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Access to primary healthcare services for the Roma population in Serbia : a secondary data analysis

Idzerda, Leanne; Adams, Orvill; Patrick, Jonathan; Schrecker, Ted; Tugwell, Peter

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Leanne Idzerda

Orvill Adams

Jonathan Patrick

Ted Schrecker

Peter Tugwell


Background: Serbia has proclaimed access to healthcare as a human right. In a context wherein the Roma population are disadvantaged, the aim of this study was to assess whether the Roma population are able to effectively access primary care services, and if not, what barriers prevent them from doing so. The history of the Roma in Serbia is described in detail so as to provide a context for their current vulnerable position. Methods: Disaggregated data were analyzed from three population groups in Serbia; the general population, the Roma population, and the poorest quintile of the general population not including the Roma. The effective coverage framework, which incorporates availability, affordability, accessibility, acceptability, and effectiveness of health services, was used to structure the secondary data analysis. Acute respiratory infection (ARI) in children less than five years of age was used as an example as this is the leading cause of death in children under 5 years old in Serbia. Results: Roma children were significantly more likely to experience an ARI than either the general population or the poorest quintile of the general population, not including the Roma. All three population groups were equally likely to not receive the correct treatment regime of antibiotics. An analysis of the factors that affect quality of access to health services reveal that personal documentation is a statistically significant problem; availability of health services is not an issue that disproportionately affects the Roma; however the geographical accessibility and affordability are substantive issues that disproportionately affect the Roma population. Affordability of services affected the Roma and the poorest quintile and affordability of medications significantly affected all three population groups. With regards to acceptability, mothers from all three population groups are equally likely to recognize the importance of seeking treatment. Conclusions: The Roma should be assisted in applying for personal documentation, the geographical accessibility of clinics needs to be addressed, and the costs of healthcare visits and medications should be reviewed. Areas for improvement specific to ARI are the costs of antibiotics and the diagnostic accuracy of providers. A range of policy recommendations are outlined.


Idzerda, L., Adams, O., Patrick, J., Schrecker, T., & Tugwell, P. (2011). Access to primary healthcare services for the Roma population in Serbia : a secondary data analysis. BMC International Health and Human Rights, 11, Article 10.

Journal Article Type Article
Publication Date Jan 1, 2011
Deposit Date Jun 21, 2013
Publicly Available Date Jun 27, 2013
Journal BMC International Health and Human Rights
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 11
Article Number 10


Published Journal Article (443 Kb)

Copyright Statement
© 2011 Idzerda et al; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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