Family planning in Serbia appears to have been neglected in the last 20 years. The situation has deteriorated further as the economic crisis and social transition pushed this area of health to a distant margin. The current situation shows a low contraceptive prevalence rate and a high abortion rate. Family planning is not regarded in terms of human rights, but rather as a demographic determinant. An explanation for this can be traced back to the opinion present among decision makers and health professionals that family planning contributes to lowering of the birth rate in Serbia. Viewed in this negative context, family planning is forced into a niche.
There is also a general tendency to see reproductive health as youth health and overlook the other components of RH. It is relevant that family-planning counseling centers in the PHC are called youth counseling centers. Efforts should be done to reposition reproductive health as not only a health care, but also a social and human rights issue, and family planning as not only a demographic or youth only specific issue. There was no serious discussion in the recent years about strategy to increase the contraceptive prevalence rate and decrease the abortion rate, or about an institutional solution for family planning.
All Governments were positive to reproductive health, but still Serbia does not have a Reproductive Health Strategy until now. Earlier, it was suggested to establish a Department for Family Planning within one of the Ministries, but this was never implemented. Political will is needed to put family planning on the national agenda.
Abortion is done both in government health care institutions and in private ones. In governmental clinics it is performed after-hours at full price and is considered a source for additional income for gynecologists. Quality of abortion services was reported as low.
Both private and public clinics lack pre- and post-abortion counseling services. Post-abortion counseling for family planning was estimated to be done only by 10% of gynecologists.
A suggestion was made to support research about economic aspects of family planning and abortion, conducted by different research or teaching public health institutions.
The offer of contraceptives is quite limited on the Serbian market. Some modern contraceptives are not on the market (injectable and implants) and the reasons stated were that pharmaceutical companies are not interested in the small market of a country with a low contraceptive prevalence. This situation is also partly to the fact that there is a low demand for contraceptives in the country, but also due to the complicated administrative procedures for registering drugs. Serbia has also a locally produced combined oral contraceptive (Legrevan), which is cheap and accessible. Available contraceptives, including emergency contraceptive pills with levonorgestrel, can be purchased over-the-counter without medical prescription.
SRH Serbia advocates for the right of women to decide whether and when to have a children, the right to safe abortion, informing women of pre and post abortion counseling as well as for improving the supply of contraceptives on the market.