Innovating Approaches: Health Education in Bulgaria

Health education is a growing priority worldwide. Health education programs have established the potential for reducing costs and improving health outcomes, especially in low-income communities. This universal push is no less applicable to Bulgaria, where structured health education programs are lacking or nonexistent. Currently, there are no structured programs dedicated to basic health topics and behaviors mandated in any level of primary or secondary education- community based programs are similarly in their infancy. Health education is primarily left up to the family or the discretion of individual teachers to promote during periods of open planning. For the Roma in Bulgaria, the country’s largest minority group and most disenfranchised, the lack of health education contributes to decreased usage of health services, especially preventative ones, increased usage of emergency services or delayed care, and overall lower life expectancies. Understanding the level of basic health in these communities is of critical importance for designing sustainable health education campaigns that address the most pertinent topics for the community. Through a survey designed to understand basic health knowledge and behaviors with tuberculosis (TB) as a proxy illness for questioning, data were collected from five distinct Roma communities across Bulgaria. In combination with informal interviews of relevant community leaders and activists, these surveys highlight the need for a greater emphasis of health education within the community. Two distinct mechanisms for addressing this need are discussed based on their primary usage of existing services for enhanced sustainability and quick impact.