Shortcomings of Maternity Care in Serbia

Authors

  • Jelena Arsenijevic MSc,

    researcher
    1. Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
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  • Milena Pavlova PhD,

    Associate Professor
    1. Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
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  • Wim Groot PhD

    Professor of Health Economics
    1. Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
    2. Top Institute Evidence-Based Education Research (TIER), Maastricht University, The Netherlands
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Address Correspondence to Jelena Arsenijevic, Department of HSR, Faculty HMLS, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.

Abstract

Background

Maternity care in Serbia is an integrated part of the centralized health care system inherited from the former Yugoslavia. Childbirth is often perceived as a medical event instead of a physiological process. This paper examines quality and access indicators, and patient payments for maternity care in Serbia.

Methods

We apply a method of triangulation using data collected through three sources: online questionnaires filled in by mothers who delivered in one of the maternity wards in Serbia in the period 2000–2008, research publications, and official guidelines. To compare the qualitative data from all three sources, we apply framework analysis.

Results

The results show a good network of maternity wards in Serbia. On the other hand, many women who gave birth in maternity wards in Serbia indicate problems with the treatment they received. The existence of informal patient payments and so-called “special connections” make the position of Serbian women in maternity wards vulnerable, especially when they have neither connections nor the ability to pay. Poor communication and bedside manner of medical staff (obstetricians, other physicians, midwives, and nurses) during the birth process are also frequently reported.

Discussion

Actions should be taken to improve bedside manners of medical staff. In addition, the government should consider the involvement of private practitioners paid by the national insurance fund to create competition and decrease the need for informal payments and “connections.”

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