The Glass Ceiling in Global Health: Perspectives of Female and Male Anesthesiologists.

BACKGROUND: Gender equity is essential for improving health outcomes globally. Despite comprising 75% of the global health workforce and dominating academic global health programs, women remain underrepresented in leadership positions in global health organizations. Our study aimed to identify potential gender differences in the beliefs and attitudes regarding barriers that women anesthesiologists encounter in pursuing careers and leadership roles in global health and to identify recommendations for improving gender equity in global health. METHODS: We conducted a cross-sectional online survey focusing on career leadership opportunities and challenges uniquely faced by women clinicians in global health. We obtained permission from the World Federation of Societies of Anaesthesiologists to distribute our questionnaire to their leadership committee members during 2 months (May-July 2022). RESULTS: The questionnaire was distributed to 164 study participants with 67 individuals (44.8% female) based in 38 different countries completing the survey (response rate 40.9%). Overall, 47.8% of the participants aspired to a leadership position in global health and 58.2% agreed women face unique barriers to global health leadership (70.0% of women compared to 48.6% of men; P = .081). Female gender (odds ratio [OR], 19.22, P = .004) and divorced marital status (OR, 746.26, P = .004) were positively associated and African ethnicity (OR, 0.002, P = .017) was negatively associated with the perception of gender bias in their career growth. The main challenges included balancing work and family responsibilities, lack of female mentors or role models, gender-based discrimination, and limited opportunities for career advancement. Men acknowledged these challenges but reported personally experiencing them to a lesser extent, particularly concerning lack of opportunities (P = .005), inadequate pay (P = .000), and lack of training (P = .000). CONCLUSIONS: Gender disparities exist in the pursuit of global health careers. This study underscored that more women than men perceive barriers in pursuing leadership roles in global health and that men generally encounter these obstacles to a lesser extent. Female representation in leadership positions could be supported through evidence-informed policies that promote work-life balance, improve mentorship, offer equal opportunities for career advancement and adequate pay, and combat gender-based discrimination.

Serbian primary care physicians' perspectives on adolescents' right to confidentiality in sexual and reproductive healthcare-a qualitative interview study.

BACKGROUND: In prominent international documents and professional position papers, confidentiality was recognized as a necessary condition for effective reproductive healthcare of adolescents. Although legally guaranteed, it is questionable if the right to confidentiality of adolescents is respected in healthcare practice in Serbia. OBJECTIVES: To assess primary care physicians' perspectives on the legal right of minors to confidentiality in sexual and reproductive healthcare, as well as their experiences in practice. METHODS: Qualitative, semi-structured face-to-face interviews with 12 primary care pediatricians and gynecologists at several municipalities of the city of Belgrade were performed. Interview transcripts were analyzed using qualitative content analysis method. RESULTS: Most interviewees were aware of their legal obligations and support the general idea of granting adolescents the right to confidentiality. They recognized that the lack of confidentiality assurances prevents adolescents' access to sensitive care. However, physicians expressed concerns regarding medical situations when parents should be notified, which was reflected in their inconsistent respect of said right in actual practice. Several organizational obstacles were emphasized by interviewees, including insufficient number of physicians, time constraints, poor access to gynecological services and vague definitions of legal provisions. CONCLUSION: If the aim is for adolescents' right to confidentiality to be consistently respected in practice, primary care physicians need to be systematically educated about legal provisions and given comprehensive clinical guidelines. The general positive attitude towards confidentiality expressed by the primary care physicians implies that a possibility exists to engage them as main advocates for improvements in access to the necessary health care.

Gynecologists' Knowledge, Attitudes, and Intentions Toward Human Papillomavirus Vaccination in Serbia.

