Good practice demonstrated 52:



  • Bulgaria



Contact organisation: 


(Community of partnership: Bulgaria, Romania, Hungary and Slovakia)


Rositsa Ivanova,

Secretary and Senior Programme Officer

Secretariat of the National Council for Cooperation on Ethnic and Integration Issues

Council of Ministers

Republic of Bulgaria

tel: +  359 2 940 36 22; mobile 0889 50 19 18

fax: + 359 2 940 21 18



  • Equal opportunities
  • health mediator
  • network
  • participation
  • training

In progress: 



  • transnational


The target audience are Roma communities in Bulgaria (7,7 % – 9,6 %), Hungary (3,9 – 5,9 % ), Romania (6,7 % ), and Slovakia (6,6 % - 7,4 %) – the 4 countries with the highest relative proportion of Roma communities within Europe, according to the WHO. In some of the countries, the health mediator is still in the process of being recognized as a profession by the institutions and in all it is still being established as one in the society.


Accelerating the improvement of the health status and education of Roma communities in Bulgaria, Hungary, Romania and Slovakia by supporting local NGO’s directly and by supporting alignment and sharing best practices between them. Working with local health institutions to ensure Health Mediators are acknowledged and embedded in legal frameworks and their profession is institutionalized. Work with EU government to develop new policies to support the Roma Health Mediator approach and to secure funding from EU budget to ensure this project is self-sustaining over time.


  • Civil society, including Roma community
  • governmental

Method used: 

The European program unites the sharing of best practices between NGO’s and institutions from the 4 countries through regular video conferencing and yearly face to face meetings. The regional approaches, however, are individual to the specificities of the countries and the nature of work of the different NGO’s.

In Bulgaria, for example, the financing of the project by GSK is used by the National Network of Health Mediators for the appointment of 15 newly trained (at the medical universities in Bulgaria) health mediators each year for the period of duration of the programme.

  • These new mediators work alongside the old health mediators from the NGO and gain experience within that year.
  • Afterwards, they are integrated into the NGO (they get appointed officially by the municipality with a designated budget, approved by the Ministry of Health)) and 15 more mediators start work under the GSK program.
  • This is one of greatest successes of the project in Bulgaria so far – a guaranteed sustainability through the continuous expansion of the Network and the cooperation of the institutions on all levels.

The stages of this process:

  • The NNHM was established in 2007 and was not related to the various municipalities at first.
  • A measles epidemic in 2010, affecting mainly the Roma communities in Bulgaria, gave start to a GSK Bulgaria  Initiative for health and vaccination, which sought the cooperation of the NGO in order to reach those vulnerable groups and counter the epidemic.
  • This stage established the contact and partnership between the NGO and the different municipalities, the Regional Health Inspectorates (part of the MoH), GP’s, and other local institutions.
  • In 2011, the Initiative grew into GSK’s European community partnership and financing on an above country level was provided for the period of duration of the program.
  • 15 new health mediators are trained each year since then at the medical universities and they remain part of the NGO after that year due to the guaranteed sustainability through the cooperation of the institutions.

The work of the health mediators involves monthly reporting; sharing of best practices on a country and above-country level.

Technical resources: 


Human resources: 


What are the keys to success of this action? : 

Involving the institutions and sharing best practices between countries.


What were the main difficulties encountered?: 

Low level of education among the vulnerable groups, including the health mediators (grammar, communication)


What would you recommend to those carrying out a similar action?: 

To take on a collaborative approach and focus on sustainability. Ensure responsibility by the governments to the health mediators NGO’s.


Diffusion resources: 

  • Publication or report
  • Website