Living Standards Measurements Study - Serbia 2002 - 2007

7. HEALTH
7.1. Introduction
Public health is determined by the individual
characteristics of individuals (sex, age, etc.),
external factors – social, economic, physical and
cultural environment, and by combined of these
parameters. Differences in health reflect differences
among population groups according to age, gender,
socio-economic status, disability and ethnicity.
These differences should not be viewed only as
necessary and unavoidable, but also as unjust,
which is also the case with poverty. Poverty has a
negative effect on health, and the connection
between poverty and ill-health is well-known.
Plentiful evidence can be found throughout the
history of medicine and in numerous studies which
all confirm a strong relationship between health
inequality and the financial situation of the
population 1 2 3 .
The biggest problem of poverty lies in the
fact that ill-health is connected with growing
expenses for health care, but also in the fact that
poor people find themselves in a vicious circle:
poverty causes illnesses, and illnesses reflect
poverty.
7.2. Health Care in Serbia
Reform of the health care system in Serbia cannot
be separated from the total reform of the state and
society which has been going on since 2000.
Maintenance of health and public health promotion
imply solving a spectrum of problems by means of
mechanisms realized through integrated strategic
approaches and activities of social systems
connected with health. To this effect the
Government of the Republic of Serbia has adopted a
whole range of important multi-sector and health
strategic documents, national programs and
activities 4 . At the same time, the legal framework
for the health care system has been improved
through new laws on medicaments, health
protection, health insurance, by means of Health
Personnel Chambers, etc. Numerous activities
realized by the Ministry of Health in association
with international partners have resulted in
improvement, particularly in the field of restoration
and modernization of health facilities and
equipment, as well as in the improved process of
health institutions performance.
Despite the definition of priority areas and of
directing health services and other sectors towards
that which will bring the greatest benefit to the
population, particularly the reduction of health
inequality which is noticeable in the positive trends
of the determinants of public health, Serbia is still
facing problems which present a great challenge to
be overcome.
Some of the most significant indicators of the
level of development, not only of the health care
system but the country and population as a whole, is
the number of newborns dying under a year of age
per 1 000 live births (infant mortality rate), and
children under 5 per 1 000 live births (children
under five mortality rate). Both indicators have a
constant positive trend going on for years. In 2000,
the infant mortality rate was 10.6, in 2002, 10.1, and
in 2006 it was 7.4. However, this percentage still
places Serbia among the European countries with a
high infant mortality rate (the average infant
mortality rate in the developed European countries
was 4.3 in 2005). The mortality rate for children
less than 5 years of age also dropped from 11.7 in
2002 to 8.6 in 2006, but the rate is still higher than
that found in highly developed EU countries (5.1 in
2005) 5 .
A study on public health in Serbia conducted
in 2006 found that there was also a positive trend in
the availability of doctors – every second inhabitant
in Serbia (51 percent) had its own General
Practitioner, which was significantly higher than in
2000 (43 percent). The availability of medicines
also increased (in 2006, 54 percent of adults in
Serbia used medicines mostly on prescription in
comparison to 39 percent in 2000). There was also a
significant increase in satisfaction of patients with
health care services, particularly with the
comprehensive treatment in hospitals, from 60
percent in 2000 to 73 percent in 2006. A positive
trend was also found in the change of population
habits, such as a reduction in the number of smokers
from 41 percent in 2000 to 34 percent in 2006 6 .
Many problems, however, still remain to be
solved, those that require long-term strategy of
health care policy such as larger investments in
health promotion and preventive medicine so as to
84 Living Standards Measurements Study - Serbia 2002 - 2007