Social Sciences Doctoral Dissertation Fellowship, University of Pittsburgh

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Social Sciences Doctoral Dissertation Fellowship, University of Pittsburgh

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Нечија или „општенародна“ пацијенткиња: значај друштвеног положаја и неформалних односа приликом порођаја у Србији

Pantovic, Ljiljana

(Etnografski institut SANU, 2021)

TY  - JOUR
AU  - Pantovic, Ljiljana
PY  - 2021
UR  - http://rifdt.instifdt.bg.ac.rs/123456789/2231
AB  - Anthropological research on post-socialism points to the need for informal relations when navigating social and health care systems, while feminist research on childbirth points out the  negative  consequences  of  the  dominant  medicalized  model  of childbirth  on  women’s experience.  This  paper  combines  these  two  types  of  research  and  points  to  the  role  of informal  relations  in  negotiating  childbirth  in  Serbia  and  the role  of  peoples  social positioning influencing the possibilities of using these relations. Based on eighteen months of ethnographic fieldwork on the practices of providing maternal health care in Serbia, the aim of this paper is to show how a woman's social position affects her ability to establish a relationship within the state health care system, and to reconsider the claim that informal relationships  can  protect  women  from  interventionism  during  childbirth  in  Serbia.  Using informal relations (veze) in order to have your doctor during childbirth is a key concern for women  in  Serbia.  Informal  relations  transform  women  from  (no)bodies  into  somebodies, someone’s patient. Women of poorer economic status, women from rural areas, and often women of Roma ethnic origin have limited opportunities to establish informal relations in state maternity hospitals. Informal relations do not fully protect women from interventions but affect the type and timing of interventions.
AB  - Антрополошка истраживања постсоцијализма указују на неопходност стварања
неформалног односа (везе) за навигирање кроз системе социјалне и здравствене
заштите, док феминистичка истраживања порођаја указују на негативне последице
доминантног медикализованог модела рађања на порођајно искуство жена који
одликује технократски и отуђујући приступ према женама. Овај рад спаја ова два вида
истраживања и указује на улогу неформалних односа, веза, приликом преговарања
порођаја у Србији, али и на значај друштвене позиције људи утичу на могућности
коришћења везе. Заснован на осамнаесто-месечном етнографском раду о праксама
пружања здравствене неге трудницама и породиљама, овај ради има за циљ да укаже
како друштвени положај жене утиче на њену способност да успостави везу унутар
система државне здравствене заштите, али и да преиспита тврдњу да везе могу да
заштите жену од интервенционизма приликом порођаја у Србији. Имати свог лекара
„преко везе“ спада у корпус основних брига жена у Србији када се приближи време за
порођај. Ако има успеха у овом подухвату, трудница се претвара из ничије, то јест,
„општенародне“ пацијенткиње у нечију пацијенткињу. Жене лошијег економског
стања, жене из руралних средина и често жене ромског етничког порекла имају
ограничене могућности остварења везе у државним породилиштима. Везе не успевају
у потпуности да заштите жене од интервенција, већ утичу на врсту и време
спровођења интервенција.
PB  - Etnografski institut SANU
T2  - Гласник Етнографског института САНУ
T1  - Нечија или „општенародна“ пацијенткиња: значај друштвеног положаја и неформалних односа приликом порођаја у Србији
VL  - LXIX (1)
DO  - 10.2298/GEI2101205P
ER  - 
@article{
author = "Pantovic, Ljiljana",
year = "2021",
abstract = "Anthropological research on post-socialism points to the need for informal relations when navigating social and health care systems, while feminist research on childbirth points out the  negative  consequences  of  the  dominant  medicalized  model  of childbirth  on  women’s experience.  This  paper  combines  these  two  types  of  research  and  points  to  the  role  of informal  relations  in  negotiating  childbirth  in  Serbia  and  the role  of  peoples  social positioning influencing the possibilities of using these relations. Based on eighteen months of ethnographic fieldwork on the practices of providing maternal health care in Serbia, the aim of this paper is to show how a woman's social position affects her ability to establish a relationship within the state health care system, and to reconsider the claim that informal relationships  can  protect  women  from  interventionism  during  childbirth  in  Serbia.  Using informal relations (veze) in order to have your doctor during childbirth is a key concern for women  in  Serbia.  Informal  relations  transform  women  from  (no)bodies  into  somebodies, someone’s patient. Women of poorer economic status, women from rural areas, and often women of Roma ethnic origin have limited opportunities to establish informal relations in state maternity hospitals. Informal relations do not fully protect women from interventions but affect the type and timing of interventions., Антрополошка истраживања постсоцијализма указују на неопходност стварања
неформалног односа (везе) за навигирање кроз системе социјалне и здравствене
заштите, док феминистичка истраживања порођаја указују на негативне последице
доминантног медикализованог модела рађања на порођајно искуство жена који
одликује технократски и отуђујући приступ према женама. Овај рад спаја ова два вида
истраживања и указује на улогу неформалних односа, веза, приликом преговарања
порођаја у Србији, али и на значај друштвене позиције људи утичу на могућности
коришћења везе. Заснован на осамнаесто-месечном етнографском раду о праксама
пружања здравствене неге трудницама и породиљама, овај ради има за циљ да укаже
како друштвени положај жене утиче на њену способност да успостави везу унутар
система државне здравствене заштите, али и да преиспита тврдњу да везе могу да
заштите жену од интервенционизма приликом порођаја у Србији. Имати свог лекара
„преко везе“ спада у корпус основних брига жена у Србији када се приближи време за
порођај. Ако има успеха у овом подухвату, трудница се претвара из ничије, то јест,
„општенародне“ пацијенткиње у нечију пацијенткињу. Жене лошијег економског
стања, жене из руралних средина и често жене ромског етничког порекла имају
ограничене могућности остварења везе у државним породилиштима. Везе не успевају
у потпуности да заштите жене од интервенција, већ утичу на врсту и време
спровођења интервенција.",
publisher = "Etnografski institut SANU",
journal = "Гласник Етнографског института САНУ",
title = "Нечија или „општенародна“ пацијенткиња: значај друштвеног положаја и неформалних односа приликом порођаја у Србији",
volume = "LXIX (1)",
doi = "10.2298/GEI2101205P"
}
Pantovic, L.. (2021). Нечија или „општенародна“ пацијенткиња: значај друштвеног положаја и неформалних односа приликом порођаја у Србији. in Гласник Етнографског института САНУ
Etnografski institut SANU., LXIX (1).
https://doi.org/10.2298/GEI2101205P
Pantovic L. Нечија или „општенародна“ пацијенткиња: значај друштвеног положаја и неформалних односа приликом порођаја у Србији. in Гласник Етнографског института САНУ. 2021;LXIX (1).
doi:10.2298/GEI2101205P .
Pantovic, Ljiljana, "Нечија или „општенародна“ пацијенткиња: значај друштвеног положаја и неформалних односа приликом порођаја у Србији" in Гласник Етнографског института САНУ, LXIX (1) (2021),
https://doi.org/10.2298/GEI2101205P . .
1

