Women were also disproportionately affected by long COVID or post COVID-19 condition, which the World Health Organization defines as “the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation”.

The topic of long COVID among women, which is rarely discussed in the Bulgarian public space, was addressed at the event “Health: from women to women”, which Ekaterina Karavelova Foundation held at the end of March 2022. The organisation received feedback from many women who followed the discussion online that there was a need for more information and engagement with long COVID.  That was what inspired the work on a policy brief regarding the situation in Bulgaria.

Summary of the policy brief “Long COVID Among Women In Bulgaria”

In short, it can be said that the topic of long COVID and the fact that it affects mostly women does not provoke much interest in the Bulgarian public space, and a registry of people with ongoing or new symptoms after recovery from the active phase of the virus does not exist.

In order to address the lack of data on long COVID among women in Bulgaria, Ekaterina Karavelova Foundation conducted an online survey in November 2022. It got responses from 141 women from across the country, including a small percentage of women from Bulgaria who currently live abroad. Although it is not a nationally representative sample, it provides valuable information that can serve as a basis for subsequent larger scale studies.

Responses to the central survey question, “Did you (or do you still) have symptoms that continued after you recovered from COVID-19?” indicate that most respondents (79.4%) had or still have some type of ongoing symptoms, with only 19.9% stating that they had no such complaints, and a single respondent answering that she had asymptomatic COVID-19.

The persistent symptoms reported by respondents varied, but the top three were:

1) fatigue, exhaustion, tiring easily (66.9%);

2) cognitive and concentration problems (46.8%);

3) hair loss (37.9%).

Other common symptoms include memory problems, headaches, sleep problems, loss of taste and smell, muscle aches, coughing and difficulty breathing, as well as hormonal imbalance and changes in the menstruation cycle.

The gathered information shows that neither patients nor all professionals are well-informed about the post COVID-19 condition and no adequate comprehensive solutions taking into account gender differences are offered. In order to address this issue, Ekaterina Karavelova Foundation prepared a list of recommendations presented at the end of the policy brief.

Recommendations:

• Conduct nationally representative research to assess the prevalence of post COVID-19 syndrome in the country, as well as the gender specificities of the condition.
• Actively involve patients in the development of measures to address the impact of long COVID.
• Design a comprehensive interdisciplinary approach to address long COVID taking into account its medical, psychological and social aspects, as well as the fact that women are more often affected by ongoing symptoms.
• Create a national programme funded by the Ministry of Health rather than the NHIF and available to all those in need regardless of their health insurance status and whether or not they have been hospitalised in the active phase of the disease.
• Develop appropriate to the national context guidelines for health professionals, including GPs. 
• Prepare information materials on post COVID-19 syndrome aimed at the general public, to be made available both online on the COVID-19 Information Portal and in the form of leaflets to be distributed in the offices of the Regional Health Inspectorates, the Regional Health Insurance Funds, among GPs and health facilities.

More information can be found in the policy brief “Long COVID Among Women in Bulgaria” available in Bulgarian here.

Answers to these questions were presented on 24 January during an online event on the topic “Institutionalising Gender Mainstreaming in Parliament: Participatory Gender Audits and Gender Action Plans”.

The web dialogue was organised by the OSCE Parliamentary Assembly and OSCE Office for Democratic Institutions and Human Rights (ODIHR). The two main objectives were the following:

• To launch the new Participatory Gender Audits of Parliaments: A Step-by-Step Guidance Document available in English and Russian.
• To create space for sharing experiences on the implementation of gender audits and gender action plans as instruments for institutionalising gender mainstreaming.

The event brought together over a hundred participants – parliamentarians, diplomats, representatives of academia and civil society orgsanisations, among whom was also Margarita Spasova, Advocacy Officer at Ekaterina Karavelova Foundation.

OSCE PA President Margareta Cederfelt and ODIHR Director Matteo Mecacci welcomed the participants and emphasised the importance of collective action in order to achieve gender equality in the OSCE region. Mr. Mecacci pointed out that the increase in women’s representation never happens accidentally, but it is rather the result of serious political mobilisation. He shared that the average level of representation of women in the parliaments of the OSCE region is 31% and the achievement of the long-term goal of gender parity (50/50) is still far away, while there is also need to create conditions for meaningful participation and real possibility to influence decision-making processes.

Saša Gavrić from OSCE ODIHR presented two gender mainstreaming tools with which the organisation supports national parliaments from the region, namely gender audits and gender action plans, as well as the new Participatory Gender Audits of Parliaments: A Step-by-Step Guidance Document. It compliments the publication Realizing Gender Equality in Parliament: A Guide for Parliaments in the OSCE Region published in 2021 and offers a framework how to implement participatory gender audits recognising the fact that each parliament is unique.

Prof. Sarah Childs from the University of Edinburgh, a leading researcher in the field of women’s political representation and a consultant with experience working with various international organisations and national parliaments, drew attention to the importance of collaboration between academia, civil society and parliaments so that the latter develop as gender sensitive institutions.

The next two speakers, Božena Jelušić, Chair of the Gender Equality Committee Parliament of Montenegro and Kenneth G. Forslund, First Deputy Speaker of the Swedish Riksdag, Chairperson of the Rikstag’s Working Group on Gender Equality, shared what actions have been undertaken by the parliaments in their respective countries in order to advance gender equality.

The event continued with a discussion around questions raised by the participants, among which were the importance of conducting gender audit not only in parliaments but also in political parties, the role of civil society organisations in the process of transformation of parliaments towards equality, and the need for implementing an intersectional approach to address not only gender inequalities, but also other factors such as ethnicity and disability.

