Human and Social Development
Health

People older than 65 years including Roma with chronic diseases and disabilities in the region of Vratca

Bulgaria faces recent demographic and socio-economic challenges where low marriage rate, low birth rates, increased urbanisation, increased mortality and intensive internal and external migration lead to a decrease of the population and population aging. The high rate of unemployment and extreme low incomes are usually the cause of miserable living conditions. All these factors contribute to worsen the health status of the population, especially among minorities and older people, who rely predominantly on the provision of care services.

The reform of the Bulgarian healthcare service started back in 1999 and was characterized by inconsistent policy and legislative amendments that complicated the relations among stakeholders. The provision of social assistance in Bulgaria was subject of a long lasting painful decentralization of services in favour of local community based facilities. One of the systematic drawbacks of the system in place is the lack of clear criteria for the selection of social services providers.

To address above challenges the proposed project endeavours a new approach thus combining delivery of health and social services to the citizens. Home care and assistance services will appear as an alternative to existing health and social cares.

The objective of the project is to improve quality of life of elderly people with chronic diseases and disabilities through provision of institutionalized home-based health and social care. The project will also address the special needs of those from the Roma community and from other vulnerable groups.

The project shall establish Home Care Centres in four municipalities in Vratsa District with poor socio-economic indicators and high Roma population. It will improve and maintain the health status, economic and social-well being of elderly, chronically-ill and disable people through direct service provision at their homes thus ensuring their independent living and social inclusion. At policy level the project will capitalize operational lessons in order to propose legislative adjustments ensuring institutional and financial sustainability of home care in health insurance packages covered by the National Health Insurance Fund (NHIF) and/or voluntary health funds.

The expected results are:

• Adoption of legislative changes, financing mechanisms and national standards for home care services; creation of new state programs, incl. funds for provision of home care
• Increased number of functioning Home Care centres (at least by 4) and increased number of beneficiaries receiving home care services (at least by 350)
• The Bulgarian Red Cross continues at least on the same scale with home care services provision after the project completion