OBJECTIVES: The aims of this study were to estimate the level of knowledge, attitudes, and intentions about human papillomavirus (HPV) infection and HPV vaccine among gynecologists and to explore predictors of gynecologists' intention to recommend the HPV vaccine. METHOD: This research was conducted between April and June 2014 among all gynecologists working at women's health departments in all primary health centers in Belgrade, the capital of Serbia, using a specially designed questionnaire. RESULTS: The response rate was 88.2%. The knowledge of gynecologists was estimated as average. The most frequently reported obstacles to HPV vaccination was the financial concern (59.8%). More than two thirds of the gynecologists were willing to recommend the vaccine (68.4%). The factors associated with the gynecologists' intention to recommend the vaccine included their positive attitudes toward boys' vaccination (odds ratio [OR], 8.96; 95% confidence interval [CI], 2.85-28.16), negative attitudes toward frequent changes the recommendations (OR, 0.31; 95% CI, 0.10-0.93), and beliefs that the vaccine application would decrease condom usage (OR, 0.31; 95% CI, 0.06-0.68). CONCLUSIONS: The findings provide an important insight into the current point of view of the gynecologists, which confirms that the better the knowledge of HPV and vaccine, the higher the likelihood of recommending it.

High rate of burnout among anaesthesiologists in Belgrade teaching hospitals: Results of a cross-sectional survey.

BACKGROUND: Decisions by anaesthesiologists directly impact the treatment, safety, recovery and quality of life of patients. Physical or mental collapse due to overwork or stress (burnout) in anaesthesiologists may, therefore, be expected to negatively affect patients, departments, healthcare facilities and families. OBJECTIVES: To evaluate the prevalence of burnout among anaesthesiologists in Belgrade public teaching hospitals. DESIGN: A cross-sectional survey. SETTING: Anaesthesiologists in 10 Belgrade teaching hospitals. MAIN OUTCOME MEASURES: Burnout was assessed using Maslach Burnout Inventory-Human Services Survey. RESULTS: The response rate was 76.2% (205/272) with the majority of respondents women (70.7%). The prevalence of total burnout among anaesthesiologists in Belgrade teaching hospitals was 6.34%. Measured level of burnout as assessed by high emotional exhaustion, high depersonalisation and low personal accomplishment was 52.7, 12.2 and 28.8%, respectively. More than a quarter of the studied population responded in each category with symptoms of moderate burnout. We detected that sex, additional academic education, marital status and working conditions were risk factors for emotional exhaustion and depersonalisation. Ageing increased the likelihood of burnout by 21.3% with each additional year. Shorter professional experience and increased educational accomplishment increased the risk of total burnout by 272%. CONCLUSION: Burnout rates in Belgrade teaching hospitals among anaesthesiologists are higher than in foreign hospitals. Emotional and/or physical breakdowns can have serious effects when these individuals care for patients in extremely stressed situations that may occur perioperatively. Causes for burnout should be examined more closely and means implemented to reverse this process.

Psychometric Properties of the Serbian Version of the Maslach Burnout Inventory-Human Services Survey: A Validation Study among Anesthesiologists from Belgrade Teaching Hospitals.

We report findings from a validation study of the translated and culturally adapted Serbian version of Maslach Burnout Inventory-Human Services Survey (MBI-HSS), for a sample of anesthesiologists working in the tertiary healthcare. The results showed the sufficient overall reliability (Cronbach's α = 0.72) of the scores (items 1-22). The results of Bartlett's test of sphericity (χ(2) = 1983.75, df = 231, p < 0.001) and Kaiser-Meyer-Olkin measure of sampling adequacy (0.866) provided solid justification for factor analysis. In order to increase sensitivity of this questionnaire, we performed unfitted factor analysis model (eigenvalue greater than 1) which enabled us to extract the most suitable factor structure for our study instrument. The exploratory factor analysis model revealed five factors with eigenvalues greater than 1.0, explaining 62.0% of cumulative variance. Velicer's MAP test has supported five-factor model with the smallest average squared correlation of 0,184. This study indicated that Serbian version of the MBI-HSS is a reliable and valid instrument to measure burnout among a population of anesthesiologists. Results confirmed strong psychometric characteristics of the study instrument, with recommendations for interpretation of two new factors that may be unique to the Serbian version of the MBI-HSS.

