National Health Survey Serbia 2006 Key Findings

Republic of Serbia
MINISTRY OF HEALTH
NATIONAL HEALTH SURVEY

SERBIA, 2006
KEY FINDINGS
SERBIA, 2006
KEY FINDINGS
Reviewers
Prof. Snežana Simić
Prof. Ljiljana Denić
Translator
Vesna Kostić, BLit
Publisher
Ministry of Health
Republic of Serbia
Design and pre-press

Dragan Brujić
Print run
500
Printed by
Donat Graf d.o.o.
2007
Republic of Serbia
MINISTRY OF HEALTH

SERBIA, 2006
K E Y F I N D I N G S
May 2007
FOREWORD
This publication presents the key findings of the 2006 Health Survey of the Republic of Serbia that
the Ministry of Health conducted with financial and professional support of the World Bank, the
World Health Organization Regional Office for Europe – Country Office Serbia and the Institute of
Public Health of Serbia „Dr Milan Jovanović Batut“. Fortunately, the 2000 Health Survey of the
Republic of Serbia published immediately before the democratic changes in October of the same
year pursued practically the same methodology, so that the results of that study provide a solid
foundation to evaluate the effects of the Ministry of Health’s work on the reform, development of the
health care system and health protection and promotion of the Serbian population.
Health surveys, conducted periodically, provide precious data on social and economic health de-
terminants, health status based on self-assessment of individuals, lifestyles, functional abilities, use
of health care services and expenditures associated with health care. These data enable evaluation
of policies and programs in the period between two surveys, identification of priority problems and
implementation of pertinent measures and activities for health promotion and health care of the
population, monitoring of the health status and epidemiological trends of diseases, formulation of
health policy objectives and defining the health system development strategy. They are also indis-
pensable for balancing the increasing health care needs with available resources in order to provide
efficient and quality health care for longer life and better quality of life of the people.
Important success in reduction of the prevalence of smoking among adults and adolescents, higher
level of information on risk factors and level of responsibility for own health, more frequent use of
services in the public sector and higher satisfaction of users with the services rendered resulting
from the findings of the health survey suggest responsible attitude of the Ministry of Health to the
citizens and Government in management of the public resources earmarked for the development of
the health care system of the Republic of Serbia.
Minister of Health
Professor Tomica Milosavljević, MD, PhD
SURVEY BACKGROUND
The 2006 National Health Survey for the population of Serbia (without data on Kosovo and Metohija) was
conducted by the Ministry of Health of the Republic of Serbia with financial and professional support of the
World Bank – the “Serbia Health Project”, the World Health Organization Regional Office for Europe – Country
Office Serbia and the Institute of Public Health of Serbia “Dr Milan Jovanović Batut”.
STUDY TEAM
Core Team Members
Jasmina Grozdanov, MD, PhD, Principal Investigator
(Institute of Public Health of Serbia)
Assoc. Prof. Dejana Vuković, MD, PhD, Deputy Principal Investigator

(Social Medicine Institute, Faculty of Medicine, University of Belgrade)
Maja Krstić, MD, MSc, Study Secretary

Biljana Vančevska-Slijepčević, MD
(Ministry of Health, Republic of Serbia)
Local Consultants
Prof. Vera Grujić, MD, PhD, for adult population,
Institute of Public Health Vojvodina, Novi Sad
Zorica Dimitrijević, MD, PhD, for population of school children and adolescents,
City Institute of Public Health Belgrade
Milena Vasić, MD, PhD, household profiles,

Institute of Public Health of Serbia
Sanda Pešić, BMath, for IT support and preparing statistical analysis,

Institute of Public Health of Serbia Consultancy Agency
Consultancy Agency
Strategic Marketing (SMMRI) Belgrade for sampling,
field study, entering, processing and statistical analyses of the data
International Consultant
Prof. Elliot M. Berry MD, FRCP, Head of the World Health Organization Collaborative Center for Capacity
Building in Public Health and Director of the Department of Human Nutrition and Metabolism of the
Braun School of Public Health of the Hebrew University - Hadassah Medical School, Jerusalem, Israel
SUPERVISORY BOARD
Prof. Tomica Milosavljević, MD, PhD,
Minister of Health in the Government of the Republic of Serbia
Prof. Snežana Simić, MD, PhD,

Assistant Minister of Health
Assoc. Prof. Goran Ilić, MD, PhD,

Assistant Minister of Health
Tanja Knežević, MD, PhD,

Director of the Institute of Public Health of Serbia
Prof. Mirjana Martinov Cvejin, MD, PhD,

Director of the Public Health Institute Vojvodina, Novi Sad
Slobodan Tošović, MD,

Director of the City Institute of Public Health Belgrade
Prof. Branislav Petrović, MD, PhD,

Director of the Institute of Public Health Niš
Assoc. Prof. Goran Samardžić, MD, PhD,

Director of the Institute of Public Health Kragujevac (by January 2007)
Saša Rikanović, MSc,

Director of the World Bank Project Coordination Unit
at the Ministry of Health of the Republic of Serbia
REVIEWERS
Prof. Snežana Simić, MD, PhD,

Institute of Social Medicine, Medical Faculty, University of Belgrade
Prof. Ljiljana Denić, MD, PhD,

Institute of Epidemiology, Medical Faculty, University of Belgrade
ACKNOWLEDGEMENTS
The study team would like to thank particularly

Prof. Tomica Milosavljević, the Minister of Health in
the Government of the Republic of Serbia whose personal
commitment has made this study possible.
We would also like to thank the following people for support and advice:
Tanja Knežević, MD, PhD

Saša Rikanović, MSc,

(World Bank Project Coordination Unit,
Ministry of Health, Republic of Serbia)
Danijela Simić, MD
Anđelka Dželetović, MD, PhD

Ivana Bjelić, BMath

(Strategic Marketing Belgrade)
Janko Janković, MD
(Medical Faculty, University of Belgrade)
Tanja Bajić, MD
(Ministry of Health, Republic of Serbia )
KEY FINDINGS
CONTENT
Foreword
Survey background
Acknowledgements
INTRODUCTION 11
HOUSEHOLD CHARACTERISTICS, HOUSEHOLD

SOCIAL-ECONOMIC STATUS, DRINKING WATER
SUPPLY AND WASTE DISPOSAL 13
HEALTH STATUS OF ADULT POPULATION 15

Self-assessment of health and satisfaction with life 15
Injuries 15
Prevalence and incidence of chronic diseases 15
Prevalence of high blood pressure 16
Nutritional status 18
Monitoring and counseling relating to risks for chronic non-
communicable diseases 19
Mental health 20
Ability to perform activities of daily living 21
ADULT POPULATION LIFE STYLE, KNOWLEDGE AND

ATTITUDES TO HEALTH 22
Hygienic habits 22
Diet 22
Leisure, exercise and sports 24
Behavior in traffic 24
Knowledge of health risks 24
Smoking 25
Alcohol consumption 26
Use of psychoactive substances 26
Sexual behavior 27
HIV/AIDS 28
REPRODUCTIVE HEALTH OF WOMEN 30
9
NATIONAL HEALTH SURVEY SERBIA
USE OF HEALTH SERVICES– ADULT POPULATION 32

Primary Health Care (PHC) 32
Dental health care 33
Private practice 34
Hospital health care 35
Use of medication 35
Patient satisfaction with health care 36
HEALTH CARE PAYMENTS 38
HEALTH STATUS OF CHILDREN AND ADOLESCENTS

AGED 7–19 YEARS 39
Self assessment of health and satisfaction with life 39
Blood pressure 39
Nutritional status 40
Information and counseling relating to risks of chronic non-
communicable diseases 40
Mental health 41
LIFESTYLE, KNOWLEDGE AND ATTITUDES TO HEALTH

IN CHILDREN AND ADOLESCENTS AGED 7–19 YEARS 43
Hygienic habits 43
Diet 43
Leisure, exercise and sports 44
Behavior in traffic 44
Awareness of health risks 44
Smoking 44
Alcohol consumption 45
Use of psychoactive substances 46
Sexual behavior and awareness of HIV and AIDS 46
RELATIONS OF CHILDREN AND ADOLESCENTS AGED

