Strengthening Nursing in Bosnia and Herzegovina


Although BiH invests significant resources in its health system, the population’s health is continuously deteriorating. As international evidence shows, nurses can tangibly improve the population’s health status at limited costs. In order to unleash the potential of BiH’s nursing workforce, the project will work in three different areas: improving the regulatory framework for nursing, reforming the formal education of nurses, and engaging nurses in the performance of health promotion and disease prevention activities.

Country/region Topic Period Budget
Bosnia and Herzegovina
Health
Health systems strengthening
Primary health care
01.10.2011 - 30.11.2017
CHF  5’351’250
Background

Health system reform in BiH has focused on the institutionalization of accessible and cost-effective primary healthcare (PHC) services. Major gaps in the education and practice of nurses, who form an important part of the PHC workforce, hinder further reform progress. The most important challenges related to nursing include nurses' inadequate formal education, the lack of clearly defined competences of nurses, the non-existence of a licensing system for nurses, and the limited outreach of nursing services at the community level.

Objectives

The quality and efficiency of nursing services, with a focus on the primary healthcare level, have increased, and access to these services, in particular for vulnerable groups, have been enhanced.

Target groups

The project’s primary target group is the nursing workforce in Bosnia and Herzegovina, primarily nurses active at the primary healthcare level. Around 19’000 nurses – the overwhelming majority of which are females – are employed in BiH’s healthcare system. End beneficiaries are service users/patients, and in particular vulnerable groups who presently don’t have access to healthcare, such as persons living in remote areas, elderly, disabled, internally displaced, unemployed and uninsured persons, minorities, single mothers and young parents, children and youth.

Medium-term outcomes

Health authorities and managers increasingly recognize nurses as an important resource for improving the performance - in terms of quality, safety, and efficiency - of the healthcare system in line with European good practices.

Community nurses provide on a continuous basis a range of gender sensitive preventive and curative services to the population in selected geographic areas, being particularly responsive to the specific needs of vulnerable population groups.

Necessary preconditions for improving the university education of nurses have been established.

Results

Results from previous phases:  

The project idea was prepared by the two entity Ministries of Health and SDC, based on an analysis of the needs in the country and lessons learnt during implementation of the SDC-funded Family Medicine Implementation Project in BiH. Following the preparation of the project concept document, a tender for the preparation and the first phase of the project was organized. After a three-month preparatory phase wide consultations with numerous stakeholders, a vision 2020 for nursing in BiH was developed and validated.


Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
Foreign state institution
  • Central State of South East
  • Consortium of Foundation fami, Geneva University Hospital and the Institute of Nursing Science of Basel University.


Budget Current phase Swiss budget CHF    5’351’250 Swiss disbursement to date CHF    4’865’387
Project phases Phase 3 01.12.2022 - 30.11.2026   (Current phase)

Phase 1 01.10.2011 - 30.11.2017   (Active)