Maternal satisfaction with organized perinatal care in Serbian public hospitals.

BACKGROUND: Understanding the experiences and expectations of women across the continuum of antenatal, perinatal, and postnatal care is important to assess the quality of maternal care and to determine problematic areas which could be improved. The objective of this study was to identify the factors associated with maternal satisfaction with hospital-based perinatal care in Serbia. METHODS: Our survey was conducted from January 2009 to January 2010 using a 28-item, self-administered questionnaire. The sample consisted of 50% of women who expected childbirths during the study period from all 76 public institutions with obstetric departments in Serbia. The following three composite outcome variables were constructed: satisfaction with technical and professional aspects of care; communication and interpersonal aspects of care; and environmental factors. RESULTS: We analyzed 34,431 completed questionnaires (84.2% of the study sample). The highest and lowest average satisfaction scores (4.43 and 3.25, respectively) referred to the overall participation of midwives during delivery and the quality of food served in the hospital, respectively. Younger mothers and multiparas were less concerned with the environmental conditions (OR = 0.55, p = 0.006; OR = 1.82, p = 0.004). Final model indicated that mothers informed of patients' rights, pregnancy and delivery through the Maternal Counseling Service were more likely to be satisfied with all three outcome variables. The highest value of the Pearson's coefficient of correlation was between the overall satisfaction score and satisfaction with communication and interpersonal aspects of care. CONCLUSIONS: Our study illuminated the importance of interpersonal aspects of care and education for maternal satisfaction. Improvement of the environmental conditions in hospitals, the WHO program, Baby-friendly Hospital, and above all providing all pregnant women with antenatal education, are recommendations which would more strongly affect the perceptions of quality and satisfaction with perinatal care in Serbian public hospitals by women.

Early sexual initiation and risk factors in Serbian adolescents: data from the National Health Survey.

OBJECTIVES: To identify factors associated with sexual initiation before the age of 17 among Serbian adolescents and to assess whether the latter is associated with other risky behaviours, such as tobacco, alcohol and illicit drug use, and fighting. METHODS: The study was an analysis of data gathered by the 2006 Serbian National Population Health Survey in which information concerning adolescents was obtained by means of questionnaires. Data were analysed using descriptive statistics and a logistic regression model. RESULTS: A total of 474 adolescents aged 15 and 16 completed the survey. Multivariate logistic regression analysis showed that male respondents reporting sexual initiation were significantly more likely to smoke daily and to have experienced two or more episodes of drunkenness in the past. Female respondents reporting sexual initiation were significantly more likely to live with both parents, to feel insecure in school, to smoke daily and to drink more than once a week. CONCLUSIONS: A strong association was found between adolescent sexual initiation and substance abuse. Although a causal relationship is evidently not established, one might contemplate including measures lowering the frequency and intensity of substance abuse in health prevention programmes and interventions aiming at reducing the risks associated with sexual initiation.

Musculoskeletal Diseases as the Most Prevalent Component of Multimorbidity: A Population-Based Study.

Background/Objectives: Due to their high frequency, common risk factors, and similar pathogenic mechanisms, musculoskeletal disorders (MSDs) are more likely to occur with other chronic illnesses, making them a "component disorder" of multimorbidity. Our objective was to assess the prevalence of multimorbidity and to identify the most common clusters of diagnosis within multimorbidity states, with the primary hypothesis that the most common clusters of multimorbidity are MSDs. Methods: The current study employed data from a population-based 2019 European Health Interview Survey (EHIS). Multimorbidity was defined as a ≥2 diagnosis from the list of 17 chronic non-communicable diseases, and to define clusters, the statistical method of hierarchical cluster analysis (HCA) was performed. Results: Out of 13,178 respondents, multimorbidity was present among 4398 (33.4%). The HCA method yielded six multimorbidity clusters representing the most common diagnoses. The primary multimorbidity cluster, which was prevalent among both genders, age groups, incomes per capita, and statistical regions, consisted of three diagnoses: (1) lower spine deformity or other chronic back problem (back pain), (2) cervical deformity or other chronic problem with the cervical spine, and (3) osteoarthritis. Conclusions: Given the influence of musculoskeletal disorders on multimorbidity, it is imperative to implement appropriate measures to assist patients in relieving the physical discomfort and pain they endure. Public health information, programs, and campaigns should be utilized to promote a healthy lifestyle. Policymakers should prioritize the prevention of MSDs by encouraging increased physical activity and a healthy diet, as well as focusing on improving functional abilities.