7-19 WITH PARENTS AND ATTITUDE TO SCHOOL 48
USE OF HEALTH SERVICES – CHILDREN AND

ADOLESCENTS AGED 7-19 YEARS 49
Primary health care services 49
Dental health care 49
Hospital care 50
Use of medication 50
Reproductive health of female adolescents 51
CONCLUSIONS 52
10
KEY FINDINGS
INTRODUCTION
The 2006 National Health Survey for the population 3. To identify changes in the health status indicators,
of Serbia (without data on Kosovo and Metohija) was distribution of risk factors in the population, use of
carried out by the Ministry of Health of the Republic health services and patient satisfaction with health
of Serbia with financial and professional support of the care in the period from 2000 to 2006.
World Bank – the “Serbia Health Project”, the World
Health Organization Regional Office for Europe Implementation of the survey
– Country Office Serbia and the Institute of Public
Health of Serbia “Dr Milan Jovanović Batut”. The A stratified two-stage sample of the population of the
study was the follow up of the baseline study conducted Republic of Serbia was used in the survey. The sample
in 2000 under the title “Health Status, Health Needs was selected to provide statistically reliable estimates
and Utilization of Health Care of the Population of of the health indicators at the national level and at
Serbia” by the Institute of Public Health of Serbia the levels of six geographical regions. The following
“Dr Milan Jovanović Batut” in collaboration with the information was collected: on characteristics of families
network of public health institutes and primary health and households; demographic and socio-economic
care centers, with technical and financial support of characteristics of responders, health self-assessment,
the World Health Organization and UNICEF. mental health characteristics, characteristics of social
interactions, ability to perform activities of daily
The primary objectives of the survey living, characteristics of behavioral habits, diseases
were: and injuries, health check-ups and early diagnosis of
1. To evaluate health, identify the main health diseases, use of health services and patient satisfaction
problems, health needs, use of health services with health care, “out-of-pocket” payment for health
and patient satisfaction with the health care, in a care and objective health status.
representative sample of the Serbian population over The information on the health of the population of
7 years of age, on the national level and at the level the Republic of Serbia was obtained from interviews,
of six geographical regions: Vojvodina, Belgrade, anthropometric and blood pressure measurements.
Western Serbia, Central Serbia, Eastern Serbia and Five questionnaires were used to collect the data:
Southeastern Serbia, as well as at the level of urban household questionnaire, questionnaire for adults
and non-urban settlements; aged 20+ years, and questionnaire for children and
2. To investigate differences in the health status, adolescents aged 7-19 years (face to face), self-
exposure to risk factors and the use of health services in administered questionnaire for adults aged 20+ years,
relation to demographic characteristics of the respective and self-administered questionnaire for children and
populations, social and economic status, geographical adolescents aged 12-19 years.
region and type of settlements in which they live;
11
Map 1. Distribution of sample by the geographical regions
Sampled municipalities
Vojvodina
Belgrade
Eastern Serbia
Central Serbia
Western Serbia
Southeastern Serbia
Kosovo and Metohija
Response rate Presentation of results
Out of 7,673 households selected for the sample, This publication presents the key findings of the
7,119 were actually living at the address and 6,156 study by gender and age of the survey population,
were interviewed. social-economic characteristics, education, household
The household response rate was 86.5%. In the income and Demographic and Health Survey Wealth
households there were 15,563 adults aged 20+ years, Index (hereafter - wealth index).
of which 14,522 were interviewed yielding a 93.3% The population distribution was made from the
response rate. Out of 2,921 children aged 7 to 19 lowest to the highest household value of the wealth
years, 2,721 were surveyed yielding a 93.2% response index into five categories (quintiles), where the first
rate. The response rate in the self-administered comprised the poorest and the fifth the richest sector
questionnaire was 70.3% for adults and 77.0% for of the population. Also, the results are presented by the
children and adolescents aged 12-19 years. The overall geographical regions and type of settlement in which
adult and children (aged 12-19) response rates were the population live. The results are compared with the
80.7% and 80.6%, respectively. findings of the 2000 Health Survey.
12
KEY FINDINGS
HOUSEHOLD CHARACTERISTICS,
HOUSEHOLD SOCIAL-ECONOMIC STATUS,
DRINKING WATER SUPPLY AND
WASTE DISPOSAL
In 2006, the average Serbian household comprised (91.2%), and significantly higher in Belgrade (98.3%).
3 members, and the most common were the ones A significant increase was recorded in comparison with
composed of 2 members. 2000 when 91.9% of the households had connection to
water supply system in the house / apartment.
The average apartment area per household member
was 33.4 m2, with the average number of persons per Sanitation facilities were available in 85.2% of the
bedroom being 1.6. In 2006, the average square area per households in Serbia, representing a fall in comparison
person in an apartment was increased in comparison with 2000 when these were available in 89.3% of the
with 2000 when it was 26.8 m2. households. Also, the number of households linked to
sewerage networks or septic tanks fell from 90.7% in
Living conditions were estimated as poor by 17.3% of 2000 to 87.7% in 2006.
households, most commonly in Southeastern Serbia
(23.3%), and other, i.e. non-urban settlements (22.4%), In 2006 in Belgrade (96.0%) and Vojvodina (90.8%) a
and in the group of the poorest households (41.0%). significantly higher percentage of the population lived
in households linked to a sewerage network or septic
In 2006, 95.2% of the population of Serbia had running tank, while significantly under-average values were
water available in the apartment; a significantly lower recorded in the Western, Eastern and Southeastern
percentage was registered in Southeastern Serbia regions of Serbia (Figure 1).
Figure 1. Percentage of population living in households linked to the sewerage network or a septic tank, by geographical regions,
Serbia, 2006
% population
0 10 20 30 40 50 60 70 80 90 100
Serbia 87.7
Vojvodina 90.8
Belgrade 96.0
Western Serbia 81.4
Central Serbia 87.5
Eastern Serbia 83.9
Southeastern Serbia 76.4
13
Figure 2. Households that are 4 km or more away from the nearest primary care clinic, by the regions and type of settlement,
Serbia, 2006
35
28.7
30
25 22. 3 23.7
% households
19.1
20
16.8
Serbia= 13.7
15
10 8. 2
6. 7
4. 4
5
Urban
Serbia
Serbia
Serbia
Serbia
Central
Eastern
Western
Belgrade
Vojvodina
Non-urban
Southeastern
In 40.5% of households in Serbia in 2006 the income as poor, which is a significant improvement over
in the month preceding the survey was sufficient to 2000 (40.0%).
cover basic outlays (food, personal hygiene, cleaning
of the apartment, clothing, footwear and utility bills); In 2006, one in seven households (13,7%) was 4 km or
in 32.9% they were sufficient to cover all expenditures, more from the nearest primary care clinic. A significan-
which is a significant improvement in comparison tly lower percentage of households were 4 km or more
with 2000 when the values were 16.8%, and 7.4%, away from the nearest primary care clinic in Vojvodina
respectively. (4.4%) and Belgrade (8.2%), and urban settlements
(6.7%), while the percentage was significantly higher
In 2006 more than one third (37.0%) of the house- in Western, Central and Eastern Serbia and non-urban
holds in Serbia described their financial situation settlements (Figure 2).
14
KEY FINDINGS
HEALTH STATUS OF ADULT POPULATION
Self-assessment of health and Injuries

satisfaction with life
In 2006 in Serbia 8.3% of the adult population suffered
In 2006, 15.7% of adults self-assessed their health as an injury in the 12 months preceding the survey, which
very poor or poor; 37.1% as fair, and 47.0% rated it as is significantly less than the figure for 2000 - 10.9%.
good or very good. A significantly higher number of One in eleven men suffered an injury (9.2%), while
women perceived their health as fair or poor, contrary women were less prone to injuries (7.2%), significantly
to men who tended to perceive their health as good or less in comparison to the Serbian average.
very good. Noticeably, people older than 55 yrs tended
to assess their health as poor, while those above the age Injuries suffered by adults were significantly higher in
of 65 described it as very poor (Figure 3). Vojvodina (9.8%), and significantly lower in Western
Serbia (4.8%).
Although in the 2006 scale of life values (rank 1
most important, rank 9 least important) the adult Prevalence and incidence of chronic
population of Serbia prioritized health with an average diseases
rank of 1.5, only one quarter of the adults (24.4%)
shared the desirable attitude on responsibility for own In 2006 over a half of the adult population of Serbia
health. Responsibility for own health was recognized (55.9%), reported one of the 19 listed chronic diseases.
significantly more commonly by persons aged 20–44, The most common disease was elevated blood pressure
groups with secondary or higher educational levels, (23.0%); it was followed by rheumatic joint diseases
those living in urban settlements, Belgrade and the (16.8%), elevated blood lipids (7.9%), kidney diseases
richest by the wealth index (Figure 4). (6.0%) and allergies except for asthma (5.3%) (Figure 5).
Figure 3. Self-assessment of overall health status of adult population by age, Serbia, 2006
48. 2
47. 7
46.5
50
43.8
42. 2
45
37.8
37. 1
36. 2
40
33.2
31. 9
31. 4
35
29.8
% population
30
24. 8
24.3
25
20. 1
19. 8
17.2
17.0
15.3
20
13. 8
12.6
10.7
15
9.3
9.2
6.9
10
6.5
4.8
4.7
3.5
3.4
3.1
2.1
2.0
5
1.4
0.4
0
Serbia 20–34 35–44 45–54 55–64 65–74 75+
Very bad Bad Fair Good Very good
15
Figure 4. Adult population sharing the desirable attitude on responsibility for own health, by age groups, Serbia, 2006
% population
0 5 10 15 20 25 30 35
Serbia 24.4
20–34 30.7
35–44 27.0
45–54 25.2
55–64 21.5
65–74 17.5
75+ 17.1
Figure 5. Adult population with history of any of the listed diseases, Serbia, 2006
Elevated blood
pressure 23.0%
Other diseases 41.0%
Rheumatic
joint disease 16.8%
Allergies
(except asthma) 5.3%
Kidney diseases 6.0 % Elevated blood lipids
7.9%
The population of Belgrade (60.2%) and those with the The most common symptoms or health complaints
lowest educational level (69.0%) had a significantly experienced by the adult population of Serbia in 2006 in
higher prevalence of all reported diseases as opposed to the 4 weeks preceding the survey were pain and insomnia
the population with secondary education (47.0%) and (Figure 6).
those rated the richest by the wealth index (52.7%).
Prevalence of high blood pressure
In the 12 months preceding the 2006 survey, some of the
19 selected diseases were initially diagnosed in 16.3% of In 2006 in Serbia, measurements showed elevated
adults (incidence). systolic (≥140 mmHg) or diastolic (≥90 mmHg) blood
16
KEY FINDINGS
Figure 6. Adult population by the symptoms or health complaints experienced in the 4 weeks preceding the survey, by gender,
Serbia, 2006
% population
0 10 20 30 40 50 60
17.2
Insomnia
28.6
31.6
Headache
52.1
39.3
Pain in neck/shoulders
49.3
48.4
Back pain
56.4
35.2
Pain in joint s Male
46.4
Female
Figure 7. Adult population of Serbia with hypertension and potential hypertension, by age groups, Serbia, 2006
90
80 77.2 75.7
68.7
70
60
% population
50.2 Serbia = 46.5

50
40
27.8
30
20 13.5
10
0
20–34 35–44 45–54 55–64 65–74 75+
pressures in 46.5% of adults, or that they took medication Hypertension was more common in men (48.9%),
to reduce blood pressure, i.e. may be described as persons persons over 45 yrs, those living in Southeastern Serbia
with hypertension or potential hypertension (high (49.9%) as well as in those with the lowest education
blood pressure). In 2006 the percentage of hypertensive level (62.7%), poorest (53.1%) and poorer (49.3%)
population was higher in comparison with 2000, when according to the wealth index (Figure 7).
it was 44.5%. In 2006 the average value of the systolic
pressure in adult population of Serbia was 134.2 mmHg In 2006 antihypertensive medication was used by
(136.3 mmHg in men, vs. 131.9 mmHg in women) and 24.1% adults in Serbia. Every other person with
systolic pressure 82.0 mmHg (83.4 mmHg in men vs. hypertension and potential hypertension (51.3%) used
80.5 mmHg in women). antihypertensive medication, which is significantly
more than in 2000 (46.5%). In the 4 weeks preceding
17
the survey 68.2% persons with hypertension were elevated blood pressure rose with age and peaked in the
regularly medicated, which is significantly more than in population over the age of 55. In 2006 of those aware
2000 when only 49.8% did so. The percentage of regular of their hypertension, 87.9% received treatment, which
medication users was significantly higher in women was a significant improvement over 2000 when only
(62.1%), and significantly lower in men (42.5%). 81.5% did so.
Also, this percentage increased in the population over
the age of 55, those living in Southeastern of Serbia Nutritional status
(59.8%), those with the lower education level (56.9%)
and those with the household income exceeded RSD In 2006 in Serbia, based on the body mass index (BMI),
15,000 per capita (i.e. household member) (56.6%) 38.3% of the population had optimum weight, one in
(Figure 8, Figure 9). two was overweight (54.5%), subdivided as 18.3%
obese and 36.2% pre-obese (Figure 10). There were
Out of the total number of people with hypertension also 2.3% of people underweight.
in Serbia, 28.4% were aware of the disease; more The average body mass index of the adult population of
precisely one in three women (30.8%) and one in Serbia aged 20+ years was 26.7 kg/m2 (27.4 for men vs.
four men (26.3%). The knowledge on the presence of 26.0 for women).
Figure 8. Antihypertensive drug use in the population with hypertension or potential hypertension by age groups, Serbia, 2006
70
62.6
60.4 62.2
60
Serbia = 51.3
50 45.0
% population
40
28.1
30
20
10.6
10
0
20–34 35–44 45–54 55–64 65–74 75+
Figure 9. Antihypertensive drug use in the population with hypertension or potential hypertension by geographical regions and
average income per household member (in RSD), Serbia, 2006
% population % population
0 20 40 60 80 40 45 50 55 60
Serbia 51.3
Serbia 51.3
Vojvodina 50.4
Up to 4,500 48.0
Belgrade 50.6
From 4,501 to 7,000 51.0
Western Serbia 51.4
47.9 From 7,001 to 10,000 49.7
Central Serbia
Eastern Serbia 48.1 From 10,001 to 15,000 53.9
Southeastern serbia 59.8 56.6

