Challenges in sexual and reproductive health of Roma people who live in settlements in Serbia

Abstract

Objective To investigate the differences in sexual and reproductive health (SRH) between Roma women of reproductive age who live in settlements and the general population of women of the same age in Serbia who do not live in settlements.

Methods The Multiple Indicator Cluster Survey 4 (MICS4) was administered to Roma and Serbian women and the results were compared between the two groups. In order to get a qualitative perspective, a specifically designed, short open-ended questionnaire about Roma women was given to Roma Health Mediators (RHMs).

Results Roma women have a higher total fertility rate and adolescent birth rate, and early marriage is much more common among them. Differences are less clear regarding antenatal care and assistance during delivery from skilled personnel. Roma women more frequently rely on traditional contraception, and are less likely to use modern contraceptives than the general female population. Problems in the socio-economic sphere, poor school enrolment and maintenance of traditional patterns in Roma people living in settlements contribute to the disparities observed.

Conclusion Although data on the SRH of the general population of women in Serbia are far from being satisfactory, those for women who live in Roma settlements are much worse. Political actions aimed at the empowerment of Roma women in the spheres of education, employment and health promotion have been implemented with the hope that they might improve the SRH of this vulnerable population group.

Chinese Abstract

摘要

目的 调查研究生活在塞尔维亚居留地的罗马育龄期女性与非居留地的同龄女性间性生殖健康（SRH）方面的差异。

方法 对罗马女性与塞尔维亚女性分别进行多指标类集调查4（The Multiple Indicator Cluster Survey, MICS4）并比较调查结果。为进行定性研究，我们提供给罗马健康调解员（RHMs）为罗马女性特殊设计的、简短的、开放性的问卷。

结果 罗马女性的总生育率与青少年分娩率更高，且早婚现象更为常见。在专业人员产前保健及分娩助产方面的差异不甚明确。罗马女性更倾向于传统避孕方法，与整体女性相比新型避孕药的使用率更低。居留地罗马居民面对的社会经济问题、低教育率以及坚持传统模式等因素可导致以上差异。

结论 整体塞尔维亚女性的性生殖健康（SRH）相关数据要比居留地罗马女性相关数据令人满意得多。政府已展开行动维护居留地罗马女性在教育、就业及健康方面的权利，这也许可以提高该脆弱群体的性生殖健康。

Keywords:

• Sexual and reproductive health
• Roma women
• Family planning health indicators
• Contraceptive prevalence
• Childbearing
• Antenatal care

ACKNOWLEDGEMENTS

The authors are very grateful to Dr Sarah Randall for reviewing the paper before submission. This investigation was part of Project no. 47006 financed by the Ministry of Education, Science and Technological Development of the Republic of Serbia.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.