Nurses' Perception of Tension, Stress, and Pressure before and during the COVID-19 Pandemic: A Multicenter Serbian Study.

The mental health of healthcare workers, especially the nursing staff in intensive care units, is crucial for the optimal functioning of healthcare systems during medical emergencies. This study implements a cross-sectional design to investigate the associations between nurses' personal characteristics, workplace challenges, and job satisfaction with the increased perception of tension, stress, and pressure at the workplace (TSPW) before and during the COVID-19 pandemic. In 2021, we surveyed 4210 nurses from 19 intensive healthcare facilities in the capital of Serbia, Belgrade, and, at that time, collected data about their perceived TSPW before and during the COVID-19 pandemic. Our study identified six predictors of the increase in TSPW, as perceived by nurses: their work in COVID-19 infectious zones (OR = 1.446), exhaustion due to work under protective equipment (OR = 1.413), uncertainty and fear of infection (OR = 1.481), a high degree of superiors' appreciation and respect (OR = 1.147), a high degree of patients' attitudes (OR = 1.111), and a low degree of work autonomy (OR = 0.889). The study's findings suggest that a solution to this issue is necessary to ensure that nurses are safe and able to alleviate the physical and mental strain that comes with prolonged use of protective equipment. Nurses on the frontline of the pandemic require better health protection, better conditions, and respect for their role. Strategies to promote mental health would help reduce nurses' stress and increase job satisfaction.

Patterns of infant mortality from 1993 to 2007 in Belgrade (Serbia).

The population of the Republic of Serbia has been exposed to radical changes in living standards and employment status and inequalities in utilization of health-care services. Given that infant mortality rates (IMR) reflect general community health, we evaluated the trends and mortality structure of Belgrade's infant population for a 15-year period (1993-2007). Data were collected from published and unpublished materials of the Municipal Institute of Statistics in Belgrade. Records were based on official notifications of live-born infants and death certificates. A linear regression equation was used to estimate mortality trends over time, while an F test was performed to assess the significance of the linear regression coefficient. The average IMR was 11.3 [95% confidence interval (CI) 9.4, 13.2] per 1,000 live births for both sexes with a higher average rate observed for male infants. Throughout the whole period, a statistically significant declining trend (y = 17.072 - 0.721x, p = 0.001) was noted. The most common causes of death were conditions occurring during the perinatal period, with an average annual mortality rate of 7.7 [95% CI 6.4, 8.9] per 1,000, arising mainly from respiratory distress of the newborns. Regarding congenital anomalies, deformations of the heart and aortic and mitral valves were most frequently found. A statistically significant inverse correlation was observed between average net salary and IMR for each sex separately (for males r = -0.727, p = 0.002, for females r = -0.721, p = 0.002) and for both sexes jointly (r = -0.759, p = 0.001). A decline in infant mortality in Belgrade has been observed. However, further promotion of health-related activities, as well as continuous surveillance of IMR, is required.

"Today one partner, tomorrow another one, and no one is suspicious that you are gay": A Qualitative Study of Understanding HIV Related Risk Behavior Among MSM in Bosnia and Herzegovina.