Above 15,000
18
KEY FINDINGS
Figure 10. Adult population by body mass index categories, Serbia, 2006
2.3% 4.9%
18.3% Obese (BMI 30)
38.3%
Pre-obese (BMI 25–29.9)
Optimum (BMI 18.5–24.9)
Underweight (BMI <18.5)
Height and weight not measured

36.2%
Figure 11. Adults population classified as obese and pre-obese by age groups, Serbia, 2006
% population
0 10 20 30 40 50
Serbia 18.3
36.2
7.6
20–34
25.5
14.6
35–44
36.9
23.6
45–54
40.5
28.9
55–64
42.6
25.1
65–74
40.3
Obese
14.4
75+ Pre-obese
37.5
The highest percentage of obese people was found Monitoring and counseling relating to
among those with the least education (23.1%), middle risks for chronic non-communicable
layer according to the wealth index (20.8%) and the diseases
populations of Vojvodina (20.5%) and Eastern Serbia
(21.4%), while the pre-obese status was more prevalent In 2006, almost every other adult citizen of Serbia
in men (42.2%) and the richest group (38.3%). The received advice for change of life style (49.7%), which
percentage of obese and pre-obese people increased was significantly less than in 2000 (53.3%).
with age until 64, whereas in the population of 75+ a In the year preceding the survey, more than one third
significant decrease in the percentage of obesity was of the Serbian population made at least one change in
noted (figure 11). health-related attitudes (37.8%). Disease was the most
19
Figure 12. Change in lifestyle of adult population in the previous year, Serbia, 2006
62.2%
No change
Due to illness
Due to beauty/looks
Due to healthier lifestyle

20.8%
Other
No answer
1.4%
1.4%
13.3%
0.9%
important impetus for change (20.8%) together with preceding the 2006 survey, in over half the population
aspiration to a healthy lifestyle (13.3%) (Figure 12). (55.8%). These symptoms were significantly more
common in women, those over the age of 55, in the
Mental health population of Vojvodine, Southeastern Serbia, those
living in non-urban settlements, as well as among
Based on the results obtained from the psychological the poorest and poorer citizens, measured by the
distress scale (range 0 to 100) indicating the incidence wealth index (figure 13). Positive states and feelings
of nervousness, despair, sadness, exhaustion and (enthusiasm, serenity, calmness, happiness, energy),
tiredness, it was found that these adverse conditions and the prevalence of which was evaluated on the vitality
feelings (score ≤58) were present longer over 4 weeks scale score (range 0 to 100), were registered as a long-
Figure 13. Adult population with a psychological distress score equal to or below 58 by geographical regions, age groups and
wealth index, Serbia, 2006
80
67.6 65.6
70 63.5
60.8 61.1 59.7
58.6 58.6 59.8 57.9 56.4
60 54.0 52.8 50.5 Serbia = 55.8
% population
46.6 46.5
50 44.1
40
30
20
10
0
Vojvodina
Belgrade
20–34
35–44
45–54
55–64
65–74
75+
Poorest
Richest
Western Serbia
Centra Serbia
Eastern Serbia
Southeastern Serbia
Poorer
Richer
Middle class
20
KEY FINDINGS
Figure 14. Adult population with a vitality score equal to or over 72.5 by geographical region, Serbia, 2006
% population
0 1 2 3 4 5 6 7 8 9 10
Serbia 4.4
Vojvodina 2.6
Belgrade 9.4
Western Serbia 3.0
Centra Serbia 3.3
Eastern Serbia 3.9
Figure 15. Adult population experiencing no difficulties in performing everyday activities for health reasons, by age groups, Serbia,
2006
100 95.0 93.2

90 85.2 Serbia = 83.2
79.8
80
70 69.0
% population
60 57.3
50
40
30
20
10
0
20–34 35–44 45–54 55–64 65–74 75+
term state (score ≥72.5) in the four weeks preceding proportion of the population (between 85% and 95%)
the 2006 survey in only 4.4% of the adult population, who managed their everyday activities easily without
more frequently among people living in Belgrade, those difficulties from health problems were between 20 and
with an household income per member exceeding RSD 54 years of age, after which a sharp fall in the ability to
10,000 and those who were classified as the richest by perform everyday activities was recorded (Figure 15).
the wealth index (Figure 14).
It is noteworthy that the percentage of people unable to
Ability to perform activities of daily perform everyday activities was highest in those with
living the lowest educational level, (72.8%), as well as those
whose income per household member was below RSD
In 2006 in Serbia 83.2% of adults did not have any 4,500 (80.7%), and the group ranked the poorest by the
problems in performing everyday activities. The largest wealth index (76.4%).
21
ADULT POPULATION LIFE STYLE,

KNOWLEDGE AND
ATTITUDES TO HEALTH
Hygienic habits Diet
In 2006 in Serbia 73.8% of adults washed their hands In 2006 three main meals were regularly consumed by
regularly, which was a significant improvement over 56.6% of adults in Serbia, which was an improvement in
2000, when only 67.4% did so. The percentage of the comparison with 2000 when only 52.8% had them. More
population taking a regular bath/shower fell from 64.9% than three quarters (77.6%) of the Serbian population had
in 2000 to 56.7% in 2006. The same applied to dental a regular breakfast. The oldest, the poorest and those living
hygiene: in 2000 56.7% of the population brushed their in non-urban settlements had their meals more regularly
teeth at least once a day, as compared to only 40.7% in than those that were better off and lived in cities.
2006. In 2006 the best hygiene indices were recorded
among adults below the age of 35, women, the urban In 2006 over half of the population (57.2%) used
population, citizens of Belgrade and those classified as predominantly white bread, and 14.8% of adults used
the richest (Figure 16). whole grain, rye and similar types of bread.
Figure 16. Adult population with good hygiene habits, by the wealth index, Serbia, 2006
100
87.6
82.1
90
79.7
74.8
73.8
80
69.3
69.0
67.9
70
56.7
55.5
54.0
52.7
60
% population
46.4
50
40.7
40.1
40
29.8
25.3
30
13.9
20
10
0
Regularly washing hands Regularly taking shower Regularly brushing teeth
Serbia Poorest Poorer Middle class Richer Richest
22
KEY FINDINGS
The use of animal lard to prepare meals was reduced in In 2006 fresh vegetables were eaten daily by 54.8%
2006 (33.8%) in comparison with 2000 (41.0%). Animal of adults, which was significantly more than in 2000
fats were mostly used to prepare meals in Western Serbia when only 42.4% did so. In Vojvodina and Central
(44.5%) and Vojvodina (43,8%), and least in Belgrade Serbia a significantly lower number of people used
(14.2%). The use of animal fats was most prevalent fresh vegetables in their daily diet (44.0% and 49.3%,
among the poorest population (58.3%) and poorer respectively). Fresh fruits were a part of the every-
(44,7%), and it gradually fell with the rise of wealth day diet of 44.0% of the population. The frequency of
index, so that only 9.0% of the richest used this type of use of fresh fruits has increased in comparison with
fat to prepare their meals (Figure 17). 2000 when it was 34.4%. The population of Western
Serbia and Belgrade used fresh fruits significantly
In 2006 in Serbia 48.7% of the population ate fish less than more (51.4% and 51.0%, respectively), compared to
once a week. The population of Belgrade and Vojvodina, those living in Central Serbia (35.4%) and Vojvodina
the richest and those living in urban settlements had fish (40.4%). The richer and richest people used fresh
in their diet more frequently (Figure 17). fruits and vegetables more often (Figure 18).
Figure 17. Adult population using fish in their diet less than once a week and using animal fats to prepare meals, by the wealth index,
Serbia, 2006
Fish Animal fat
70 64.4 70 58.3
60 52.4 51.6 Serbia = 48.7 60
44.7
%population
%population
50 50 Serbia = 33.8
40 39.6 35.0 40 34.0
30 30 22.3
20 20 9.0
10 10
0 0
Poorest
Middle
class
Richest
Poorer
Richer
Poorest
Middle
class
Richest
Poorer
Richer
Figure 18. Adult population that eat fresh fruits and vegetables daily, by the wealth index, Serbia, 2006
Fresh vegeta bles Fresh fruits
70
52.5 5 7 .3 5 8 .8 58.9 Serbia = 54.8 60 52.6
60
50 45.3 50.0 Serbia= 44.0
39.9
%population
50 46.6
%population
40
40 32.6
30 30
20 20
10 10
0 0
Poorest
Middle
class
Richest
Poorest
Middle
class
Richest
Poorer
Richer
Poorer
Richer
23
In 2006 one in five adults in Serbia (19.9%) never Behavior in traffic

