The history of the National Network of Health Mediators dates back some ten years ago, when in Bulgaria the serious problems in the sphere of health care and especially the limited access of minorities to the system of health services began to be mentioned. 

The almost non-existent health culture, high sick rate, serious disabilities leading to permanent deviations, problems with diagnostics of illnesses that are comparatively easily spread such as tuberculosis etc., infant and mother mortality rates outline the alarming picture if the Roma population health profile. The introduction of the profession of the health mediator is a new and unfamiliar model for Bulgaria, which aims to begin to overcome the problems related to health services for disadvantaged groups of society. 

During this period, serious progress has been achieved thanks to the continuous efforts of the present network members. The efforts of all stakeholders continue, but already united in a National network of health mediators. The National Network of Health Mediators was established on April 23 in Sofia.  

The network’s founders are:

• Health mediators;
• Medical doctors-specialists;
• General practitioner doctors and nurses, who provide care to Roma;
• Trainers of the health mediators;
• Experts in integration policies;
• Experts and specialists in the field of public health care;
• Stakeholders and citizens who have been supporting the introduction of the figure of the health mediator during the past few years.

The idea for the establishment of a network of the health mediators has been developing throughout the years to become a fact to date, when 50 health mediators from more than 25 municipalities all over the country have been appointed at work. During the period 2003-2006, within the framework of several projects, more than 85 health mediators from the whole country have been trained. They have been prepared by one and the same interdisciplinary team under a programme, approved by the Ministry of Health. The team of trainers is also part of the National Network of Health Mediators. 

Resources:

• Training programmes have been developed;
• Multidisciplinary and highly qualified training team;
• Trained medical staff from Roma quarters for work in multiethnic environment;
• GPs acquainted in detail with the socially significant diseases of the Roma;
• System for information and information exchange between Health mediators to help them resolve various cases;
• Supportive national and local institutions.

The main goals of the National Network of Health Mediators are: 

• To assist and facilitate the access to health and social services for everybody in disadvantaged position;
• To improve the quality of health and social services in Bulgaria;
• To raise the health culture of disadvantaged ethnic minorities;
• To raise public awareness and information to citizens on health related issues;
• To develop and strengthen European practices and approaches for facilitation of the disadvantaged groups access to health services;
• To create and develop novel higher quality services in the field of mediation and provision of health services;
• To exchange experience between health mediators throughout the country;
• To raise the health mediators’ capacity and skills;
• To participate in civil society development, democratisation and transparency in the actions of the central and local governments by implementing civil initiatives and cooperation with government institutions, local and regional authorities.

The National Network of Health Mediators unites more than 80 members. More than 65 of them are health mediators, trained and certified by the Ministry of Health. HM work in Roma quarters, with different risk groups from their community. They speak Romany language, know the health and social legislation, as well as the specific problems of each municipality in which they work and live, and have built good partnership relationships with municipal and regional experts on ethnic and demographic issues. They are also well known and accepted by the local health institutions such as the Regional Health Care Centres, the Regional Inspectorates for Public Health Care, etc. 

The National Network’s short-term goals are: 

* To continue the programme for appointment at work of health mediators through delegated budget by the Ministry of Finance for the municipalities where there are health mediators, trained and certified by the Ministry of Health. Similar programme should target and be designated not only the Roma community but for anybody with limited or difficult access to health services;

* Presentation and clarification of the health mediator’s position and role among society and professional circles with the collaboration of institutions and local authorities;

* Work with municipal administration and local authorities for clarification of the importance of the health mediator’s position and role – campaigns, information meetings, etc.

* Development and optimisation of the health mediator position through: continuous training and additional qualifications; improvement of the health mediator job description; introduction of training programme (syllabus) at a college or university for health mediators, etc.

* Work with medical circles and specialists: establishment of better working environment and conditions for GPs who provide services to Roma and disadvantaged groups;

* Work with the community – and improvement of the HMs work with the community for increasing the Roma’s health awareness. 

The Network’s Board Chair is Peter Tzvetanov from the village of Septemvriitski, Vulchedrum municipality, Monatna District, who works as a health mediator as well as participates in build up training of health mediators. Network Board members are the health mediators, experts and doctors. 

An Ethical Commission has been established with the National Network of Health Mediators. It monitors the observation and compliance with an ethical code, regulating the responsibilities and moral obligations of the health mediators-network members. The Ethical Commission Chair is Olya Stoyanova, who has been working as a health mediator for three years at the Municipality of Dupnitsa. 

The Network’s Board of Directors presented their goals and mission to representatives of the Ministry of Health, Deputy Minister of Labour and Social Policy, the Royal Dutch Embassy in Bulgaria, representatives of the National Council for Ethnic and Demographic Issues and the Ethnic and Demographic Directorate at the Council of Ministers, donor organisations.