THE PRESENCE OF HEALTH-RISK BEHAVIOUR IN ROMA FAMILY

Roma people in B&H are a marginalised population group. Th eir health condition is considerably worse than the condition of other population groups. Th e health problems of Roma people correlate with inadequate living and dwelling conditions. Roma children are facing the impossibility of being health care benefi ciaries, because their parents are unemployed. Th e objective of this survey was to examine the family surrounding of children in age up to  years, including the social conditions under which they live and the presence of health risk behaviour. Th e research presents a descriptive cross-section study. We interviewed  non-Roma parents and children and  Roma parents and children (in the communities of domicile Roma people) in B&H Federation. Th e results obtained indicate that only ,  of Roma parents are secondary-school leavers, while remaining percentage covers those with incomplete primary school or without education at all, against , of non-Roma parents who have secondary education. Th e parents consider themselves good providers for their children (, of Roma parents and  of non-Roma parents often play with their children). Th e Roma parents seek for medical attention for their children only in the cases when urgent health problems occur, such as fever/increased body temperature (one-half of the interviewed parents) or diarrhoea (,). Physical punishment of children occurs more frequently in Roma families (, this is only the top of an iceberg) then in non-Roma families (,). Th e parents usually beat children by using their hands or punish them by fl ogging. Th e domestic violence is accepted amongst Roma people and it has most sever impact on children, who suff er emotionally and physically. In the future, it will be necessary to create the kind of family environment that would enable improvement of health condition and decrease the behaviour that endangers the health of children.


Introduction
A family is the fi rst environment of a child, and it has impact on establishment of child's attitude regarding health.A child receives the basics of culture from one's parents, and develops the habits and patterns in health-related behaviour ().The presence of risk behaviour factors in the family render impossible good, sound start in life.A good health in childhood constitutes a foundation for good health in adult age.There are considerable differences between family environment in majority groups and the one in marginalised groups, such as Roma people.Th e problems of Roma people relate to their specific life-style, low level of education, overall poverty, small percentage of full-time employed Roma people, and their living in inadequate and low-hygienic dwellings with minimum dwelling standards ().Th e Roma families give greater importance to male children then the female.Therefore, male children attend school more frequently then the female ones.Roma women conceive families quite early in their lives and take over the role of a mother ().Due to none or very low level of education, Roma people lack suffi cient level of knowledge on the needs of a child and health care.UNICEF has undertaken a series of activities in B&H to enhance the health conditions of Roma children, through education of their parents ().

Objective
The objective of this survey was to examine the family surrounding of children in age up to  years, including the social conditions under which they live and the presence of health risk behaviour.

Material and Methods
Th e research presents a descriptive cross-section study, conducted during  years.We interviewed  non-Roma parents and children (, of children up to  years of age, , boys).We interviewed  of Roma parents and children (, of children up to  years of age,  boys) in the communities of domicile Roma people, in Sarajevo, Kakanj, Visoko and Tuzla.In our survey, we used questionnaire (anonymous), based on the recommendations of UNICEF.Th e observed variables in the research were the following: • attitude of a parent towards the needs of a child • reaction of a parent concerning emotional state of a child • role of a father in child's development • risky health behaviour of a parent perceived in the sense of punishment methods applied on a child We particularly reviewed the answers of fathers and mothers, since there are very frequent discrepancies in the attitudes and pedagogical practice of both parents.

Results
The total sample was composed of  parents and children, amongst which , percentage of Roma people.Th e age and educational structure of non-Roma parents correspond to age and educational structure of an average B&H population (the highest percentage of respondents obtained secondary education -,).Th e Roma parents are very young (, of respondents were up to  years of age) and most of them did not complete primary school or have no junior-level certificate at all (only , of parents obtained secondary school diploma).There are statistically considerable differences in the level of education and age of the mothers in these two groups of respondents.Th e mothers mainly participated in the survey, since they take care of the children for the most part.Th e Roma children live with the foster parents in considerably larger percentage (,) then non-Roma children (,), and this diff erence is statistically signifi cant (Table ).A child has a basic need to play.While playing, child acquires perception of the world, things, himself ∕herself, ones abilities, learns to cooperate with others, and to make a diff erence between reality and imagination.All interviewed families have children toys, either bought by the parents or presented as a gift (Figure ).Th e children of respondents mostly play with the toys, which are bought (, of non-Roma children and , of Roma children) or presented as a gift (, of non-Roma children and , of Roma children).Th e hand-made or manufactured toys are equally used.In their play, Roma children use less domestic items, objects, (, of Roma children against , of non-Roma children) and universal materials such as water and sand (, of non-Roma children and , of Roma children).A fear represents negative experience for a child and therefore, parent's reaction is important for overcoming of it.Th e bearing of interviewed parents when a child is afraid is mostly verbal, that is, the parents talk to a child, trying to explain that there is no reason for a child to be afraid ( of non-Roma parents and , of Roma parents).Th e parents behave protectively, namely  of non-Roma parents and , of Roma parents put their arms around a child when one is afraid.Only few respondents (, of non-Roma parents and , of Roma parents) use distraction of child's attention onto other activities as a method to overcome fear, while , of Roma parents do not react when a child is afraid (Table ).Th e Roma parents, in a greater percentage, always fulfil the desires and wishes of their children (, of mothers and , of fathers), comparing to non-Roma parents (, of mothers and , of fathers).In the category "always fulfi l the wishes" -mothers fulfi l the wishes of the children in larger percentage then the father, while in category "often fulfi l the wishes" -fathers fulfi l the wishes of children in larger percentage (, of non-Roma fathers and , of Roma fathers) then mothers (, of non-Roma mothers and , of Roma mothers).There are statistically significant differences in the actions of Roma and non-Roma parents.
The most common form of physical punishment inflicted upon a child is slap by hand (, of non-Roma parents and , of Roma parents), and flogging (, of non-Roma parents and , of Roma parents).The parents rarely beat their children by a belt (, of non-Roma parents and , of Roma parents).Th e diff erences between the parents are not sta-tistically signifi cant.Th e fathers then the mothers far more infl ict this form of physical punishment (Table ).Th e issue of child upbringing stems from the basic obligations and responsibilities of the spouses, the mother and father equally (Figure ).Th e results of the survey indicate that the most common activity of a father is playing (, of non-Roma fathers and , of Roma fathers) and conversation with a child ( of non-Roma fathers and , of Roma fathers).Th e second most common activity is buying clothes for a child (, of non-Roma fathers and , of Roma fathers) .A father takes care of a child while mother is away (, of non-Roma fathers and , of Roma fathers).