thought of the health implications when they chose
what to eat, which was more than in 2000 (15.4%). In 2006, more than four fifths of drivers (83.0%) in
When selecting their diet, the elderly (75+) appeared Serbia used a safety belt while driving, which was
to think less (25.3%), and so did the population of significantly more than in 2000 (31.4%). In the 18–34
Southeastern Serbia (24.8%) and the poorest part of age group, practically all drivers have occasionally
population (28.7%). driven under the influence of alcohol (97.7%), exceeded
the speed limit (88.9%) and used their mobile phone
Leisure, exercise and sports while driving (82.9%).
In 2006 the percentage of the adult population, based on
In 2006 two thirds of the population of Serbia their own admission, that behaved recklessly, crossing
(67.7%) spent their free time mainly in a sedentary streets at undesignated areas (no zebra), or at red traffic
way (Figure 19). light was 6.5%, peaking in Belgrade at 8.4%.
In 2006 the percentage of adults who exercised more Knowledge of health risks
than 3 times a week intensively, i.e. sweating and
breathing faster, reached 25.5% which was significantly In 2006 the percentage of the adult population in
more than in 2000 when only 13.7% did so. Serbia who were not aware of a single health risk in
their environment was 1.9%, which was significantly
In 2006, one third of the employed population in Serbia less than in 2000 when it reached 5.0%. Health risks
(31.1%) had a sedentary type of work: one quarter of associated with ultraviolet radiation was recognized by
men (25.4%) and two fifths of women (40.6%). The 28.1% of the population, most in Vojvodina (37.6%),
percentage of employees with a sedentary type of work those aged 20–44 (33.2%) and the richest (36.0%).
was significantly increased in comparison with 2000 Violence as a health risk was identified by 23.8%
when it was only 25.2%. The number is the highest adults in 2006 which was significantly less than in
among the richest (49.7%) and tends to fall with the 2000 when 26.6% identified it. Violence and crime
wealth index, reaching the lowest value with the were recognized mostly as health risks by the richest
poorest, i.e. only 12.0%. (40.2%) and urban populations (32.4%).
Figure 19. Adult population who spend their free time in an active manner, by intensity of the exercise, Serbia, 2006
67.7% 19.9%
10.5%
0.6% 1.3%
Inactive
Engaged in moderate physical activities
Engaged in light physical activities
Practice training
No answer
24
KEY FINDINGS
Smoking overall number (37.5%) and in the group of those

that smoked every day (30.7%) (Figure 21). The
In 2006 in Serbia 33.6% of the population were same applied to urban settlements where the number of
smokers (regular or occasional), suggesting a smokers was higher than in other types of settlements.
reduction of the smoking rate by 6.9% in comparison
with 2000. Although the reduced number of smokers In 2006, out of the total number of people that smoked
was higher among men, the habit was still more daily, 66.8% smoked more than 20 cigarettes a day,
prevalent among them (38.1%) than among women while the history of smoking of those that smoked
(29.9%) (Figure 20). every day was 18.8 years on the average.
In 2006 in Serbia 27.7% of adults, or almost one in In 2006 almost two thirds of the population of Serbia
four women (23.7%) together with one in three men (61.7%) was exposed to tobacco smoke at home
(32.5%) smoked on a daily basis. In Vojvodina the and 44.9% were exposed to tobacco smoke at work,
number of smokers was significantly higher, both the significantly more in Vojvodina and Western Serbia.
Figure 20. Smoking prevalence among adults, by gender, Serbia
47.9
50
45 40.5
38.1
40 33.6 33.7
35 29.9
% population
30
25 Year 2000
Year 2006
20
15
10
5
0
Serbia Male Female
Figure 21. Adult population – regular (daily) smokers by the type of settlement and geographical regions, Serbia, 2006
35
30.6 30.7 29.6
30 28.7 Serbia = 27.7
24.9 24.0 24.7
% population
25 23.2
20
15
10
5
0
Urban
Non-urban
Vojvodina
Belgrade
Western
Serbia
Central
Serbia
Eastern
Serbia
Southeastern
Serbia
25
In 2006 57.5% of the population of Serbia was aware consumption of alcohol. Conversely, 8.7% of men
of the noxious effects of smoking, i.e. tobacco smoke, were classified in the same group (daily consumption
which was an outstanding improvement over 2000, of more than 40gr ethanol).
when only 34.6% knew that.
The percentage of adults who drink over 50gr ethanol
Alcohol consumption daily is an indicator of heavy drinking. In 2006 the
group at high risk for development of chronic illnesses
In 2006 in Serbia 40.3% of the population drank alcohol resulting from excessive use of alcohol comprised
(occasionally or daily), where the number of non- 3.9% of adult population of Serbia. In Eastern Serbia a
consumers of alcohol increased by 5% in comparison higher percentage of population belonged to this group
with 2000. The 3.4% of the adult population of Serbia (7.6%) and the same was recorded in the group of the
drank alcohol on a daily basis. Most commonly they poorest (6.1%).
drank strong spirits, which are followed by beer and
wine. The greatest percentage of regular alcohol Use of psychoactive substances
consumers is recorded in the age group of the elderly
(75+ yrs), in Eastern Serbia and among the poorest In 2006 in Serbia 35.6% of adult population were
(Figure 22). familiar with the effects of psychoactive substances
(they knew that cannabis, ecstasy, cocaine, LSD,
In 2006 in Serbia the average number of weekly heroin and crack were always harmful), which is 7%
alcoholic drinks amounted to 6.4 which was more than in 2000. A significantly lower percentage of
significantly less than in 2000 when it was 8.3. On the adults familiar with the effects of psychoactive drugs
average, men drank four times more than women (8.5 was recorded in Eastern (24.0%) and Southeastern
vs. 2.0 drinks per week). Serbia (26.3%), as well as in populations living in non-
urban settlements (29.5%) (Figure 23).
In 2006 somewhat less than 3% of women were
classified as being at medium risk (daily consumption Also, the percent of properly informed people on the
of more than 20gr ethanol) for the development effects of psychoactive substances was lower among
of chronic illnesses resulting from excessive the poor and uneducated groups (Figure 24).
Figure 22. Adults using alcohol on a daily basis, by age groups, Serbia, 2006
% population
0 1 2 3 4 5 6 7
Serbia 3. 4
20 – 3 4 1. 1
35 – 4 4 2. 4
45 – 5 4 3. 5
55 – 6 4 4. 8
65 – 7 4 5. 6
75 + 6. 1
26
KEY FINDINGS
Figure 23. Adults familiar with effects of psychoactive substances by the type of settlement and geographical regions, Serbia, 2006
50
42. 9
45 41. 8
40 38. 7 38. 1 Serbia = 35.6
35. 4
% population
35
30 29. 5 26. 3
25 24. 0
20
15
10
5
0
Urban
Non-urban
Vojvodina
Belgrade
Western
Serbia
Central
Serbia
Eastern
Serbia
Southeastern
Serbia
Figure 24. Adults familiar with effects of psychoactive substances by educational level, Serbia, 2006
% population
Serbia 35. 6
Primary school and lower 16 .9
Secondary school 42 .9
University education 56.8
The questions relating to the use of certain psychoactive with). Men and the population in the age group 20 to
substances were associated with very low response rate, 34 years had significantly more sexual relations with
substantiating the impression that in this area specially non-regular partners (12.4% and 16.3%, respectively);
designed studies should be conducted. a significantly lower percentage of sexual relations
with non-regular partners was recorded in women
Sexual behavior (3.6%) (Figure 25). The average number of casual
partners was 2.4.
In the course of the 12 months preceding the 2006
survey, 7.6% adults in the population of Serbia had Out of the total population of Serbia who had sexual
sexual relations with a non-regular partner (defined as relations with non-regular partners in the 12 months
a partner to whom they are neither married nor living preceding the 2006 survey, only 51.6% used a condom
27
for the latest intercourse. The use of condom for HIV/AIDS

intercourse with non-regular partners was more
prevalent in the population aged 20 to 34 (66.1%) In 2006 in Serbia 90.5% were aware of HIV and
and among those classified as rich (63.4%), and less AIDS, significantly more in urban settlements
so among the population in the 45+ ages group and (93.9%) than in the others (87.1%). The level of
the poor (39.3%) (Figure 26). information about HIV and AIDS was the highest
In 2006 out of the total number of women of in Belgrade (94.8%), and significantly lower in
childbearing age with a steady partner 37.3% used Western (87.7%) and Southeastern Serbia (87.9%).
proper birth control (contraceptive pill, intra uterine
device, local chemicals, condom, diaphragm), while In 2006 somewhat more than a third of the population
36.9% used unreliable methods of birth control of Serbia (37.9%) knew where they could get tested
(unfertile days, interrupted coitus). for HIV. Knowledge of the testing site was more
Figure 25. Adults having had sexual relations with non-regular partners in the 12 months preceding the survey, by age group and
gender, Serbia, 2006
18
16.3
16
14
12.4
12
% population
10
Serbia = 7.6
8 7.2
6.0
6
3.9 3.6
4
2.4
2
0.9
0
20–34 35–44 45–54 55–64 65–7 75+ Women Men
Figure 26. Adults using a condom with non-regular partners, by the age groups, Serbia, 2006
70 66.1
60
Serbia = 51.6
50
44.6
% population
40 36.3
31.0
30
20
10 8.4
0.0
0
20–34 35–44 45–54 55–64 65–74 75+
28
KEY FINDINGS
prevalent in women (40.1%) and less in men (35.1%). In 2006 Central Serbia registered the sharpest rise in
In Serbia 4.2% of adults have been tested for HIV. the number of people in this age group that were free
of prejudices (no discrimination), 29.2%.
Less knowledge in relation to prevention of HIV
infection, and more prejudices against the infected In 2006 somewhat more than one fifth of the young
persons were registered in Western Serbia, the (20.3%) in Serbia aged 15 to 24 had sufficient
population of non-urban settlements, the poor and knowledge on HIV and AIDS, i.e. identified correctly
uneducated groups. Nevertheless, in Serbia in 2006, ways to prevent sexual transmission and at the same
in comparison with 2000 the increased tolerance, i.e. time denied misconceptions relating to transmission
lack of prejudices against HIV infected people was of HIV, their number having trebled in comparison
registered in 35-45 age-group, from 13.7% to 18.9%. with 2000 (7.3%).
29
REPRODUCTIVE
HEALTH OF WOMEN
According to the 2006 survey, the average age of by pregnancy (30.2%) and complaints (18.8%).
women in Serbia at their first visit to a gynecologist One in eight women in Serbia aged 15–24 years was
was 21.3 years, while 6.3% have never visited a pregnant (15.9%). Out of these 3.9% terminated
gynecologist. The percentage of those that have the last pregnancy intentionally. The percentage
never been to a gynecologist was significantly of women aged 15–24 years that were pregnant
higher in Southeastern Serbia (9.1%), in non-urban was significantly higher in the poorest households
settlements (7.9%), the poorest households (12.4%) (30.7%) and non-urban settlements (23.3%).
and those with the lowest education level (8.4%)
(Figure 27). Out of the total number of women in Serbia who gave
birth in the year preceding the 2006 survey 77.4%
In the year that preceded the 2006 survey 45.8% of received a home visit from a health worker in the first
women of child-bearing age visited a gynecologist, post-delivery week, which was significantly more
which was substantially less than in 2000 when than in 2000 when only 45.6% received such visit.
49.8% of them did so. The average number of visits
of women of child-bearing age using gynecological The 2006 survey in Serbia has shown that one in
care was 2.6. The most common reasons for visits three women (34.1%) performs a self-examination
to a gynecologist were check-ups (45.4%), followed of the breast once a month, while one in ten of those
Figure 27. Women above the age of 20 who have never visited a gynecologist, by the geographical region and type of settlement,
Serbia, 2006
9.1
8.5
10 8.1 7.9
9
8 6.3
7 6.3 5.6
6 5.0
% wom en
5
3.2
4
3
2
1
0
Vojvodiina
Bellgrade
Western
Cenntral
Serbia
Eastern Serbia
Southeastern
Serbia
Urban
Non-urban
Serbia
30
KEY FINDINGS
in the 40–69 age group (10.4%) had a mammography In Serbia 30.5% women over the age of 20 had
in three years preceding the study. The percentage a Papanicolaou smear (for detection of cervical
of women in the 40–69 age group who had a cancer) in the three years preceding the 2006 study,
mammography was significantly higher in Belgrade while 2.0% of women had the test done within an
(16.6%) and in urban settlements (13.2%) than in organized preventive screening, significantly more
non-urban settlements (6.8%). in Eastern Serbia (5.2%).
31
USE OF HEALTH SERVICES

