Reducing Health Risk Factors in Bosnia and Herzegovina


Chronic diseases are the main cause of death and disability in Bosnia and Herzegovina, entailing substantial costs for the country. Chronic diseases are to a large extent influenced by unhealthy lifestyles, which means that they can be prevented by changing behaviors. The project will facilitate an increased focus of country’s health system on preventive care, reducing behavioural risks factors among the population. In the longer term, strengthened prevention should lead to a reduction in chronic diseases and significant cost savings.

Country/region Topic Period Budget
Bosnia and Herzegovina
Health
Health systems strengthening
Primary health care
Health education
01.12.2012 - 31.03.2020
CHF 7'140'000
Background

Chronic diseases are the leading cause of death and disability in Bosnia and Herzegovina (BiH). They are caused by wide-spread risk factors among the population: smoking (35%), physical inactivity (71%), and overweight/ obesity (60/27%). The treatment of chronic diseases requires long-term care-intensive therapies, thus an increase in chronic diseases implies growing healthcare costs. Chronic diseases can be effectively prevented through preventative public health measures. In BiH, primary health care (PHC) reform has so far mainly focused on curative care (i.e. the treatment of diseases), while prevention has been neglected. This is because investments into public health only pay off in the longer term, whereas policy-makers prefer interventions that offer quick benefits for the population.

Objectives

To contribute to a reduction of chronic diseases and to an improved health of BiH’s population.

Target groups

Direct project beneficiaries are the health authorities and other governmental institutions relevant for public health, and over 4’500 family medicine doctors and nurses. Indirect beneficiaries are all other health service providers, professional associations, and health insurance funds. An estimated 60% of citizens of BiH are the end beneficiaries, benefiting from the new healthcare services for changing unhealthy behavior and reducing risks from chronic diseases. Disadvantaged and vulnerable groups, who are more prone to suffering from chronic diseases than the general population, will particularly benefit from the intervention. Youth is a special target group, benefiting from targeted interventions for the adoption of healthy lifestyles in early adolescence. The project will have countrywide geographical coverage.

Medium-term outcomes

Intermediate outcomes:

1. Health authorities are better able to manage major public health risks.

2. Civil society, the media, the private sector and municipal governments effectively advocate for healthy environments and lifestyles.

3. Primary healthcare providers offer higher-quality services for the prevention of cardiovascular diseases.

 

Results

Expected results:  

Health Authorities are capacitated to advocate for, coordinate and lead consolidated intersectoral responses to public health priorities in BiH

Public health policy framework and tobacco control polices developed and operationalized

Strengthened capacity of teachers and employers to implement healthy policies and related promotional programs among youth/employees

Communication campaign for social mobilization focused on behavioral change implemented

Cardio-Vascular Risk Assessment and Management interventions package developed, quality-assured and implemented in primary health care/family medicine practices in BiH

 

 


Results from previous phases:  

The entity Ministries of Health (MoH) individually requested support in the area of public health from all major health sector donors in BiH. As a response to the requests, the Swiss Cooperation Office took the initiative in bringing these donors – SDC, the World Health Organization (WHO) and the World Bank – together. As a result of this cooperation, a project concept and detailed project action plan were developed, in close cooperation with BiH’s health authorities and other sector stakeholders. Through the process of consultations, the strong commitment of the entity MoH in strengthening public health has been confirmed.


Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
International Financial Institution (IFI)
Private sector
United Nations Organization (UNO)
  • Other WB
  • Foreign private sector South/East
  • Swiss Private Sector
  • World Health Organization
  • World Bank/Washington


Other partners

Entity Ministries of Health and other relevant line ministries, namely for trade & economy, agriculture, finances, education, culture & sports, environment & tourism, and local self-governance; Entity Public Health Institutes and Agencies for Accreditation and Quality in Health.

Coordination with other projects and actors

The project will coordinate its efforts with the EC Delegation to BiH (Public Health Project II); UNICEF (health promotion strategies); and the World Bank (Health Sector Enhancement Project). Synergies with other SDC-funded health projects will be developed: with the Strengthening of Nursing Project in enhancing the competences of nurses in public health outreach; with the Mental Health Project in enhancing intrasectoral care coordination for persons with mental disorders; and with the regional project supporting the SEE Health Network in mobilizing regional public health expertise and in disseminating good practices.

Budget Current phase Swiss budget CHF   7'140'000 Swiss disbursement to date CHF   7'038'493
Project phases Phase 1 01.12.2012 - 31.03.2020   (Current phase)