Men who have Sex with Men (MSM) are often exposed to stigma and discrimination, especially in developing countries. Discrimination might have an impact on their sexual behavior. The proportion of MSM among HIV positive persons is rising in Bosnia and Herzegovina (B&H). The aim of this qualitative study was to understand the country context and HIV-related risk behaviors among MSM in B&H. We found that MSM in B&H have a dominant fear of expressing their sexual orientation in the homophobic societal environment, including their own family. Disclosures are often connected with escalated family violence, followed by the silence and ignorance. The fear of being connected to one particular partner and being labeled as a gay lead to the need of "masking" their sexual orientation, and having sexual intercourse with non-steady sexual partners. Although most MSM were aware of the risk of HIV and other STIs, the fear of rejection and remaining alone, shapes their decisions to agree to have sex without condoms.

Trends and patterns of ovarian cancer mortality in Belgrade, Serbia: a joinpoint regression analysis.

OBJECTIVE: Ovarian cancer (OC) represents the leading cause of gynecological cancer deaths. The aim of our study was to estimate the patterns and trends in OC mortality in the population of Belgrade (Serbia) during the period 1976 to 2007. METHODS: Mortality data (official death certificates) for OC have been gathered from the Municipal Institute of Statistics in Belgrade. Mortality rates with corresponding 95% confidence intervals were adjusted by the European standard population. Trends in age-adjusted and age-specific mortality rates were calculated using joinpoint regression, according to the method of Kim et al. An annual percent of changes in mortality rates for each line segment was estimated by fitting a regression line to the natural logarithm of the rates using calendar years as a regressor variable. RESULTS: The average age-adjusted OC mortality rate during the period 1976-2007 was 5.4/100,000 (95% confidence interval, 4.8-6.1). For total women population, no joinpoint is found, whereas significantly increasing mortality trend was observed during the whole study period (+3.6% annually; P < 0.001). In the group age 55 to 64 years, one joinpoint was detected with a significant increase in OC mortality trend between 1976 and 1990 (+9.8% annually; P < 0.001) and with nonsignificant decreasing tendency between 1990 and 2007 (-1.0% annually; P = 0.773). In the two oldest age groups, statistically significantly increasing tendency in OC mortality was evident during the overall calendar period with no apparent change in linear trends. CONCLUSIONS: Mortality due to the OC in Belgrade has continued to increase, suggesting that this malignancy is becoming an increasing public health problem in our country.

Determinants of preventive health behavior in relation to cervical cancer screening among the female population of Belgrade.

Identifying the factors that deter or stimulate the women to participate in screening activities is very important in order to design effective education and motivation strategies, particularly in the countries without an organized system. The study employed a case-control design. The participants were recruited in four primary health care institutions in Belgrade over a month. The study group comprised all women aged 18-70 years, who demonstrated an initiative for a PAP- smear. The controls were women with no Pap smears within the last 4 years, matched by age (±2 years), education and marital status with the study group participants. The study instrument was the 62-item self-administered questionnaire. According to multivariate analysis, adherence to cervical cancer screening practices is significantly related to better financial status [odds ratio (OR) = 10.8, P = 0.001], no gender preference for a gynecologist (OR = 3.1, P = 0.015), consultations with a gynecologist (OR = 4.7, P = 0.029), conversation with the women with cervical cancer about that disease (OR = 2.8, P = 0.029) and higher media exposure to information about cervical cancer prevention (OR = 5.0, P = 0.004). Open communication, social networks and improving social-economic status of women in our society are the most prominent factors, most of which are mainly outside the health services' domain and require multisectoral collaboration to improve women's reproductive health.

Corrigendum: Surprising Differences in the Practice of Exclusive Breastfeeding in Non-Roma and Roma Population in Serbia.

[This corrects the article DOI: 10.3389/fpubh.2020.00277.].

Knowledge, attitudes and practices and fear of COVID-19 among medical students in Serbia.