– ADULT POPULATION
Primary Health Care (PHC) The percentage of adults who waited for diagnostic
examinations in the primary health care services for
In 2006 every other citizen of Serbia (50.6%), had over a month was 5.0% in 2006 which was more than
their own GP or occupational medicine specialist, in 2000 when it was 3.8%. The population of Eastern
which was significantly more than in 2000 (43.4%). Serbia waited for these examinations significantly
less than the average of Serbian population (2.8%)
In the year preceding the 2006 survey, over half of (Figure 28).
the population visited a GP (54.2%) which was on
the 2000 level. Specialist services of primary health The percentage of adults waiting for specialist
care centers were used by 29.7% of the population, examinations over a month was longer in 2006
significantly less than in 2000 when 31.9% of adults (6.4%) than in 2000 (4.4%). Significantly fewer
visited specialists. In 2006 users of the abovementio- inhabitants of Central (3.8%) and Southeastern
ned forms of health care visited their GP 5.6 times Serbia (2.8%) waited for specialist examinations in
and a doctor in the specialist services 3.3 times. These PHC for over a month.
services were used mostly in Southeastern and Eastern
Serbia. The use of health care services in 2006 linked In 2006 less than a third of the Serbian population
with the average number of visits per user remained (30.7%) using specialist health care procured
at the same level as it was in 2000. medication and medical consumables to provide
Figure 28. Adults who waited for diagnostic examination in primary health centers (PHC) over a month, by geographical regions,
Serbia, 2006
7
6.3
6 5.7
5.0
5 4.6
4.4
% population
4 3.7
3 2.8
0
Vojvodiina
Bellgrade
We stern
Eastern Serbia
Sou theastern
Serbia
Serbia
Central Serbia
32
KEY FINDINGS
Figure 29. Adult population that procured medication and medical consumables upon request, by the geographical regions, Serbia,
2006
% population
0 5 10 15 2 25 30 35 40 45
Serbia 30.7
Vojvodiina 41.4
Bellgrade 24.8
Western 20.1
Central Serbia 31.8
Eastern Serbia 32.3
for their health care. The population of Vojvodina Dental health care
procured medication and medical consumables
significantly more frequently (41.4%) than the In 2006 34.8% of the population of Serbia had their
population of Belgrade (24.8%) and Western Serbia own dentist, the number being the lowest among the
(20.1%) (Figure 29). poorest (14.3%), and the highest among the richest,
(60.4%). The percentage of population visiting their
In 2006 in Serbia payment of health care services dentist in the year preceding the 2006 survey (30.7%)
was the main reason for 3.0% of the population not was significantly lower than in 2000 (36.8%). For
to use health care, which was significantly less than 15.1% of the Serbian population, the main reason for
in 2000 when the corresponding percentage was a visit to the dentist in 2006 was a check-up of dental
4.2%. Significantly more of the poorest (8.1%), health, which was a significantly higher percentage
those living in the Western (4.2%) and Southeastern than in 2000, i.e. 8.6% (Figure 30). The population
Serbia (4.4%) did not use the health care services of Belgrade was most regular in their dental check-up
because of such payments. visits (21.9%).
Figure 30. Adult population whose main reason for a visit to a dentist was dental check-up, by geographical regions, Serbia, 2006
% population
0.0 5.0 10.0 15.0 20.0 25.0
Serbia 15.1
Vojvodiina 15.1
Bellgrade 21.9
Western 9.9
Central Serbia 11.1
Eastern Serbia 7.6
33
In 2006 in Serbia 8.5% of adult population had all (23.9%). These services were used significantly more
of their teeth, 9.3% were edentulous, while a quarter by those in the 20-34 yr age group (24.5%), women
of the population (26.6%) did not have more than 10 (23.4%), and particularly those living in Belgrade
teeth. The number of missing teeth increased with age, (29.5%) as well as the richest (31.8%) (Figure 32).
the lowest number of missing teeth was present among Among the population of Serbia the most common
the population below 55 years of age, and the highest reasons for opting for private practice included
number among those above the age of 55 (Figure 31). absence of waiting (66.5%), higher quality work
(51.9%) and attitude/kindness (37.0%).
Private practice
In 2006 absence of waiting was the most common
In 2006 a lower percentage of the population of Serbia reason for resorting to private practice –a substantially
used the private practice services (19.4%) than in 2000 higher percentage than in 2000. The percentage of the
Figure 31. Missing teeth in adult population, by the age groups, Serbia, 2006
% population
0% 20% 40% 60% 80% 100%
Serbia 8. 5 37.0 18.4 26.6 9.3
20–34 24.8 63. 9 8.3
35–44 6. 4 55. 4 23,1 13. 5

No teeth
missing
45–54 37. 0 26.9 28,4 4.8
1 to 5 teet h
6 to 10 teeth
55–64 18.7 25.8 41.3 12.3
Mor than 10,
but not all
65–74 10.5 16.8 49.2 21.5 Edentulous
No answer
75+ 10.4 49. 9 32.7
Figure 32. Adult population using the private practice health services by the geographical regions, Serbia, 2006
% population
0 5 10 15 20 25 30 35
Serbia 19.4
Vojvodiina 19.5
Bellgrade 29.5
Western 13.6
Central Serbia 13.5
Eastern Serbia 16.2
34
KEY FINDINGS
Figure 33. Adult population by the most common reasons for resorting to private practice, Serbia
% population
0 10 20 30 40 50 60 70
Absence of waiting 51.9
66.5
49.4
Quality work
51.9
39.6 Year 2000

Attidude/kindness
37.0 Year 2006
population of Serbia that resorted to private practice tended to do this more (40.7%), than those living
for the better quality of their services and attitude did in Western (18.6%) and Central Serbia (23.1%).
not change in comparison to 2000 (Figure 33). Analgesics (26.0%), vitamins and minerals (14.8%),
antibiotics, and drugs for specific diseases (9.4%) were
Hospital health care most commonly used in this manner. In comparison
with 2000 the percentage of self-medication was
In 2006 in Serbia 6.6% of adult population received reduced by 7.3% in 2006.
hospital care in the year preceding the survey.
The population receiving in-patient care had 1.3 However, in comparison with 2000 the percentage of
hospitalizations on the average, which was comparable population using anti-cholesterol drugs in the week
with the data in 2000 (1.7). The population over preceding the 2006 survey was significantly increased:
the age of 65 used these services more. Almost from 2.6% to 4.3%. The same applied to vitamins and
three quarters of all users (74.0%) was referred and minerals, from 12.0% to 16.6% (Figure 34).
admitted immediately, while 2.7% waited for over
a month, significantly less in Central and Eastern In 2006 54.2% of the population of Serbia who used
Serbia. In 2006 the percentage of the population in medication obtained them mostly by prescription,
Serbia waiting for hospitalization for over a month which was significantly more than in 2000 when the
was the same as in 2000. corresponding percentage was 39.4%. The poorest
used prescriptions the most (63.2%). 44.3% of
Use of medication the population most commonly bought the drugs,
significantly more by those that were classified as
In 2006 in Serbia 29.1% of adult population used the richer (47.9%) and richest (57.4%) by the wealth
self-medication. Women resorted to self-medication index (Figure 35). In comparison with 2000 the share
more than men (33.5% and 25.1%, respectively). The of population buying their medication in 2006 was
population aged 55+ and those living in Belgrade reduced by 12.8%. Also, the percentage of those
35
Figure 34. Use of drugs in the adult population of Serbia

