with Roma women, in some regions Roma women have experienced problems accessing maternity hospitals because of their lack of personal documents.90 Furthermore, as a result of the medical reform in 2017, in order to be provided with healthcare all citizens of Ukraine should conclude an agreement with their family doctor. It is feared that without internal passports, Roma are precluded from signing such agreements and therefore precluded from accessing health care.91 However, it remains to be seen how the reform will be carried out and the possible implications of the reform for Roma without personal documents will be. This situation could be solved by introducing specific measures ensuring the enjoyment of the right to health for Roma and other persons without access to personal identification. By doing this, the government would tackle two key challenges: access to healthcare for the underprivileged, and the intergenerational problem of Roma lacking personal documents. Access to housing benefits and enjoyment of the right to adequate housing are also hampered by the lack of personal documents. This is one of the key issues internally displaced Roma experience after their forced displacement from crisis-affected areas. Finally, employment opportunities are not easily accessible for IDPs in general. Employers are reluctant to offer IDPs jobs92 and the employment situation for IDP Roma without personal documents is even worse. None of the Roma without personal documents who were interviewed during the course of this study was formally employed. All said they were working in the informal sector in low-paid and often physically very demanding jobs. VI THE WAY FORWARD: CONCLUSIONS AND RECOMMENDATIONS To “respect, protect and fulfil”93 the human rights framework, as well as their already-ratified human rights instruments and commitments, the Ukrainian authorities should provide a clear roadmap for their future steps to improve access to birth registration and internal passports for Roma. Given the importance of personal documents for the enjoyment of the full catalogue of human rights, measures related to accessing such documents would also have a significant impact on addressing the deep-rooted marginalization of Roma, combatting discrimination against Roma, enhancing Roma inclusion and improving their access to other human rights. In 90 Information from International Charitable Organization “Roma Women’s Fund Chiricli”, NGO meeting, 17 March 2017, Kyiv. 91 The medical reform has not been implemented at the time of writing. For the link between access to personal documents and the right to the highest attainable standard of health and healthcare, please see the report submitted by the Special Rapporteur on the right of everyone to the highest attainable standard of physical and mental health, Paul Hunt, Addendum, Mission to Romania, paras. 74–81, 21 February 2005, UN Doc. No. E/CN.4/2005/51/Add.4. 92 Information from the SMM Kharkiv, 31 March 2017. 93 According to the UN Office of the High Commissioner for Human Rights, the “obligation to respect” means that States must refrain from interfering with the enjoyment of guaranteed human rights. The “obligation to protect” requires States to protect individuals and groups against human rights abuses, while the “obligation to fulfil” means that States must take positive action to facilitate the enjoyment of basic human rights. 35