INTRODUCTION: The outbreak of the disease caused by the novel coronavirus, SARS-CoV-2 named COVID-19 has spread throughout the world. The number of registered cases is increasing and almost no country or territory worldwide has been without any COVID-19 patient. The aim of this study was to examine the level of knowledge on the SARS-COv-2 and COVID-19 among medical students and to explore the differences in attitudes, practices and fear of COVID-19 among students with sufficient and students with insufficient knowledge. METHODOLOGY: The cross-sectional study among the 1,722 medical students was conducted through an online platform of the Faculty of Medicine, University of Belgrade. The instrument used was a questionnaire with sections on socio-demographic characteristics, knowledge, attitudes and practices towards COVID-19 and the Fear of COVID-19 scale. RESULTS: Total of 1576 (91.50%) students were in the sufficient knowledge group. The multivariate logistic regression analysis showed that there was a significant association between the sufficient knowledge on COVID-19 and female sex (OR = 1.70, 95% CI = 1.18-2.45), age (OR = 1.10, 95% CI = 1.02-1.18), considering the preventive measures enforced in Serbia as good (OR = 2.57, 95% CI = 1.18-5.56), wearing the surgical mask outside of the household in the past 14 days (OR = 1.87, 95% CI = 1.22-2.87) and score on Fear of COVID-19 scale (OR = 0.94, 95% CI = 0.91-0.98). CONCLUSIONS: Medical students showed good knowledge of COVID-19 and could be a part of the promotion of health education messages as a part of preventive measures.

An approach to assess trends of pharmacist workforce production and density rate in Serbia.

The policy dialog on human resource in health care is one of the central issues of the ongoing health care system reform in the Republic of Serbia. Pharmacists are the third largest health care professional group, after nurses and doctors. This study's objective was to analyze population coverage with pharmacists employed in the public sector of health care system of Serbia during 1961 - 2007, and to project their density by 2017. In this respect, additionally, time-series of annual number of enrolled and graduate pharmacy students were modelled. Time trends of routinely collected national statistical data, concerning the pharmacists, were analyzed by join point regression program, according to grid-search method. During the observed period of time, in Serbia, pharmacist workforce production and deployment trends were generally positive, but with different annual dynamic. Key findings were the slow rise of pharmacist workforce density rates per 100,000 population; the insufficient balance between pharmacists workforce supply side (annual number of enrolled and graduated students) and the public health care sector's ability to absorb annual number of pharmacy graduates. For ten years ahead, density rates of publicly active pharmacist workforce would probably increase for 46%, if no policy interventions were planned to adverse trends of pharmacist workforce production and deployment in public health care sector. The study results may be useful for variety of stakeholders to better understand how and why the supply and deployment of pharmacists were changing; and that the coordination among policy interventions is a crucial successes factor for a health workforce development plan implementation. The repercussions of any changes made to the pharmacy workforce, need to be considered carefully in advance.

Physicians' Attitudes Toward Adolescent Confidentiality Services: Scale Development and Validation.

INTRODUCTION: Confidentiality is one of the oldest ethical principles in healthcare. However, confidentiality in adolescent healthcare is not a universally-accepted doctrine among scholars. The ethical acceptability of confidential services in adolescents' healthcare is based on perceptions of adolescent maturity and an appreciation of its importance to adolescents' access and utilization of healthcare services. Despite legal policies that promote adolescents' rights, physicians' attitudes toward adolescent confidentiality can be a determining factor in their ultimate decision to protect adolescents' confidentiality. METHOD: A new Attitude towards Adolescent Confidentiality Scale was developed based on the results of a qualitative interview study. This new instrument was administered to a sample of 152 physicians working at school pediatric and gynecology departments in 13 primary healthcare institutions in Belgrade. Principal component analysis was applied to determine the main components of the scale. Reliability was assessed by calculating Cronbach alpha and mean inter-item correlations. RESULTS: Psychometric analysis of the final 19-item version of the scale showed a high level of reliability (Cronbach alpha of 0.83). Principal component analysis showed four components, which present subscales of the instrument: Confidentiality in clinical situation, Iimportance of confidentiality, Adolescent maturity, and Communication with parents. CONCLUSIONS: The instrument showed satisfactory levels of reliability and validity. The results of the scale dissemination may be a valuable tool for needs assessment for future educational interventions and training programs that will raise physicians' awareness of the importance of adolescent confidentiality.