Discussion
The Roma people are imperilled population group, which is hard to reach ().It is particularly diffi cult to gain access to Roma family, which is the reason why population Roma people p-value broj % broj % Th e reaction of a parent to child's pranks: -explanation of a child's action -conversation, and analysis of an action -explanation and give "some" spanking -give "some" spanking -give a good beating -emotional pressure (verbal pressure)

Conclusion
Th e parents are responsible for their child's health.Th e sound family climate contributes to reduction of health risks.Our survey has indicated that Roma children mostly live in the broken homes, burdened by numerous health risk factors.
Traditionally, there is a strong emotional attachment between the parents and children in Roma families.It should be used when planning the activities of health workers, aimed to enhance the health status of Roma children.Good-quality education of the parents on importance and role of a family, child's health care, importance of a play as the basic child's need, bad infl uence of physical punishment, etc., is one of the pre-conditions to have proper and sound development of a child ().
Considering that this decade of st century is dedicated to Roma people, we should undertake the activities to improve their social, economic and health status ().Th is would eliminate many health risks in present-day Roma families and enhance the health status of Roma children.
only few surveys covering Roma population have been conducted in a world.We conducted our study owing to a support received from the representatives of the local Roma communities (people in Roma population's confidence).Owing to their intervention, the Roma people accepted to participate in the survey and study.We had to adjust the questionnaire to the Roma respondents' level of education ().Th e family environment and conditions of Roma children are of a lower quality then the conditions of other children.Th e very young mothers who are poorly educated perform the upbringing.In terms of statistical data, considerably more Roma children live with the foster parents ().Th e surveys indicate that the children, apart from using the toys in their play, like to play using universal materials such as water, leaves, sand, trees, etc (,).While playing, children also like to use domestic objects and items (jars, cups, spoons, etc.).Th e parents equally buy toys for their children, regardless to their economic status.Although the Roma families are indigent, their children play the most using toys bough by the parents or presented as a gift.
Only few parents make toys at home fore their children.
Th e emotional state of a child is frequently changed and it depends of an attitude of a parent towards a child, as well as of the impact of environmental factors ().Th e development of emotions is the most intensive in a preschool age and it leaves a profound imprint on the later moulding of character.A fear represents negative experience for a child.Th e feeling of a child that one has the parents to protect him ∕her is essential to establish of rational reaction of a child to a fear.Our survey indicates that  of non-Roma parents and , of Roma parents reacted protectively when a child was afraid.Th e results also indicate that the parents mostly fulfi l the wishes of their children ().Th e Roma parents fulfi l the wishes of their children more frequently.In the category "always fulfi l the wishes" -mothers fulfi l the wishes of the children in larger percentage then the father, while in category "often fulfi l the wishes" -fathers fulfi l the wishes of children in larger percentage then mothers.
Th e parents infl ict physical punishment upon a child as an upbringing method ().Th e parents consider that the repetition of such punishment has positive upbringing infl uence, but they do not understand that the repeated punishments aff ect both, the punisher (parent) and the punished (child).When physically punished, a child feels hurt and humiliated.Th e physical punishment may also cause physiological crises in sensitive children ().Th e parents-respondents stated they mostly react in educational manner when a child makes some sort of prank or roguery.In most of the cases, they explain to a child what was it that one did wrong, and then follows a discussion and analysis of a child's bad manners.
If conversation, persuasion, or explanations do not yield results, the parents will have resort to physical punishment.According to the answers of the parents, physical punishment is quite frequent, and more then  of the parents punish their children physically.Our results correspond to the results of other authors ().Th e care for a chills' wellbeing assumes parental love for a child, and exteriorisation of that love in the providing and caring activities.In this process, both parents play equally important role."New father" should be actively engaged in child's care ().Th e Roma fathers buy clothing and footwear for their children more often then non-Roma fathers.Th e economic status of Roma family depends on a father, and he is the main provider for his family.Th e most common activity of a father, regarding the child's care, is playing with a child and conversation with a child.

TABLE 2 .
Th e quality of parent-child communication DRAGANA NIKŠIĆ, AMIRA KURSPAHIĆ  MUJČIĆ: THE PRESENCE OF HEALTH-RISK BEHAVIOUR IN ROMA FAMILY