The Influence of Ethnicity and Displacement on Quality of Antenatal Care: The Case of Roma, Ashkali, and Balkan Egyptian Communities in Kosovo

摘要

The conflict in Kosovo created mass displacement and a fractured health system. Roma, Ashkali,and Balkan Egyptian communities are particularly vulnerable to discrimination and exclusion frominstitutions. We aimed to examine Roma, Ashkali, and Balkan Egyptian disparities in quantity andquality of antenatal care received. We conducted a cross-sectional study in August 2012 with 603 womenaged 15 or older who had given birth in the previous two years. We measured quantity of antenatalcare using number of visits and quality of care using antenatal checklists. We used linear regressionwith interaction terms of displacement and type of health institution (for example, Serbian or Kosovar)to assess ethnic disparities in antenatal care. Women from Roma, Ashkali, and Balkan Egyptiancommunities received poorer quantity and quality of antenatal care compared to Kosovar Albanian andSerbian women. In adjusted models, Roma, Ashkali, and Balkan Egyptian women scored 3.5 points lower[95% CI (-5.2, -1.8)] on the checklists. Roma, Ashkali, and Balkan Egyptian women who were displacedreceived even poorer quality of care. Ethnic disparities exist in quality of antenatal care. Women fromRoma, Ashkali, and Balkan Egyptian communities receive the poorest quality of services. As Kosovostrives to build a multiethnic health care system, a focus on equity is important to ensure the right tohealth for Roma, Ashkali, and Balkan Egyptian women.