Adolescents' right to confidential health care: knowledge, attitudes and practice of pediatricians and gynecologists in the primary healthcare sector in Belgrade, Serbia.

OBJECTIVES: Confidential counseling is a critical condition of the healthcare quality in adolescent medicine. This study aimed at assessing knowledge, attitudes and practice of primary healthcare pediatricians and gynecologists regarding adolescents' rights to confidentiality. METHODS: A cross-sectional study was conducted in a sample of 152 pediatricians and gynecologists who are employed at 13 primary healthcare centers in Belgrade, Serbia, in 2017-2018. Data were collected by a self-administered questionnaire purposefully constructed for this study. The questionnaire examined knowledge and attitudes toward adolescents' right to confidentiality as well as whether participating physicians practice confidential health care with adolescents. RESULTS: Physicians scored 4 out of 7 on a knowledge scale, but they overall supported adolescents' right to confidential health care (average attitude score was 71 out of 95). On average, physicians scored 21 out of 30 on practice of confidentiality scale. Multivariate analysis showed that better knowledge and stronger positive attitudes toward duty of confidentiality were associated with consistent practice of confidential health care. CONCLUSIONS: Knowledge about adolescents' rights to confidentiality and attitudes toward keeping adolescents' information confidential influence the practice of providing confidential services.

Surprising Differences in the Practice of Exclusive Breastfeeding in Non-Roma and Roma Population in Serbia.

Background: Exclusive breastfeeding is essential for early childhood development, although the use of adaptive milk formulas instead of breastfeeding is widespread nowadays. This study aimed to examine the prevalence of exclusively breastfed infants under the age of 6 months in non-Roma and Roma population and factors associated with this practice. Materials and Methods: This study is a secondary analysis of the Serbian Multiple Indicator Cluster Survey investigating non-Roma and Roma infants under the age of 6 months. The study included mothers of 321 non-Roma and 164 Roma infants younger than 6 months. Univariate and multivariate logistic regression served to analyze factors associated with the practice of exclusive breastfeeding in both populations. Results: The prevalence of exclusive breastfeeding was almost the same among mothers in both non-Roma and Roma population (13.3 vs. 13%, p = 0.910). Exclusive breastfeeding was significantly more often (p < 0.001) among wealthier women, women whose newborns were over 2,500 g on birth, multipara, and women who had not established menstrual cycle among both populations. Living outside the capital significantly diminishes the chance for exclusively breastfed infants in the non-Roma community (Vojvodina: OR 0.16, CI 95% 0.03-0.92; eastern Serbia: OR 0.02, CI 95% 0.01-0.35) as well as living in the rural area (urban: OR 10.35, CI 95% 1.94-55.28). Unexpectedly, in the non-Roma population, not staying in the same room with the newborn in the maternity ward increases the chance for the baby to be exclusively breastfed (OR 7.19, CI 95% 1.80-28.68). The same pattern has been observed in Roma population. Non-Roma mothers multipara are more likely to exclusively breastfeed their children than primipara (OR 7.78, CI 95% 1.09-20.93), while among Roma mothers, the inverse association has been found although not significant (OR 0.42, CI 95% 0.14-1.23). Attending a childbirth preparation program more than 18 times increases the chances of infants being exclusively breastfed (OR 18.65, CI 95% 1.34-53.67). In the Roma population, there was no single woman that attended a childbirth preparation program. Conclusion: The pattern of exclusive breastfeeding significantly differs between non-Roma and Roma populations. Preventive work should have focus on strengthening support to mothers and medical staff in maternity wards.