% population
0 10 20 30 40 50
Analgesics for headache 46.5

35.1
Antihypertensive drugs 23.3
24.7
0.0*
Cardiovascular medication 15.0
13.4
Sedatives 13.7
7.7
Antibiotics 7.5
0.0*
Hypoglycemic medication 5.3
2.6
Ani-cholesterol drugs 4.3
4.1 Year 2000
Antitusics
4.8 Year 2006
12.0 *not studied
Vitamins and minerals 16.6
Figure 35. Most common ways of obtaining drugs in the adult population by the wealth index, Serbia, 2006
% population
0 10 20 30 40 50 60 70
Serbia 54.2
44.3
Poorest 63.2
34.2
57.3
Poorer 41.0
58.6
Middle class 40.5
50.8
Richer
47.9
On prescription
41.7
Richest 57.4 Buying
who did not take medication because of the price was The population aged 65 to 74 led in their satisfaction
reduced from 1.2% in 2000 to 0.2% in 2006. with their GP (83.8%), together with those in Central
(88.4%) and Southeastern Serbia (86.2%). The level
Patient satisfaction with health care of satisfaction was the lowest among the population
of Belgrade (71.7%), 20-34 yr age group (72.5%) and
In 2006 in Serbia a high percentage of health care users the richest (74.9%). The share of those satisfied with
were satisfied with their GP (78.6%) and the hospital hospital care has significantly increased, from 20.9%
care in general (72.8%). The level of satisfaction was in 2000 to 33.2% in 2006, while the satisfaction with
significantly improved from 2000 when 73.9% were health care workers in hospitals (63.2%) remained
satisfied with their GP and 60.4% with hospital care. the same as in 2000.
36
KEY FINDINGS
Figure 36. Satisfaction of adult population with their GP, hospital care and overall health services, Serbia
% population
0 20 40 60 80 100
73.9
General practitioner
78.6
60.4
Hospital care
72.8
0.0*
Year 2000
Health services 41.4 Year 2006
*not studied
In 2006 in Serbia 41.4% of the population were satisfi- age, living in Central Serbia (49.4%), and it was lowest
ed with overall health services. The percentage was among the men, population of Vojvodina (36.0%) and
highest among women (44.9%), those over 55 yrs of those defined as the richest (38.3%) (Figure 36).
37
HEALTH CARE
PAYMENTS
In the 12 months preceding the 2006 survey in Serbia, (50.5%). Those in Central (34.9%) and Western Serbia
44.1% of the total population had expenditures for (35.5%) did so the least.
health care, almost a half of women (48.0%) and two
fifths of men (40.5%), as well as over 70.0% of the The average total annual amount of “out of pocket”
population over 65 yrs of age (Figure 37). By the payments for health care was RSD 14,696.7 per capita.
geographical regions, the population in Southeastern Over two fifths of the health care payments are for
Serbia covered most of the expenses “out of pocket” medication (Figure 38).
Figure 37. Population paying health care “out of pocket” by age groups, Serbia, 2006
% population
0 10 20 30 40 50 60 70 80
Serbia 44.1
0–6 26.4
7 – 11 26.6
12 – 19 23.7
20 – 34 30.0
35 – 44 36.0
45 – 54 47.3
55 – 64 60.5
65 – 74 71.2
75+ 73.3
Figure 38. Share of certain types of expenditures in the total health care expenditures, Serbia, 2006
% total expenditures
0 5 10 15 20 25 30 35 40 45 50
Outpatient services (public) 5.5
Outpation services (private) 9.4
Dental services (public) 4.0
Dental sevices (private) 17.7
Diagnostic services (public) 3.9
Diagnostic services (private) 7.9
Payments for drugs (total) 42.4
Complementary medicines 3.3
Alternative medicine services 0.4
Hospital care (public) 1.3
Hospital care (private) 0.5
Rehabilitation 0.5
Medical devices- orthopaedic and other (total) 1.4
Direct (informal) payment 0.5
Others 1.2
38
KEY FINDINGS
HEALTH STATUS OF CHILDREN AND

ADOLESCENTS AGED 7–19 YEARS
Self assessment of health and satisfaction Correct, i.e. desirable attitude on responsibility for
with life one’s own health was reported by only a quarter of
the population of children and adolescents in Serbia
In 2006, almost all children and adolescents in Serbia (25.3%) (Figure 40). Nevertheless, health was on the
(92.3%) defined their health as good or very good top of their list of life values. The average satisfaction
(Figure 39). with life of the young (1-10 scale) reached 8.2 in
Relatively few considered themselves obese (7.5%) or 2006, which was an increase in comparison with the
underweight (14.0%). Only one third of children and significantly lower rank of 6.4 recorded in 2000. The
adolescents (31.7%) evaluated their level of exercise young were mostly dissatisfied with lack of money
as good, 20.9% described it as average, and 3.9% (33.5%) – significantly more so in Southeastern
described it as poor or very poor. The young from Serbia (45.8%) and those from the poorest households
Central (21.3%) and Southeastern Serbia (24.3%) (51.2%).
defined their level of physical exercise as very good
significantly less than the young in Belgrade (49.2%). Blood pressure
Children and adolescents from the poorest households
were prone to define their level of physical activity The average value of the measured systolic blood
positively much less (22.5%). and diastolic pressures in children and adolescents
Figure 39. Self-assessment of general health status of children and adolescents aged 7–19 years, Serbia, 2006
% children and adolescents
0 10 20 30 40 50 60
0.3
Very bad
Bad 0.6
Fair 6.7
Good 43.6
Very good 48.7
No answer 0.2
39
Figure 40. Children and adolescents aged 7–19 sharing the desirable attitude on responsibility for own health, by the geographical
regions, Serbia, 2006
0 5 10 15 20 25 30 35 40 45 50
Serbia 25.3
Vojvodiina 21.1
Bellgrade 43.9
West ern 15.3
Cent ral Serbia 16.0
East ern Serbia 22.5
Southeast ern Serbia 28.3
in Serbia in 2006 were 111.3 mmHg and 69.3 underweight children, which was an improvement in
mmHg, respectively. No significant differences were comparison with 2000 (8.4%).
identified by gender, age, geographical regions and
social-economic status for either of the parameters. Information and counseling relating
The obtained values were comparable with those to risks of chronic non-communicable
recorded in 2000: where the average systolic and diseases
diastolic pressures were 111.1mmHg and 70,9 mmHg,
respectively. In 2006 almost a half of children and adolescents aged
7 to 19 in Serbia (47.9%) were advised to change
Nutritional status their lifestyle. The young in Central Serbia received
advice to change the lifestyle less commonly (39.1%)
In 2006 two thirds of children and adolescents aged 7– then their Belgrade counterparts (54.7%). Advice
19 in Serbia had a healthy weight (67.7%) (Figure 41). to change the lifestyle was given by a physician or a
Almost one fifth of the young (18.0%) were moderately health worker only to 9.0% of the young. In the course
obese, i.e. under the risk of overweight (11.6%) and of 12 months preceding the survey only one third of
obese, i.e. overweight (6.4%) which is an increase in the young (34.6%) changed their behavior health-wise,
comparison with 2000 when there were 8.2% and 4.4% significantly less so among the children and adolescents
of moderately obese and obese, respectively. Among in non-urban areas (29.0%) and central Serbia (26.2%).
children aged 7 to 11 in 2006 there were significantly The most common reasons for the change of lifestyle
more obese (9.8%) in comparison with the total health-wise included healthier life, improved looks and
population of the young. In 2006 there were 6.2% of prevention of diseases (Figure 42).
40
KEY FINDINGS
Figure 41. Children and adolescents aged 7-19 by the nutritional status, Serbia, 2006
67.7%
Obese, i.e. overweigh
Moderately obese, i. e.
under the risk of
overweight
Healthy weight
Moderately
underweight
7.8%
Underweight
11.6% 6.2%
0.3% Height and weight
6.4%
not measured
Figure 42. Change of attitude to health, children and adolescents aged 7–19, Serbia, 2006
0 10 20 30 40 50 60 70 80
No change 71.2
Due to healthier lifstyle 17.4
Due to improved look 6.9
Due to prevention of illness 2.3
Other 1.5
The young population usually received health information in comparison to the 15-19 yr age group (30.5%).
from parents (75.1%) and media messages (53.3%). The Referring to emotional problems, 16.5% of the young
13.5% of children and adolescents participated in some confirmed having them in the month preceding the
form of health promotion activities. Evaluating three survey, again significantly less in the younger group,
leading causes of disease in the population, most of the aged 7 to 11 yrs (8.8%), than in the older group
young recognized smoking (62.6%), difficult living (23.3%). Importantly, in 2006 the percentage of the
conditions (39.4%) and stress (38.7%). young experiencing tension and stress, as well as
emotional problems was reduced in comparison with
Mental health 2000 (22.1%, and 24.7%, respectively).
In 2006 almost one fifth of children and adolescents Based on the score of the psychological distress scale
(18.0%) experienced tension and stress in the month (0 to 100) suggesting the frequency of nervousness,
preceding the survey. The number of children with depression, sadness, exhaustion and tiredness, in
these symptoms was significantly lower (7.0%) the 4 weeks preceding the survey these negative
41
Figure 43. The psychological distress scale for children and adolescents aged 15–19 and the population over the age of 15, Serbia,
2006
% population
0 10 20 30 40 50 60 70
54.6
58
34.0
43.4 15+
58–78
62.2 15–19
2.0
78
3.8
Figure 44. The vitality scale in children and adolescents aged 15–19 and the population over the age of 15, Serbia, 200
% population
0 10 20 30 40 50 60 70 80 90 100
86.9
62,5
67.7
11.0 15+
62,5–72,5
25.9 15–19
2.1
72,5
6.4
feelings and emotions were present (score ≤ 58) in Positive states and emotions (enthusiasm, serenity,
almost every other citizen of Serbia above the age of calmness, happiness, energy) whose frequency in the
15 (54.6%) and one in three adolescents aged 15–19 four weeks preceding the 2006 survey was estimated
(34.0%) (Figure 43). on the basis of the vitality scale (0 to 100) score have
been registered as a long-term state (score ≥ 72,5)
The long-term presence of psychological distress in only in 2.1% percent of the Serbian population over
the population over the age of 15 was also suggested the age of 15 and in 6.4% adolescents aged 15–19
by the average score on the psychological distress years (Figure 44).
scale, which reached 55.2 in 2006. Among the young Short-term presence of positive states and feelings
aged 15 to 19 the value of the score was significantly (score 62.5) in these population groups are suggested
higher, i.e. 61.0 suggesting that the negative states and by the average score values of 45.0 in those aged 15+,
emotions were present less in this population. and 54.9 in the young aged 15 to 19.
42
KEY FINDINGS
LIFESTYLE, KNOWLEDGE AND ATTITUDES

TO HEALTH IN CHILDREN AND
ADOLESCENTS AGED 7–19 YEARS
Hygienic habits In 2006 56.7% of children and adolescents brushed

