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      Sanitation Infrastructure at the Systemic Edge: Segregated Roma Settlements and Multiple Health Risks in Slovakia

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          Abstract

          This article explores how multiple health risks in municipalities with Roma settlements in Slovakia are related to the varieties of local governance and the authorities’ conduct towards the local Roma population. The first part of the paper describes the situation in Roma settlements from the perspective of unequal access to sewerage and water pipelines. Introduced here are data on identified contagious diseases that correlated multiple health risks with the lack of sanitation and/or water infrastructure. The second section of the paper put forth typologies of government approaches towards the Roma, which based on ethnographic fieldwork, allows us to identify factors of attitudinal, structural and policy-oriented nature. Research results point to a “triad” of key circumstances: these are the structural conditions in municipalities and the history of local inter-ethnic relations and attitude of authorities towards Roma. Finally, possible solutions and approaches regarding how to mitigate the multiple health risks are discussed. It is suggested that on the one hand, in many villages there is a profound institutional discrimination of Roma with respect to water and sanitation infrastructure; on the other hand, water services are increasingly becoming an expensive commodity that not everyone can afford. The article concludes with discussion on enabling conditions and ways to ensure access to basic infrastructure in rural Roma communities. The solution is not only a compliance with principles of non-discrimination and existing technical norms and standards but also in securing the accessible funding for construction of the sanitation infrastructure in a smart way, including innovations and operation of cheaper and environmentally responsible sanitation technologies.

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          Most cited references 40

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          Equity in water and sanitation: developing an index to measure progressive realization of the human right.

          We developed an index to measure progressive realization for the human right to water and sanitation. While in this study we demonstrate its application to the non-discrimination and equality component for water, the conceptual approach of the index can be used for all the different components of the human right. The index was composed of one structural, one process, and two outcome indicators and is bound between -1 and 1, where negative values indicate regression and positive values indicate progressive realization. For individual structural and process indicators, only discrete values such as -1, -0.5, 0, 0.5, and 1 were allowed. For the outcome indicators, any value between -1 and 1 was possible, and a State's progress was evaluated using rates of change. To create an index that would allow for fair comparisons between States and across time, these rates of change were compared to benchmarked rates, which reflect the maximum rates a State can achieve. Using this approach, we calculated the index score for 56 States in 2010 for which adequate data were available and demonstrated that these index scores were not dependent on factors such as achieved level of coverage or gross national income. The proposed index differs from existing measures of inequality as it measures rate of change and not level of achievement, and thus addresses the principle of progressive realization that is fundamental to human rights. Copyright © 2012 Elsevier GmbH. All rights reserved.
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            The Structural Origins of Territorial Stigma: Water and Racial Politics in Metropolitan Detroit, 1950s-2010s

             Dana Kornberg (2016)
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              Why don’t segregated Roma do more for their health? An explanatory framework from an ethnographic study in Slovakia

              Objectives The health status of segregated Roma is poor. To understand why segregated Roma engage in health-endangering practices, we explored their nonadherence to clinical and public health recommendations. Methods We examined one segregated Roma settlement of 260 inhabitants in Slovakia. To obtain qualitative data on local-level mechanisms supporting Roma nonadherence, we combined ethnography and systematic interviewing over 10 years. We then performed a qualitative content analysis based on sociological and public health theories. Results Our explanatory framework summarizes how the nonadherence of local Roma was supported by an interlocked system of seven mechanisms, controlled by and operating through both local Roma and non-Roma. These regard the Roma situation of poverty, segregation and substandard infrastructure; the Roma socialization into their situation; the Roma-perceived value of Roma alternative practices; the exclusionary non-Roma and self-exclusionary Roma ideologies; the discrimination, racism and dysfunctional support towards Roma by non-Roma; and drawbacks in adherence. Conclusions Non-Roma ideologies, internalized by Roma into a racialized ethnic identity through socialization, and drawbacks in adherence might present powerful, yet neglected, mechanisms supporting segregated Roma nonadherence. Electronic supplementary material The online version of this article (10.1007/s00038-018-1134-2) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Role: Academic Editor
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                04 June 2021
                June 2021
                : 18
                : 11
                Affiliations
                [1 ]Center of Social and Psychological Sciences, The Institute for Forecasting, Slovak Academy of Sciences, 811 05 Bratislava, Slovakia
                [2 ]Institute of Ethnology and Social Anthropology, Slovak Academy of Sciences, 813 64 Bratislava, Slovakia; Daniel.skobla@ 123456savba.sk
                Author notes
                [* ]Correspondence: progrfil@ 123456savba.sk
                Article
                ijerph-18-06079
                10.3390/ijerph18116079
                8200179
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

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