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© 1996 Oxford University Press

research-article

Health Care Delivery and the Status of the Population's Health in the Current Crises in Former Yugoslavia Using EPI-Design Methodology

B LEGETIC*, D JAKOVLJEVIC*, J MARINKOVIC{dagger}, O NICIFOROVIC* and D STANISAVLJEVIC{dagger}

* Institute for Public Health, Medical Faculty Novi Sad, Yugoslavia.
{dagger} Institute for Social Medicine, Statistics and Health Research, Medical Faculty Belgrade, Yugoslavia.

BACKGROUND: The aim of this study was to assess accessibility to health care services and the needs of the population and demands on the health service in the areas most affected by the current crisis in the former Yugoslavia. The delivery of health care services and problems in its realization and the status of the population's health in the crisis period (from the second half of 1993 to the end of the first half of 1994) were also investigated together with the results of Government measures concerning health care priorities during the period of UN Sanctions in Yugoslavia.

METHOD: By the end of the 1980s, as an alternative to traditional data collection, a new method called ‘Rapid Health Assessment’ appeared. The EPI design (Expanded Programme on Immunization), the most frequently applied method, was used in this study. It is a cluster sample selection, where a household is the basic unit.

RESULTS: This study showed that the first effects of the crisis appeared in the field of health care delivery and then in the population's health status. The difficulties were not the same for all categories of the population, and children and urgent cases had less problems than others. The expected difficulties in vaccination coverage were not shown in this survey. The morbidity structure for children and adults changed in comparison with routine statistical data but the size of the chosen sample, as well as the short period of the crisis investigated, mean that definite conclusions cannot be drawn on this issue. This study provides recent data on health care delivery, morbidity structure, and vaccination coverage, as well as giving a more complex and precise estimate of the real situation.

Keywords health care delivery, crisis, EPI design methodology, health needs, health demands, Yugoslavia

Revised 1 May 1995


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