their teeth more than once a day. The girls led (66.8%),
Hygienic habits in children aged 7–19 years in Serbia followed by children and adolescents aged 15 to 19
have changed significantly in 2006 as compared to (66.3%) and the richest, while the lowest percentage
2000. In 2006 75.7% children and adolescents regula- was recorded among the poorest (32.3%) (Figure 45).
rly washed their hands, which was an improvement
over 2000 (63.8%). This was most regularly practiced
by children and adolescents in Western and Southea- Diet
stern Serbia, by adolescents aged 15–19 (80.6%)
and the young classified as the richest by the wealth In 2006 in Serbia 87.3% of children and adolescents
index (80.8%) (Figure 45). In 2006, however, regular aged 7 to 19 had breakfast every day, while 74.4% had
bathing or showering and tooth brushing was reduced three meals a day every day, which was comparable
in comparison with 2000. Children and adolescents to the results obtained in 2000. In 2006, however,
in Vojvodina, those aged 15 – 19, and those classified significantly fewer young people had at least one glass
as the richest pursued hygienic habits most regularly, of milk or dairy products (57.3%) in comparison with
while only one third of the poorest had a shower or a 2000 (62.0%). Over a half of children and adolescents
bath more than three times a week. (51.6%) ate fresh fruits every day.
Figure 45. Children and adolescents aged 7-19 who maintain their hygiene regularly, by the wealth index, Serbia, 2006
80.8
80.0
90
78.4
77.5
75.7
74.1
72.6
68.7
80
66.1
64.3
62.6
61.9
61.3
70
56.7
54.7
53.1
60
50
34.3
32.3
40
30
20
10
0
Regularly washing hends Regularly taking shower Regularly washing teet h
Serbia Poorest Poorer Midlle class Richer Richest
43
In 2006 about a half of the young (48.9%) had fresh When participating in traffic as pedestrians 8.7% of the
vegetables in their daily diet, which was significantly young admitted to crossing the street beyond the zebra
more than in 2000 (46.3%). In Serbia over half of crossing or when there was a red light.
children and adolescents aged 7 to 19 (52.8%) ate fish
less than once a week. Awareness of health risks
In 2006 the percentage of children and adolescents who In 2006 in Serbia 19.4% children and adolescents aged
never think of their health when they chose what to eat 7–19 recognized ultraviolet radiation as a health risk.
was 36.7 % - a significant improvement in comparison This awareness was greatest in the 15-19 yr age group
with 2000 when it was only 22.0%. (25.9%), among the richest (25.0%) and children and
adolescents in urban settlements (22.5%). In 2006
Leisure, exercise and sports 19.7% of the young recognized violence as a health
risk, as compared to 27.5% recorded in 2000.
Children and adolescents in Serbia used their free time
mostly to watch TV, CDs or video cassettes (73.3%) One fifth of the young (20.5%) were not satisfied
or listen to music (61.9%). In relation to 2000 there with the level of hygiene in their schools in 2006.
was a significant increase in the percentage of those The young in Belgrade were dissatisfied most
who watch TV, CDs or video cassettes (from 58.8% to (32.8%). In 2006 safety and opportunity for recreation
73.3%), play computer games (from 9.7% to 28.2%) at school were evaluated as poor by 10.9%, and
and listen to music (from 38.3% to 61.9%). 16.0% of schoolchildren, respectively, which was an
improvement over the corresponding data for 2000.
In 2006 in the age group 7–14 years 45.7%, and in the (13.8% and 19.8%, respectively).
age group 15–19 years 46.0% of the population spent
at least 2 hours a week in strenuous physical exercise, Smoking
out of school. The percentages were significantly
higher for boys. The percentage of children spending The prevalence of smoking among the young in Serbia
at least 2 hours a week in strenuous physical exercise aged 15–19 was 15.5% in 2006 The total number of
increased with the wealth index. smokers was reduced by 7.4% in comparison with
2000, more in girls (by 8.4%) than boys (by 6.4%)
Also, 8.0% of children and adolescents had less than 7 (Figure 46). Significantly lower smoking prevalence
hours of sleep on weekdays, which remained the same was found among the young in Eastern Serbia (5,9%).
as in 2000. In the population of secondary school age
as many as 16.2% of the children had less than 7 hours In 2006 in Serbia one in ten adolescents aged 15–19
of sleep during weekdays. smoked (10.0%), while 4.2% of the young in Serbia
smoked more than 20 cigarettes a day.
Behavior in traffic
In 2006 70.8% of the young were exposed to tobacco
Over 70% of children and adolescents aged 7–19 smoke at home, which was 14.3% less than in 2000.
in Serbia used car seat belts when driving or sitting On the other hand, the finding that 16.0% of the young
in the front seat. Of those that used rollerblades or were exposed to tobacco smoke indoors for more than
skateboards, 86.5%, did not use protective helmet on a 5 hours a day is a reason for serious concern, together
regular basis. The same applies to 96.5% of the bicycle with the fact that 89.3% of the young stated that at least
riders and 66.3% of motor bikers. one person in their immediate social environment was
44
KEY FINDINGS
Figure 46. Smoking prevalence among the young aged 15-19, by gender, Serbia
24.4
25 22.9
21.4
20 18.0
15.5
% adolescent s
13.0
15
Year 2000
10 Year 2006
0
Serbia Boys Girls
a smoker. Out of the total number of smokers aged 15– were not consuming alcohol was significantly higher
19 in Serbia, 34.6% wanted to quit in 2006. Half of in Vojvodina (76.1%). The 2006 survey has found that
the young of that age (50.5%) did not have a desirable 14.6 years was the average age of first exposure to
attitude to smoking. Both of the indicators were similar alcohol in the group of 15–19 olds, where the average
in 2006 and 2000. amount of weekly intake among those who use alcohol
amounted to 4.7 drinks.
Alcohol consumption
The habit of getting drunk at least once a month was
In 2006 in Serbia 33.6% of the young aged 15–19 reported by 5.5% of the young people in Serbia in
used alcohol (Figure 47). The percentage of those that 2006. This habit was significantly more common in
Figure 47. Alcohol consumption by the young aged 15-19 years, Serbia, 2006
% adolescents
0 5 10 15 20 25 30 35
Never 29.3
Once or twice 30.3
Before, but not anylonger 4.1
Occasionally 33.1
Daily 0.5
No answer 2.8
45
boys (9.1%) than in girls (1.9%) aged 15–19. One in In Serbia 6.9% of the young aged 15–19 tried
four children in Serbia (25.5%) aged 12–19 has been psychoactive substances. A significantly higher
drunk at least once, almost one in three boys (31.8%) percentage of those who tried drugs was recorded in
and one in five girls (19.5%). This phenomenon was households with income in the excess of RSD 15,000
significantly more common in children and adolescents per household member (22.7%).
living in households with incomes exceeding RSD
15,000 per household member (29.6%). The 2006 survey in Serbia suggest that the young aged
15–19 tend to try psychoactive substances (for the first
One third of children and adolescents in Serbia aged time) between the ages of 13 and 17. The places most
12–19 know a person using alcohol in their immediate commonly given as where they take it for the first time
social circle. As many as 60.2% did not have desirable are a party, discothèque or cafe (35.4%), home, own or
attitude to alcohol consumption. Sale of alcoholic friend’s (32.1%). Almost one in ten tried a psychoactive
beverages in public places in Serbia was still a problem substance at school first (Figure 48).
in 2006. i.e. 10.5% of children and adolescents below
the age of 18 purchased alcohol in supermarkets, cafes, In Serbia 32.0% of the young aged 15–19 in 2006 did
restaurants, etc. not have desirable attitude to psychoactive substances.
Use of psychoactive substances Sexual behavior and awareness of HIV

and AIDS
In 2006 35.0% of the young in Serbia aged 15–19 were
aware of the effects of psychoactive substance use (they According to the 2006 survey 29.0% of the young
knew that cannabis, ecstasy, cocaine, LSD, heroin and in Serbia aged 15–19 have already become sexually
crack were always harmful). Out of the total number active. The number is significantly higher for boys
of the young, 15.2% stated that drugs had been offered (36.3%), than for girls (21.8%). In comparison with
to them, while 21.5% stated that some of their friends 2000 an increase of 10.4% was recorded in the sexually
used drugs. active compared with 2006.
Figure 48. Place of initial exposure to a psychoactive substance among the young aged 15–19 years, Serbia, 2006
% adolescent s
0 5 10 15 20 25 30 35 40
Party, discothèque or cafe 35.4
Street 13.3
School 9.7
Own or friend's home

32.1
Other 9.5
46
KEY FINDINGS
Figure 49. Reasons for the first sexual intercourse among the young aged 15–19 years, Serbia, 2006
% adolescents
0 5 10 15 20 25 30 35 40 45 50
Most of our friends have already done it 4.2

Partner’s persistence 0.8
Curiosity 19.9
Under the influence of alcohol or drugs 0.3
Passion 8.7
Love for the partner 44.6
The time has come to do it 16.2
Receiving gifts 0.3
5.1
No answer
A significantly higher percentage of sexual activity One third of the young in Serbia (33.6%) aged 15–19
was recorded in Belgrade (38.5%), and the young who were sexually active in the 12 months preceding
living in households with income in the excess of RSD the survey used unreliable methods of birth control
15,000 per household member (51.5%). The young in (unfertile days, interrupted coitus).
Serbia aged 15–19 have their first sexual intercourse
at the age of 16, where love for the partner (44.6%) In 2006 90.4% of the young aged 15–19 were aware
and curiosity (19.9%) are the most commonly offered of HIV and corresponding disease, i.e. AIDS.
reasons for doing so (Figure 49).
In 2006, 17.8% of the young had sufficient knowledge
Out of the total number of the young aged 15-19 who on HIV/AIDS so that they were able to identify ways of
had sex with casual partners in the year preceding prevention of sexual transmission and at the same time
the 2006 study, 78.4% used condom at the latest recognized misconceptions related to HIV transmission
intercourse. The average number of casual partners in which was an 11.1% improvement over 2000 .
this population was 2.6.
47
RELATIONS OF CHILDREN AND ADOLESCENTS AGED

7-19 WITH PARENTS AND ATTITUDE TO SCHOOL
Figure 50. Ease of communication between parents and children and adolescents aged 7–19 years, Serbia, 2006
With mother With father

10.1%
28.1%
Yes Yes
No No
89.9% 71.9%
Almost all children and adolescents aged 7–19 years in Less than a half of children and adolescents aged 7–19
Serbia (89.9%) could easily discuss their problems with had a favorable opinion of school (46.9%). Children
their mothers. 71.9% of the young could communicate aged 7 to 11 years had significantly better perception
with the fathers, as well (Figure 50). Younger children of school (59.1%), while children aged 12 to 14
had better communications with both mother (93.9%) years (40.4%) and 15 to 19 years (37.3%) had a good
and father (79.4%) than the older ones. In 2006 the perception of school to a much lower degree. Relating
percentage of children who found it easy to discuss to geographical regions in Serbia, perception of school
their problems with both mother (89.9%) and father increased from developed towards lesser developed
(71.9%) was increased in comparison with 2000 regions. In Belgrade a significantly lower percentage of
(88.3% and 66.5%, respectively). 3.7% of the young the young (37,9%) had a good attitude to school, while
did not have a person to rely on. in Central (55.7%) and Southeastern Serbia (56.1%)
the percentage of the young with a good perception of
school was higher.
48
KEY FINDINGS
USE OF HEALTH SERVICES – CHILDREN AND

