Strengthening Nursing in Bosnia and Herzegovina
The health system of BiH is expensive and providing poor quality services, partly due to underutilised potential of nurses. With the support of the project, the health authorities will reform the profession of nurses by aligning nursing practice to quality standards, improving their capacities, expanding their tasks and stimulating homebased care and health education. This will enhance the coverage, quality and cost-effectiveness of health services thereby improving the health status of men and women in BiH.
Bosnia and Herzegovina
Health systems strengthening
Primary health care
Sector according to the OECD Developement Assistance Commitiee categorisation HEALTH
Sub-Sector according to the OECD Developement Assistance Commitiee categorisationHealth policy and administrative management
Basic health care
Basic health care
Cross-cutting topics The project also supports partner organisation improvements
Aid Type Mandate with fiduciary funds
Mandate without fiduciary fund
|Background||The health system in BiH is expensive and achieves low health outcomes. It still follows outdated approaches to the organization of the service provision and is unable to address the challenges of an aging population, increasing rate of migration and a rise in non-communicable diseases. This situation is exacerbated by the growing emigration of the nursing workforce to Western Europe, leaving health institutions under-staffed. Furthermore, there is growing inequity in access to health care: more than 15% of population remain uncovered by health insurance and the rural-urban gap is increasing. The health sector reform led by health authorities is setting Primary Health Care as the cornerstone of the health system. Nurses, forming the largest group of health professionals, being critical in the delivery of essential health services and having considerable underutilised potential, are seen as a key factor in ensuring success of the health reform.|
|Objectives||Women and men in BiH benefit from improved nursing services.|
|Target groups||The project’s primary target group are the approximately 20.000 nurses. End beneficiaries are service users/patients, with a particular attention to socially excluded such as patients with NCDs, terminally ill and persons living in remote and underdeveloped areas. The project will have countrywide coverage.|
1. Health authorities and institutions establish a supportive professional environment that allows nurses to deliver safe and high quality services.
2. Citizens, with a special attention to socially excluded, benefit from comprehensive community nursing services including prevention, health promotion and palliative care in 55 municipalities.
3. Nurses with decision making responsibilities are equipped with managerial skills allowing them to appropriately manage their teams, ensure good inter professional collaboration and the delivery of effective health care.
- Health workforce plan and retention strategies are developed.
- Certification, licensing and continuous education programs (credit system) are in place.
- Additional standard operating procedures are made available and applied and capacity to keep SOPs up-to-date and to develop newly required SOPs are created.
- Community nursing services are made available to additional 33 municipalities, hence covering 55 municipalities. Guidance will be provided for the remaining 80 municipalities if they are interested to implement community nursing services by their own efforts.
- Leadership programmes for nurses are co-created with the International Council of Nurses and conducted in BiH and managerial skills of nurses in decision-making positions are increased.
Results from previous phases:
- All eight nursing faculties have adopted and are using a new competence based curriculum in line with EU standards. They have developed teaching capacities and harmonized Bachelor and Master degree programs with the EU directive.
- An important revision of the healthcare and health record laws in the Republika Srpska have adopted standardization procedures of the nursing profession and community nursing.
- Comprehensive community nursing services including health promotion and prevention are sustainably provided in 22 municipalities (out of 135), providing access for 1.02 Mio people.
- Standardisation of nursing services has been upgraded by developing 290 standard operating procedures, while nursing-related corresponding by-laws were developed and integrated in the system.
|Directorate/federal office responsible||
International or foreign NGO
Ministry of Civil Affairs of BiH
|Coordination with other projects and actors||
The project closely cooperates and coordinates its interventions with over sixty institutions related to the nursing profession across the country. These include entity and cantonal ministries of health, health insurance funds, agencies for quality and accreditation on health, public health institutions, health centres, hospitals, educational institutions, social work centres, municipalities, nurses’ and patients’ associations and NGOs.
Important partners are as well World Bank, EU, WHO, International Council of Nurses.
Synergies with SDC-funded projects are ensured: the Healthy Communities in BiH Project, the Ageing and Health, the World Bank Trust Fund supporting the health reform and the Civil Society Support Project in BiH.
|Budget||Current phase Swiss budget CHF 5’700’000 Swiss disbursement to date CHF 506’665 Total project since first phase Swiss budget CHF 10’476’250|