At the end of the event, the speakers encouraged national parliaments and all stakeholders to act systematically step by step, apply a multi-party approach, seek cooperation and expertise from civil society organisations and academia, and work to strategically develop processes that can lead to real institutional change regardless of the existing state of gender equality from which they start in their context.

Advocacy is also an important part of the work of Ekaterina Karavelova Foundation, through which we aspire to achieve gender equality and women’s full participation in all spheres of life.

This is why the participation of Margarita Spasova from our team in the second edition of the RARE programme (Recharging Advocacy for Rights in Europe) is a wonderful opportunity to increase the capacity of the foundation and develop a network of active civil society organisations in the European Union. The programme is a joint initiative of the Hertie School, Berlin, the Hungarian Helsinki Committee, the Netherlands Helsinki Committee, the Helsinki Foundation for Human Rights in Poland and Oxfam Novib. Its aim is to bring together representatives of civil society organisations from different countries to enhance their skills and build a strong alliance to advocate for human rights and civic space at a European level. The programme lasts for 2 years and includes 10 thematic meetings on topics such as communicating human rights, policy writing, non-profit leadership, etc.

The new edition of the RARE programme kicked off in October in Crete, where 26 participants from civil society organisations from across the European Union gathered to share about their advocacy work and lay the foundations for working together to defend fundamental rights and rule of law in the EU. The next thematic meeting of the advocacy network will take place at the end of November in Tallinn and will give participants from the first edition of the programme and the new group the opportunity to exchange experiences and develop their public speaking skills.

We are confident that increasing Ekaterina Karavelova Foundation’s advocacy capacity will enable us to work even more effectively in support of gender equality and women’s rights at both national and European level.

The problem with representation in the Bulgarian parliament is persistent, and the low participation of women in the 48th National Assembly was expected given the composition of the electoral lists. “Ekaterina Karavelova” Foundation works to address this problem and with the support of Friedrich Ebert Stiftung Bulgaria organised the round table “Advancing gender equality in Bulgaria: the role of the parliament and the political parties”. The event gathered representatives of 7 of the political parties represented in the 47 National Assembly – BSP, Yes, Bulgaria, DPS, DSB, The Green Movement, There is such people and We continue the change. Internal party policies on gender equality and women’s political participation were discussed.

The challenges that the roundtable participants identified were related to gender-based stereotypes, the challenges in combining both family and work related responsibilities, the lack of funding for the women’s wings of the parties and the lack of trainings for capacity building, structural barriers which place women in a disadvantage position in terms of financial independence and opportunities for development, as well as the tendency to ignore women’s issues.

Political parties represented in the 47 National Assembly were invited to participated in the round table, which took place on the 20th of September in the city of Plovdiv.

The round table, which aim was to identify political parties needs in their work to advance internal party policy on gender equality was opened by Ms Marina Kisyova de Geus, executive director of Ekaterina Karavelova Foundation and Ms Kalina Drenska from Friedrich Ebert Stiftung Bulgaria. They presented the alarming trends which show the decline of women’s participation the last 3 parliaments in Bulgaria and expressed the commitment of both organisations to work towards finding solutions.

Special guest of the round table was Corien Jonker, former member of parliament from The Netherlands and international expert on women’s political empowerment and leadership. In April 2021 she also served as the Head of Mission of the Limited Election Observation Mission deployed to Bulgaria by ODIHR OSCE.

Her keynote address was followed by presentations on internal party policies on gender equality by Ms Aleksandra Berdankova (BSP), Ms Vesselina Aleksandrova (Yes, Bulgaria), Mr Krassimir Asenov phd (DPS), Ms Kristina Petkova (DSB), Ms Dobromira Kostova (Green Movement), Ms Snezhanka Trayanska (There is such people) and Ms Ventsislava Lubenova (Volt. We continue the change).

In the second part of the round table, Margarita Spasova, advocacy officer at “Ekaterina Karavelova” Foundation facilitated an interactive session in which the participants had the opportunity to share what they think are the challenges and barriers facing women involved in politics. As a result of the discussion, they can be summarized in 3 categories:

• personal factors (women more often have lower self-esteem and as a result doubt whether they have all the knowledge and skills)
• environmental factors (gender-based stereotypes, difficulties in combining family commitments and work, economic inequalities and unequal access to financial resources)
• internal party factors (the lack of funding for the women’s wings in political parties and the lack of capacity-building training, the more frequent placement of women in non-elective positions on candidate lists during elections)

A snapshot of the 48th National Assembly

According to the data announced by the Central Election Commission on October 7, women in the 48th National Assembly will be 58 or 24% of its composition.

Out of a total of 31 multi-member constituencies, 7 will not send a single female representative – Gabrovo, Kyustendil, Razgrad, Silistra, Smolyan, Sofia region and Yambol. At the same time, all 6 mandates from the 8th MIR Dobrich went to women from 6 different parties, and each of them was the leader of the respective electoral list in the city.

With the best ratio of the number of women and men in the new parliament is the smallest group, that of Bulgarian Rise, where 4 out of a total of 12 people’s representatives are women. With the most unbalanced ratio of women and men are the parliamentary groups of We continue the change and Vazrazhdane, and both parties have only 19% women of their total number of MPs.

Ekaterina Karavelova Foundation will publish a detailed report from the round table, accompanied by good international practices for promoting gender equality in politics.

Photographer: Lina Krivoshieva