonia, including ministers and institutions’ representatives. They expressed willingness the Bulgarian model of the profession "health mediator" to be multiplied in their country. 

In April 2011, the Third National meeting on the project "Initiative for Health and Vaccinations", part of the European Immunization Week was provided in Rousse. During the event discussed different ways and means of improving and expanding immunization coverage in Bulgaria were discussed. The start of a new extraordinary immunization campaign against poliomyelitis among the Roma community, which supposed to cover 70,000 children, was launched. Participants have had the opportunity to closely monitor how the immunization is done with the assistance of the mediators, n the "Three pigeons" district of Rousse, which has a Roma population. Participants were on an extremely high political level – the Chairman of the Healthcare Committee at the 41st National Assembly of Bulgaria, MPs, the Minister of Labour and Social Policy, Deputy Ministers from the Ministry of Health,ambassadors, medical experts and professional and patient organizations. 

IVth National Meeting of the “Initiative for Health and Vaccination” took place in Sofia, in December 2011. During the event the Health mediators, GPs and Regional Health Inspectorates representatives’ common activities were presented regarding the recently approved National strategy for roma population integration in Bulgaria (2012-2020), recommendations of UNFPA and WHO. Educational modules on COPD, Cervical Cancer and Viral Hepatitis were provided from Bulgarian medical experts. High political level was shown once again and the participants were more than 300. Among the special guests were institutions, NGOs and private sector’s representatives. The meeting once again demonstrated the willingness of the government, NGOs and private sector to coordinate their actions to improve access to the health care system for the vulnerable minority groups in Bulgaria.

• Better vaccination coverage 

In May 2010, in Hisarya the First National Meeting under the “Initiative for health and vaccination” project was provided. Over 250 participants – health mediators, Regional health inspectorates’ representatives and GPs shared their experience and best practices regarding the measles outbreak common work, as well as the further measures for infectious diseases’ control. Among the special guests were institutions, NGOs and private sector’s representatives. Due to improving the further communication between the participants an educational modules were provided, including information of the infectious diseases’ dissemination and the specificity of the vulnerable groups. 

In October 2010, in Plovdiv the Second National Meeting was provided. The event confirmed that the good cooperation between the key stakeholders in campaigns for the vaccine-preventable diseases prevention among the vulnerable communities will be essential part of the further activities. During the meeting were also identified different ways of expanding the immunization coverage, increasing health awareness and improving the level of prevention among vulnerable groups. Medical experts and specialists in infectious childhood diseases have conducted training for the participants on issues related to vaccine prevention. During the meeting interest was shown from a delegation from Macedonia, including ministers and institutions’ representatives. They expressed willingness the Bulgarian model of the profession "health mediator" to be multiplied in their country. 

In April 2011, the Third National meeting on the project "Initiative for Health and Vaccinations", part of the European Immunization Week was provided in Rousse. During the event discussed different ways and means of improving and expanding immunization coverage in Bulgaria were discussed. The start of a new extraordinary immunization campaign against poliomyelitis among the Roma community, which supposed to cover 70,000 children, was launched. Participants have had the opportunity to closely monitor how the immunization is done with the assistance of the mediators, n the "Three pigeons" district of Rousse, which has a Roma population. Participants were on an extremely high political level – the Chairman of the Healthcare Committee at the 41st National Assembly of Bulgaria, MPs, the Minister of Labour and Social Policy, Deputy Ministers from the Ministry of Health,ambassadors, medical experts and professional and patient organizations. 

IVth National Meeting of the “Initiative for Health and Vaccination” took place in Sofia, in December 2011. During the event the Health mediators, GPs and Regional Health Inspectorates representatives’ common activities were presented regarding the recently approved National strategy for roma population integration in Bulgaria (2012-2020), recommendations of UNFPA and WHO. Educational modules on COPD, Cervical Cancer and Viral Hepatitis were provided from Bulgarian medical experts. High political level was shown once again and the participants were more than 300. Among the special guests were institutions, NGOs and private sector’s representatives. The meeting once again demonstrated the willingness of the government, NGOs and private sector to coordinate their actions to improve access to the health care system for the vulnerable minority groups in Bulgaria.