Study of social-economic inequalities and use of health services among women and children in Serbia

Socijalno-ekonomske nejednakosti u zdravlju su nepravedne i rezultiraju iz nejednake distribucije socijalnih determinanti koje utiču na mogućnost jedne individue da bude zdrava, njen rizik od bolesti kao i korišćenje usluga zdravstvene zaštite. Cilj ove disertacije bio je da se ispita povezanost demografskih i socijalno-ekonomskih determinanti sa korišćenjem usluga zdravstvene zaštite žena i dece tokom prenatalnog, antenatalnog i postnatalnog perioda, zatim uz pomoć koncentracionih indeksa proveriti da li nejednakosti u korišćenju usluga postoje, kao poređenje ovih nejednakosti tokom 2005., 2010. i 2014. godine u Srbiji među opštom populacijom žena i među ženama iz romskih naselja. Metod: U istraživanju su korišćeni podaci iz tri istraživanja istraživanja višestrukih pokazatelja (Multiple Indicators Cluster Survey - MICS): MICS3 iz 2005., MICS4 iz 2010. i MICS5 iz 2014. Godine sprovedenih u Srbiji na reprezentativnom uzorku opšte populacije žena i žena koje žive u romskim naseljima starosti od 15-49 godina. Kao instrumenti istraživanja korišćeni su upitnici. Rezultati: Među populacijom žena u Srbiji uočava se pad nezadovoljene potrebe za kontracepcijom u poslednjih 10 godina. U odnosu na Beograd kao referentnu kategoriju, sve žene koje žive na teritoriji Vojvodine tokom proteklih 10 godina imale su značajno manje šanse za postojanje nezadovoljenih potreba za kontracepcijom. U odnosu na 2005. godinu, upotreba kontracepcije je višestruko porasla u obe populacije tokom 2010. i 2014. godine i bila je veća među ženama koje su živele u romskim naseljima u odnosu na opštu populaciju žena...Social and economic inequalities in health are unfair and occur as a result of unequal distribution of social determinants that affect the ability of an individual to be healthy, its risk of disease and also the utilisation of health care services. The aim of this thesis was to examine the association between the demographic and socio-economic determinants and the utilization of health services in women and children during the prenatal, antenatal and postnatal periods, to explore whether health inequalities in the utilization of health service exists by using concentration index and compare them over 2005, 2010 and 2014 in Serbia among the general population of women and among women from Roma settlements. Method: The study used data from three Multiple Indicator Cluster Survey (MICS): MICS3 from 2005, MICS4 from 2010 and MICS5 from 2014. All studies were conducted in Serbia on a representative sample of the general population of women and also on women living in Roma settlements aged 15-49 years. The survey instruments were questionnaires. Results: Among all women it was identified the decrease in unmet need for contraception in the last 10 years. Compared to Belgrade, as the reference category, all women living in Vojvodina had significantly less chance for the existence of unmet need for contraception over the past 10 years. Compared to 2005, the use of contraception has grown significantly in both populations in 2010 and 2014. The rise was higher among women who live in Roma settlements compared to the general population of women. Withdrawn was reported as the most frequent method of contraception among all women during the three years of the study (significantly more frequent among the population in Roma settlements)..