386 Community spaces of influence: asserting gender justice to address Roma health inequities

Abstract OP 15: Exclusion and Discrimmination 1, B308 (FCSH), September 3, 2025, 17:00 - 18:00 Background Roma women and girls (RWG) experience some of the poorest health outcomes in Europe due to systemic antigypsyism, gender oppression, and exclusion from decision-making spaces that impact their health and wellbeing. Aim This study examines RWG’s involvement and influence in three Roma grassroots initiatives in Spain. It analyzes the mechanisms that enable RWG to assume leadership roles and influence health-related decisions, proposing a multi-level framework for Community Spaces of Influence (CSOI)—understood as collaborative spaces that foster public participation, and structural change toward greater health equity. Methods An instrumental case study was conducted including participant observation, documentary analysis, semi-structured interviews (n = 11), and two focus groups with Roma and non-Roma stakeholders (n = 5 and n = 4, respectively). The data were analyzed using thematic content analysis, following a deductive-inductive approach, guided by empowering community settings frameworks. Results Findings outline the multi-level changes needed to establish and maintain CSOI, providing RWG opportunities to assume new roles, self-represent, and lead social change towards gender justice and health equity. At the personal level, CSOI strengthen RWG’s capacities by fostering a shared identification of oppression, reinforcing their sense of mattering linked to rights, and enhancing their resilience. At the organizational level, CSOI facilitate RWG’s governance by ensuring their presence, voice, and leadership, creating safe and fair participation pathways, and promoting accountability for gender-responsive actions. At the societal level, CSOI amplify RWG’s influence by incubating social role models, strengthening networks, and advancing advocacy efforts. Conclusion This study underscores exclusion and discrimination as key determinants of RWG’s health inequities. CSOI can provide RWG with access to decision-making spaces, tools to co-create health solutions, and mechanisms to hold institutions accountable. This framework offers a replicable model for promoting health equity and social justice among marginalized populations around the globe.