A Successful Advocacy Campaign for Improved Access to Prenatal Care in Bulgaria

Trust for Social Achievement foundation’s We Care project successfuly campaigned to give Bulgarian uninsured women the right to monitor their pregnancy.

In Bulgaria every seventh person is without health insurance and around 7,000 women every year deliver babies without regular monitoring of their pregnancy by a doctor due to their insurance status.

This poses risks to both the baby and mother’s health. One of the main reasons for this “healthcare status interruption” is due to financial difficulties – according to the Bulgarian health system, each individual must contribute to the National Health Insurance Fund by paying his/her health insurance fee on a monthly basis for 60 months without any interruptions in between to have full access to healthcare services.

In 2007 the Bulgarian health ministry adopted an ordinance for provision of obstetrical aid to uninsured pregnant women and examinations out-of-scope of the compulsory health insurance ones. However, this ordinance does include only one medical check-up during the pregnancy. In addition to this, the analysis of secondary quantitative data proves that there are many district areas across the country whereby the strategic document has not been applied for the last three years by any gynecologist.

In 2019 the Trust for Social Achievement foundation, First Years First Priority National Co-Coordinator for Bulgaria, started to work on a project called We Care aiming to increase the health outcomes of the most excluded women from the Roma communities in Bulgaria. To do so, the Trust supported the establishment of informal advocacy network of 11 NGOs to advocate for changes on system level under the 5 domains of the nurturing care: good health, nutrition, responsive caregiving, opportunities for early learning, safe and secure environment for the development of the child in its early years.

One of the network’s goals was to advocate for regular access to prenatal care of every woman in Bulgaria. The collected research-based data and evidences played a crucial role for achieving this advocacy goal – In August 2022 the health ministry amended the Ordinance and increased the number of free medical check-ups from one to four, incl. examinations and up to two hospitalizations, when needed. From January next year every uninsured pregnant woman will have the right to monitor her pregnancy. This will increase the opportunities for a healthy development of the newborn and better health outcomes in the long-term perspective.

For further information:
Contact Rositsa Milkova – Joel, project manager of We Care project. Trust for Social Achievement Foundation,