CEDAW/C/77/D/143/2019 States parties must legally recognize and prohibit such intersecting forms of discrimination and their compounded negative impact on the women concerned. 11 7.4 The Committee further notes the authors’ assertion that Roma women systematically face stigma in their access to gynaecological services and that women from the Roma community tend to be disproportionately affected compared with other women who are of reproductive age and in need of gynaecological services. The Committee also notes the authors’ claim that the State party failed to take appropriate positive measures for the elimination of the discriminatory practice and failed to provide any adequate remedy to the authors. In that connection, the Committee recalls its concerns about the financial, cultural and physical barriers to gynaecological services faced by Roma and rural women (CEDAW/C/MKD/CO/4-5, para. 33). It also recalls the obligation of States parties to eliminate multiple forms of dis crimination against women who may suffer from discrimination based on, inter alia, race, ethnic or religious identity, including through the use of temporary special measures. 12 It further recalls that, in its concluding observations on the State party’s combined fourth and fifth periodic reports (CEDAW/C/MKD/CO/4-5, para. 19), it recommended that the State party adopt temporary special measures, inter alia, in situations in which women from ethnic minorities were disadvantaged. The Committee observes that the authors were treated differently from other women of reproductive age not belonging to ethnic minority groups who were seeking gynaecological services at the same time. The Committee also observes that the right to be free from discrimination entails not only treating people equally when they are in similar situations, but also treating them differently when they are in different situations. 7.5 The Committee notes the authors’ contention, which remained unrefuted by the State party, that the courts lacked an understanding of the phenomenon of discrimination and of the vulnerability of Roma women in society and, despite the evidence of unequal treatment, failed to establish that the gynaecologist h ad demonstrated a discriminatory attitude and to provide redress. It also notes the authors’ argument, also unrefuted, that the court lacked an understanding of the shifting of the burden of proof in a prima facie discrimination case to the defendant to establish that discrimination had not occurred. 7.6 The Committee considers with appreciation the information provided by the State party concerning the adoption in 2019 of a new legislative framework on the prevention of and protection against discriminatio n, especially in the health sector, the training programme implemented by the Ministry of Labour and Social Policy and the Ministry of Health and the project on Roma health mediators as part of the implementation of the Decade of Roma Inclusion 2005 –2015. However, it observes that the State party’s overview of legislation and measures is of a general nature and does not address the specific situation and grievances of the authors. In the absence of further information on file, the Committee therefore gives due weight to the authors’ detailed allegations. It observes that the State party did not ensure the practical realization of the principle of equality and the effective protection of the authors against any act of discrimination by any person, organizatio n or enterprise, which constituted a breach of the authors’ rights under articles 1 and 2 (a), (c) and (e) of the Convention. 7.7 The Committee further notes the authors’ claims that they faced serious obstacles to the enjoyment of their health rights, in breach of article 12 of the Convention. The Committee notes that it remained undisputed that the authors were refused enrolment as patients at the practice of their local gynaecologist and denied a __________________ 11 12 8/10 General recommendation No. 28 (2010) on the core obligations of States parties under article 2 of the Convention, para. 18. General recommendation No. 25 (2004) on temporary special measures, para. 12. 20-16465