The lack of engagement and influence of the Roma population has been identified as a key challenge to overcome the health inequities suffered by them. In this direction, the European Commission developed a framework for National Roma Integration Strategies-Health component (NRIS-H) to ensure that Roma would benefit from the Health 2020 agenda . Within this framework, the health domain is understood not only in regard to healthcare but also to environmental, occupational, housing, and personal health and wellbeing. To achieve the NRIS-H’s goals, member states committed to complement and reinforce the EU’s equality legislation by monitoring, sharing and strengthening Roma approaches in policies, as well as to create networks led by Roma to promote local health governance. Governance for health allows assessing power asymmetries in “the distribution of economic, intellectual, normative, and political resources” and its effect on health. Despite these efforts, in 2014, the latest Spanish survey comparing non-Roma and Roma’s health show that the health status of the latter remains virtually unchanged, thus maintaining a significant gap in regard to the large society3 . Some of the reasons for this lack of policy impact are due to the lack of engagement of Roma in the development and implementation of policies and actions. As a consequence, there exist a low implementation of agreed measures, scarce resources and the inadequate use of funds, as well as deficient support, commitment of institutions and stakeholders involved .

Amidst this landscape, the 9th meeting of the EU Platform for Roma Inclusion in 2015 offered an ideal framework for achieving change in ensuring the effective implementation of the NRIS-H at local levels. The Spanish NRIS-H and its Operational Plan are in line with the conclusions of this meeting.By setting up multi-stakeholders platforms at local level, policy advocacy is promoted through building effective partnerships between local, national and European actors to develop evidence- and narrative-based policies, practices and tools. Advocacy processes are required as organized attempts to transformative change policies, practices and attitudes by presenting arguments for how and why change should happen.