Private within the Public: Negotiating Birth in Serbia

Pantović, Ljiljana

(2019)

TY  - THES
AU  - Pantović, Ljiljana
PY  - 2019
UR  - http://rifdt.instifdt.bg.ac.rs/123456789/2198
AB  - This dissertation is about trust, authority, social personhood, and the importance of everyday negotiations that take place within a shifting health care landscape. Specifically, this was an ethnographic inquiry, grounded on twelve months of fieldwork, of how maternal care is provided in a low-income Eastern European country, Serbia. Maternal care is the case study for understanding how the previously exclusively public health care system is slowly unbundling along the seams of the different levels of care and thus opening new avenues for interventions by the private sector. While previous studies focused on the civil sector and informal economy, private medical sector has been an invisible avenue in the studies of informality. The private sector is not just reserved for elites, nor has it, as some scholars of Eastern European public health predicted, ended informal economies such as those expressed through the concept of “connections” (veze).
The starting point in this dissertation was the concept of “negotiating,” as a signal for looking at the practices and intersections of seemingly fixed dimensions, such as private and public, formal and informal, trust and mistrust; and how through the articulation of these seemingly fixed binaries we gain insight into how a health care system actually works. I looked at the sites of negotiations to understand the importance of sociality and social personhood within health care systems thus demonstrating that while the public health care system is being disarticulated in segments, neoliberal reforms are not replacing them but reconfiguring them. The selective privatization of maternal care has generated new avenues for (re)negotiating trust and authority between patients and providers, and thus contributed to reshaping the health care landscape. My work shows how patients and medical providers, in different but mutually congruent ways, leverage the emerging private medical sector as brokering strategies with and within the public health institutions.
T2  - http://d-scholarship.pitt.edu/35994/
T1  - Private within the Public: Negotiating Birth in Serbia
UR  - https://hdl.handle.net/21.15107/rcub_rifdt_2198
ER  - 
@phdthesis{
author = "Pantović, Ljiljana",
year = "2019",
abstract = "This dissertation is about trust, authority, social personhood, and the importance of everyday negotiations that take place within a shifting health care landscape. Specifically, this was an ethnographic inquiry, grounded on twelve months of fieldwork, of how maternal care is provided in a low-income Eastern European country, Serbia. Maternal care is the case study for understanding how the previously exclusively public health care system is slowly unbundling along the seams of the different levels of care and thus opening new avenues for interventions by the private sector. While previous studies focused on the civil sector and informal economy, private medical sector has been an invisible avenue in the studies of informality. The private sector is not just reserved for elites, nor has it, as some scholars of Eastern European public health predicted, ended informal economies such as those expressed through the concept of “connections” (veze).
The starting point in this dissertation was the concept of “negotiating,” as a signal for looking at the practices and intersections of seemingly fixed dimensions, such as private and public, formal and informal, trust and mistrust; and how through the articulation of these seemingly fixed binaries we gain insight into how a health care system actually works. I looked at the sites of negotiations to understand the importance of sociality and social personhood within health care systems thus demonstrating that while the public health care system is being disarticulated in segments, neoliberal reforms are not replacing them but reconfiguring them. The selective privatization of maternal care has generated new avenues for (re)negotiating trust and authority between patients and providers, and thus contributed to reshaping the health care landscape. My work shows how patients and medical providers, in different but mutually congruent ways, leverage the emerging private medical sector as brokering strategies with and within the public health institutions.",
journal = "http://d-scholarship.pitt.edu/35994/",
title = "Private within the Public: Negotiating Birth in Serbia",
url = "https://hdl.handle.net/21.15107/rcub_rifdt_2198"
}
Pantović, L.. (2019). Private within the Public: Negotiating Birth in Serbia. in http://d-scholarship.pitt.edu/35994/.
https://hdl.handle.net/21.15107/rcub_rifdt_2198
Pantović L. Private within the Public: Negotiating Birth in Serbia. in http://d-scholarship.pitt.edu/35994/. 2019;.
https://hdl.handle.net/21.15107/rcub_rifdt_2198 .
Pantović, Ljiljana, "Private within the Public: Negotiating Birth in Serbia" in http://d-scholarship.pitt.edu/35994/ (2019),
https://hdl.handle.net/21.15107/rcub_rifdt_2198 .

