Despite a vast potential and reforms, the country's healthcare faces significant problems.
By Katica Djurovic for Southeast European Times in Belgrade -- 17/10/12
Key public health concerns in Serbia are cardiovascular disease and cancer which, cause 55 percent and 20 percent of the deaths, respectively. [Reuters]
The World Health Organization (WHO) office in Belgrade said that Serbia is well on the way to improving its healthcare system, although experts say the nation still has many problems.
"Every two years we reach an agreement with the ministry [of health], which makes a list of priorities, and we help their work, bring our experts, organise workshops," Dorit Nitzan, head of the WHO office in Serbia, told SETimes.
A recent study by Serbian NGO Doctors Against Corruption shows that Serbia allocates 11 percent of its GDP to healthcare – more than Croatia (8 percent), Bulgaria (7 percent) or Romania (5 percent).
But the results are among the worst in the region, the organisation said.
Various surveys show the public considers healthcare, together with political parties, to be the most corrupt institutions in Serbia, and the 2012 European Health Consumer Index (EHCI) ranks Serbia last in the quality of healthcare.
"Over the 10-year period, Serbia spent over 20 billion euros on health reforms but the money has not shown the desired progress. Nobody is satisfied with the health reform, neither the patients nor the doctors," Drasko Karadjinovic, co-ordinator of Doctors Against Corruption, told SETimes.
Lack of integrated healthcare and corruption are key factors in the poor performance, the study said. It listed the separation of private, public and military healthcare as an example, which does not allow for the transfer of patients or funds.
"We had over 40 EU-funded projects worth 140 million euros and none of the priorities have been met. We need a total systemic change and a consistent struggle against the corruption stemming from party interests," Karadjinovic said.
Serbia began healthcare reform in 2002; it addressed structural and functional issues, including human resources and organisation of services.
The reform also sought to restore the role of, and public trust in, primary care, while enhancing primary care practitioners' capacity to deal with a higher proportion of health issues.
Vladimir Djukic, state secretary at the ministry of health, blamed the financial crisis and previous governments for the poor state of affairs, but said the new ministry is ready to solve any of the problems.
"One can hardly say we do not do anything. In 2011, the ministry planned to spend only 670 million dinars on healthcare from the state budget, but we ended up spending over 20 billion dinars," Djukic told SETimes.
Nitzan said in the past two years, Serbia has taken a huge step forward in improving health care, especially in covering marginalised groups such as the Roma.
Nitzan explained the system has four pillars which have not improved equally -- standards and regulations, resource generation such as education and modern technologies, financing and service delivery to patients.
Of the four, financing remains the most problematic pillar.
"Serbia is one of the countries that has great standards, inherited from the former Yugoslavia. ... the laws are perfect, but the rules of procedures and implementation are obscure. ... It is in the process of improving, but it is not yet completed," Nitzan said.