Abstract

Every child has the right to the highest level of health care and access to health and medical services, with special emphasis on primary and preventive health care, public health and education and reduced infant mortality. Ensuring equity in health is a very important determinant of any public health policy. The aim of this paper is to establish the degree of realization of the right to health care from the aspect of equity in health and to establish the degree of realization of these rights in relation to access to health care. The study was descriptive cross-sectional study conducted on a sample survey of 1020 children aged 0-6 years in all the municipalities of Central Bosnia Canton. We studied the geographic, time, personnel and economic access to health care. The existence of the certified birth certificate and child health booklets are indicators for the right to access to health care. We also explored the social factors that may affect the realization of the given rights. The results show a significant violation of the children rights, especially when it comes to equality in health. We found significant differences in social status of urban and rural families. Rural population is much shakier on the basis of level of education of mother and termination of mother´s employment. Rural population threatened by inadequate geographical, time and personnel, availability of health care. A particular problem is the weak economic approach, as is evident from the fact that 66% of families live below the poverty line of 185 KM per household per month. 70.5% of all respondents have paid some of the health care services. However, members of the urban population are more vulnerable to this issue than rural. The right to access health care, which is based on the birth certificate, is not achieved for 1.5% of children, but on the basis of health insurance for 11.9%. We have shown that social and economic factors have significantly affected on the possession of the birth certificate and health insurance. Analysis of the results obtained, regulatory requirements and guidelines indicates that there is disparity between the goals, the situation in practice and opportunities for their realization. Amendments to the Law of health insurance, by the introduction of a unique program of measures, by development of family medicine, and especially the development of visiting activity can be at least partly overcome the existing disparities in the realization of children’s rights to health care.

Key words: children rights, health care, equality in health, access to health care