ADOLESCENTS AGED 7-19 YEARS
Primary health care services The percent of children and adolescents aged 7–19
years in Serbia who had never used health services,
In 2006 almost every other child in Serbia (45.6%) their GP or pediatrician, fell significantly from 6.6% in
had their own GP or pediatrician, which was an 2000 to 2.0% in 2006.
improvement over 2000 by 11.9%. The groups of
the poorest and poorer children and adolescents had Dental health care
their own physician in a significantly lower percentage
(31.8% and 38.5%), contrary to the group of the richest In Serbia in 2006 every other child, i.e. 53.5% had their
children and adolescents (60.8%) (Figure 51). own dentist, which was significantly more than in 2000
(42.6%). In Belgrade the percentage of the young with
In the course of the year preceding the 2006 survey, their own dentist (76.9%) was significantly higher than
60.4% population of the young visited their GP or in other parts of the country.
pediatrician, which was on the same level as in 2000.
In comparison to 2000 the number of children and
Children and adolescents in Belgrade visited their GP adolescents who visited their dentist in the year
or pediatrician significantly more often (77.1%), than preceding the 2006 survey was also increased (58.9%
the children in Central (51.4%), Western (50.3%), and vs. 63.7%). A positive trend was also noted in the
Eastern (48.1%) Serbia. percentage of children and adolescents who have
Figure 51. Children and adolescents aged 7-19 years who have their own GP or pediatrician, by the wealth index, Serbia, 2006
0 10 20 30 40 50 60 70
Serbia 45.6
Poorest 31.8
Poorer 38.5
Midlle class 46.4
Richer 48.7
Richest 60.8
49
Figure 52. Children and adolescents aged 7-19 years having their dentist, and visits to the dentist, Serbia
0 10 20 30 40 50 60 70
42.6
Have own dentist
53.5
58.9
Visited dentist in previous year
63.7
8.5
Year 2000
Never visited dentist
3.2 Year 2006
never visited a dentist (8.5% in 2000 vs. 3.2% in 2006) Use of medication
(Figure 52). The poorest children and adolescents also
used the dental health care to the lowest degree. Only In Serbia in 2006 one in 12 children resorted to self-
34.3% had their dentist, and 46.8% visited him/her in medication (8.7%). Boys and adolescents used self-
the year preceding the survey. medication significantly less (6.2%). Self-medication
without prior consultation with physicians was
Hospital care significantly more common in the 15-19 years age
group (15.6%), than in the younger, 7-11 age group
In Serbia 3.9% children and adolescents aged 7–19 (2.7%). In Serbia the young usually used analgesics
were hospitalized in the year preceding the 2006 for self-medication (6.5%). They were followed
survey, i.e. 1.1% less than in 2000. by vitamins and minerals (5.9%), herbal medicinal
products (3.0%) and antibiotics (2.7%) (Figure 53).
Children and adolescents using hospital care did that In comparison with 2000 no significant changes were
1.5 times on the average, which was comparable with identified in the percentages of the young that resort to
the 2000 data. No significant changes were noted in self-medication, except in the case of herbal medicinal
any of the parameters of hospital care of children and products, where a rising trend was seen (3.0% in 2006
adolescents. vs. 1.3% in 2000).
50
KEY FINDINGS
Figure 53. Self medication with analgesics, vitamins and minerals, and antibiotics in the population of children and adolescents
aged 7-19 years, by the age groups, Serbia, 2006
0 2 4 6 8 10 12 14
6.5
Analgesics 0,7
4.7
13.0
5.9
Vitamins and minerals
2.2
4.5
10.3 Serbi a
2.7 7–11 years of age
Antibiotics
5.8
Reproductive health of femele adolescents visiting gynecologists was noted in Vojvodina (6.3%).
In 2006 the most common reason for a visit to the
In Serbia 17.9% girls aged 15–19 used gynecological gynecologist was a check up in 60.4%, followed by
health care in the year preceding the 2006 survey. On complaints (17.1%) and pregnancy (8.0%). Birth
the average, they visited a gynecologist at the age control was the reason for a visit to gynecologist for
of 16.5 years. A significantly lower number of girls 3.4% of adolescent girls (Figure 54).
Figure 54. Most common reasons for visit to a gynecologists, girls aged 15–19 yrs, Serbia, 2006
4.9% 6.3%
3.4% Health check up
8.0% Complains
Pregnancy
Contaception
Other
No answer
17.1% 60.4%
51
CONCLUSIONS
1. Almost a half of the adult population and about 5. Two thirds of adults spent their free time passively,
ninety percent of children and adolescents perceived in sedentary activities, and almost one third of the
their overall health as good and very good. One in six working population had a sedentary type of work. In
adults defined their health as poor or very poor. Only comparison with 2000 the number of children and
one quarter of adult population as well as one quarter adolescents pursuing sedentary activities in their free
of the total number of children and adolescents have time has increased: they watched TV, CDs or video
a desirable attitude to responsibility for their own cassettes, played computer games or listened to music.
health.
6. Risky behavior in traffic was particularly marked in
2. Almost every other adult had at least one of the drivers aged 18–34 years, where almost all confessed to
chronic diseases (elevated blood pressure, rheumatic having driven under the influence of alcohol, exceeding
articular diseases, elevated blood lipids, etc.).The the speed limit and using a mobile phone while driving.
proportion of adults with high blood pressure has A large number of children and adolescents participated
increased reaching 46.5% in 2006. in traffic on their rollerblades or skateboards, bicycles
or motorbikes without protective gear.
3. With regard to nutritional status, in 2006 the body
mass index (BMI) showed that 38.3% of the population 7. The smoking prevalence in the adult population was
weighed within normal values, while every other reduced in comparison to 2000: 40.5% vs. 33.6%, as
person was overweight (54.5%) i.e. 18.3% were obese well as in the young aged 15–19 from 22.9% to 15.5%.
and 36.2% pre-obese. 2.3% were underweight. No Smoking was more prevalent in men (38.1%) than in
changes in weight categories of adults have been noted women (29.9%), in boys (18.0%) than in girls (13.0%).
in the period 2000–2006. In comparison with 2000 the In 2006 a significant improvement was achieved in
number of underweight children has been reduced, but awareness of adverse consequences of smoking, i.e.
the numbers of moderately obese and obese children tobacco smoke: 57.5% of adults as compared to 34.6%
have increased. in 2000. The percentage of the young that do not have
a desirable attitude to smoking remains high – 50.5%,
4. Relating to hygienic habits of both adults and i.e. unchanged since 2000.
children, a significant improvement was achieved in
regular hand washing, but the percentages of those 8. One third of the young aged 15–19 drank alcohol,
that took regular baths or showers and maintained oral and 5.5% of the young had the habit of getting drunk
hygiene were reduced. at least once a month. Sale of alcoholic beverages at
52
KEY FINDINGS
public places is still present, i.e. 10.5% of children and of use of general practice and pediatricians remained
adolescents bought alcohol in supermarkets, cafes, at the 2000 level. The use of specialist services and
restaurants, etc. dental services in primary health care centers by adult
population has been reduced, while the use of dental
9. Out of the total number of adults who had sex with services by children has increased. Satisfaction with
non-regular partners, only somewhat above one half services provided by GPs and hospital services has
used a condom at the latest sexual intercourse with a non- increased in comparison with 2000.
regular partner. Over one fifth of the young aged 15 to 19
years had sufficient knowledge on HIV/AIDS, which 11. In 2006 the percentage of users of private practice
is a three-fold improvement over 2000. A significant services was reduced in comparison with 2000.
improvement was also achieved in the percentage of
women who went for regular gynecological check- 12. In 2006 54.2% of adult population obtained their
ups, as well as in increased coverage by post-delivery medication on prescription mainly, which was more
home visits by health workers. than in 2000 (39.4%).
10. Half of adult population had their own GPs, and 13. The average annual amount of the total “out of
about half of children and adolescents had their own pocket” expenses for health care per capita totaled
pediatrician and dentist, which was an improvement RSD 14,696.7. Over two fifths of the sum accounted
over 2000 for both categories of population. The level for purchase of medications.
The integral version of the Final Report and Key Findings of the National Health Survey, Serbia 2006
have been published in e-format as PDF documents. They are accessible at the websites of the Ministry
of Health of the Republic of Serbia (www.zdravlje.sr.gov.yu) and the Institute of Public Health of Serbia
„Dr Milan Jovanović Batut“ (www.batut.org.yu).
53

National Health Survey Serbia 2006 Key Findings

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Republic of Serbia

NATIONAL HEALTH SURVEY

Design and pre-press

NATIONAL HEALTH SURVEY

Assoc. Prof. Dejana Vuković, MD, PhD, Deputy Principal Investigator

Maja Krstić, MD, MSc, Study Secretary

Milena Vasić, MD, PhD, household profiles,

Sanda Pešić, BMath, for IT support and preparing statistical analysis,

Prof. Snežana Simić, MD, PhD,

Assoc. Prof. Goran Ilić, MD, PhD,

Tanja Knežević, MD, PhD,

Prof. Mirjana Martinov Cvejin, MD, PhD,

Slobodan Tošović, MD,

Prof. Branislav Petrović, MD, PhD,

Assoc. Prof. Goran Samardžić, MD, PhD,

Saša Rikanović, MSc,

Prof. Snežana Simić, MD, PhD,

Prof. Ljiljana Denić, MD, PhD,

The study team would like to thank particularly

Tanja Knežević, MD, PhD

Saša Rikanović, MSc,

Anđelka Dželetović, MD, PhD

Ivana Bjelić, BMath

HOUSEHOLD CHARACTERISTICS, HOUSEHOLD

HEALTH STATUS OF ADULT POPULATION 15

ADULT POPULATION LIFE STYLE, KNOWLEDGE AND

REPRODUCTIVE HEALTH OF WOMEN 30

USE OF HEALTH SERVICES– ADULT POPULATION 32

HEALTH CARE PAYMENTS 38

HEALTH STATUS OF CHILDREN AND ADOLESCENTS

LIFESTYLE, KNOWLEDGE AND ATTITUDES TO HEALTH

RELATIONS OF CHILDREN AND ADOLESCENTS AGED

USE OF HEALTH SERVICES – CHILDREN AND

Map 1. Distribution of sample by the geographical regions

Response rate Presentation of results

Western Serbia 81.4

Central Serbia 87.5

Eastern Serbia 83.9

Southeastern Serbia 76.4

HEALTH STATUS OF ADULT POPULATION

Self-assessment of health and Injuries

Very bad Bad Fair Good Very good

50.2 Serbia = 46.5

Southeastern serbia 59.8 56.6

Optimum (BMI 18.5–24.9)

Underweight (BMI <18.5)

Height and weight not measured

Due to healthier lifestyle

Western Serbia 3.0

Centra Serbia 3.3

Eastern Serbia 3.9

Southeastern Serbia 2.6

100 95.0 93.2

ADULT POPULATION LIFE STYLE,

Hygienic habits Diet

Serbia Poorest Poorer Middle class Richer Richest

Fish Animal fat

Fresh vegeta bles Fresh fruits

In 2006 one in five adults in Serbia (19.9%) never Behavior in traffic