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You are here: > DETERMINE Key Outcomes > Innovative Approaches > Improving Homeless Health, Slovenia

(Slovenia)

Improving homeless health: innovative project. Enabling homeless to help themselves and improving their access to health services as well as the publics’ awareness and perceptions, through a wide range of initiatives, Slovenia

Project Summary

Some of the most common issues related to homelessness are exclusion from housing, employment networks, public health services, system information and a lack of social networks. Primary health care problems of the homeless population are extensive, and appear either as a result or consequence of a homeless lifestyle.

This programme has been designed for extremely socially excluded individuals that can’t be reached by existing health sector and social services, and are excluded from formal and in-formal networks and have alcohol and drug addictions. This programme takes a holistic approach to dealing with these people.

Due to the environment in which the homeless live and their habits, they often suffer from numerous types of health problems such malignant heart and vein damages, lung complaints, liver disorders, skin infections, allergic reactions, gangrenous wounds and necrosis, virus infections with hepatitis A, B, C and HIV and minor injuries and fractures. In addition, many have mental health problems and drug or/and alcohol addictions.

This programme recognises the influence of the social and economical environment on health and is based on lowering health risk factors. Elements of the programme include informing, advocating, mediating, and stimulating changes to provide the homeless with equal access to public health services and health education and encouraging this group to spend their time in a healthier way.

The Kings of the Street organisation coordinates a number of different interventions to engage with this group:

• A drop-in centre which is open 6 days a week to engage with vulnerable groups.
• Resettlement programmes.
• Employment projects in the drop-in centre to try to reduce employment.
• Promote the intake of healthier and better quality food.

Project Aims

The main aims of the ‘Improving Homeless Health’ project are:

• The prevention and reduction of health damage that accompanies the homeless lifestyle and reduction of the social risk factors of homelessness.
• To inform a wide circle of readers and experts in different fields about homeless health risk factors and the fact that they and other ‘hidden’ groups in the population are often not reached by the public health and health care services.

Objectives

1. Structural implementation of outreach work and work in drop-in centre with homeless than have health and medical difficulties - informing, promoting social and psychological health, individual planning, escorting, visiting, motivating users for entering in other programmes; Sept. 2008 - Sept. 2009
2. Advocacy, support, and personal assistance for homeless to enable them to get public health care; Sept. 2008 - Sept. 2009
3. Support and personal assistance for hospitalized users; Sept. 2008 - Sept. 2009
4. Equipping the homeless with information on how to approach and obtain public health care; Sept. 2008 - Sept. 2009
5. Organization of different workshops, lectures and personal advising in drop-in centre Sept. 2008 - Sept. 2009
6. Weekly organization of sports activities (football, basketball, swimming, outing, fitness); Sept. 2008 - Sept. 2009
7. Raising the themes of social exclusion and public health care issues amongst a wide public and decision makers through the street newspaper “Kings of the street”; Sept. 2008 - Sept. 2009
8. Monthly publication of professional newspaper articles on issues like public health care for the socially excluded, lowering damage by writing about discrimination and stigmatization in public health care, introduction of other organizations that offer professional assistance for drug and alcohol abusers; Sept. 2008 - Sept. 2009
9. Publishing articles of ex-drug and alcohol abusers and their life stories; Sept. 2008 - Sept. 2009
10. Informing homeless and public with promotional leaflets and flyers; Sept. 2009 - Sept. 2009
11. Cooperation with experts from the Institute of Public Health and and other institutions that are working in a field of social welfare and public health and work in the field of vulnerable  groups; Sept. 2008 - Sept. 2009
12. At the end of the project we will co-organize (with the Institute of Public Health) a national symposium of vulnerable groups and health inequalities. At the meeting we will bring together all actors involved, from decision makers to researchers, experts, service providers and representatives of our target group. - Sept. 2009
13. Undertake qualitative and quantitative research addressing the socio-economic determinants of health that will feed into the national symposium and provide an evidence base for policy makers. This research will focus on:
    - Do homeless people have access to the support they need?
    - Do they have access to information, prevention materials, health and social care and support?
    - Are they able to empower themselves and take over the steering wheel of their lives?
    - What are their other health related needs?

Why is this innovative?

This project was deemed to be innovative for the following reasons:

• It takes a holistic approach to addressing the problems related to homelessness.
• It uses progressive inclusion - the principle of small steps and small aims to generate behaviour change.
• The project provides a number of different flexible options for an individual to change their behaviour. For example, people can sell copies of a street newspaper, whereas others can be involved in all aspects of the programme from individual counselling and group work to mentoring others.
• It addresses different audiences. It looks at working directly with vulnerable groups, but also works with the public to address the wider environment to improve inclusion and provide more opportunities for vulnerable groups.
• The breadth of intervention entry points is innovative - looking at individual level behaviours such as healthy eating to housing related schemes. In addition, it tries to change the wider public’s perceptions of this vulnerable group.
• It will use ‘action research’ that involves the target group in the design and implementation of the study. The aim is to organise the study as a learning process for the people in charge, including homeless people.

Why is this relevant to the social determinants of health?

• This programme looks at tackling the wider determinants of housing and employment rather than simply focussing on health. Through entry into employment and housing, it is hoped that health of the individual will improve.
• It attempts to address the wider environment which vulnerable groups live in, looking to change the wider public’s attitudes and include these groups in society.
• The drop-in centre looks to improve the group’s access to and use of health care systems.