Not-So-Informal Relationships. Selective Unbundling of Maternal Care and the Reconfigurations of Patient–Provider Relations in Serbia

Pantović, Ljiljana

(De Gruyter, 2018)

TY  - JOUR
AU  - Pantović, Ljiljana
PY  - 2018
UR  - http://rifdt.instifdt.bg.ac.rs/123456789/2197
AB  - Social practices, such as connections (veze) and gift giving, are often labelled as socialist legacies that lead to corruption and are contrary to the establishment of market practices in postsocialist societies. This paper investigates the effects of the selective opening of aspects of maternal care to market practices on patient–provider relationships. Ethnographic research indicates that doctors are navigating between the constraints and opportunities afforded by both sectors, private and public, to negotiate their daily interactions with patients. In the attempt to maintain both authority and trust with their patients in a very precarious economic and social context, doctors have to be both medical experts and entrepreneurs. This practice points towards the conclusion that it may not be the legacies of socialism that have created the need for finding new ways of forging connections between medical providers and their patients, but rather the unbundling of socialist healthcare into the market.
PB  - De Gruyter
T2  - Südosteuropa. Journal of Politics and Society
T1  - Not-So-Informal Relationships. Selective Unbundling of Maternal Care and the  Reconfigurations of Patient–Provider Relations in Serbia
IS  - 3
VL  - 66
SP  - 371
EP  - 391
DO  - 10.1515/soeu-2018-0029
ER  - 
@article{
author = "Pantović, Ljiljana",
year = "2018",
abstract = "Social practices, such as connections (veze) and gift giving, are often labelled as socialist legacies that lead to corruption and are contrary to the establishment of market practices in postsocialist societies. This paper investigates the effects of the selective opening of aspects of maternal care to market practices on patient–provider relationships. Ethnographic research indicates that doctors are navigating between the constraints and opportunities afforded by both sectors, private and public, to negotiate their daily interactions with patients. In the attempt to maintain both authority and trust with their patients in a very precarious economic and social context, doctors have to be both medical experts and entrepreneurs. This practice points towards the conclusion that it may not be the legacies of socialism that have created the need for finding new ways of forging connections between medical providers and their patients, but rather the unbundling of socialist healthcare into the market.",
publisher = "De Gruyter",
journal = "Südosteuropa. Journal of Politics and Society",
title = "Not-So-Informal Relationships. Selective Unbundling of Maternal Care and the  Reconfigurations of Patient–Provider Relations in Serbia",
number = "3",
volume = "66",
pages = "371-391",
doi = "10.1515/soeu-2018-0029"
}
Pantović, L.. (2018). Not-So-Informal Relationships. Selective Unbundling of Maternal Care and the  Reconfigurations of Patient–Provider Relations in Serbia. in Südosteuropa. Journal of Politics and Society
De Gruyter., 66(3), 371-391.
https://doi.org/10.1515/soeu-2018-0029
Pantović L. Not-So-Informal Relationships. Selective Unbundling of Maternal Care and the  Reconfigurations of Patient–Provider Relations in Serbia. in Südosteuropa. Journal of Politics and Society. 2018;66(3):371-391.
doi:10.1515/soeu-2018-0029 .
Pantović, Ljiljana, "Not-So-Informal Relationships. Selective Unbundling of Maternal Care and the  Reconfigurations of Patient–Provider Relations in Serbia" in Südosteuropa. Journal of Politics and Society, 66, no. 3 (2018):371-391,
https://doi.org/10.1515/soeu-2018-0029 . .
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