Bosnia and Herzegovina: Improving nursing care for better health services


A nurse sitting in a treatment room.
Nurses at the Petrovo health centre can now offer better health services with the new ultrasound machine. © Imrana Kapetanovic for UNDP BiH

In Bosnia and Herzegovina nurses make up the largest group of healthcare professionals. However, the potential offered by their proximity to local communities is underexploited. They are often responsible for administrative tasks rather than patient care and, with limited career prospects, many nurses are attracted by better working conditions in Western Europe. This is regrettable because nurses and the care they provide can be a gateway to better health services for people living in rural areas and marginalised communities.

RegionCountry Topic Period Budget
Bosnia and Herzegovina
Health
Education
Health systems strengthening
Primary health care
Education facilities and training
01.12.2017 - 30.11.2021
CHF 5'125'000

The authorities in Bosnia and Herzegovina have implemented various healthcare reforms over the past 20 years. The Swiss programme has helped to improve the services available and, at the same time, lower costs. However, inequalities still exist in regard to accessing health services. The 'Strengthening Nursing in Bosnia and Herzegovina' project seeks to provide high-quality health services for all segments of the population needing them, including vulnerable and marginalised people. 

The project, supported by the SDC, works along three axes:

  1. regulating and improving the standing of the nursing profession;

  2. improving the training of nurses;

  3. expanding and promoting nursing care at the community level. 

Visible results

In the first phase of the project, 1.3 million people benefited from improved health services at primary health centres and 45,000 vulnerable people (60% of whom were women) availed of community and home services.In regard to training, four of the eight existing nursing schools have developed a teaching programme in line with EU training requirements, and one school is already applying its new programme.Moreover, nurses are now included in the process of formulating regulatory policies for nursing (although they remain under-represented). 

The second phase of the project will build on the results obtained so far and make sure they can be sustained. In this stage, services will be provided to 12 additional municipalities, taking the total to 22 municipalities. This will extend the reach of the project to 2.2 million people. 

The groups who will benefit directly or indirectly from these improvements are:

  • nurses (approximately 20,000 people, of whom 93% are women);

  • doctors, who will be able to reduce their workload by delegating certain tasks;

  • patients, particularly certain groups with limited access to health services, such as people living in remote regions, elderly and disabled patients, the unemployed with no health insurance, single mothers and minorities.

Local training will benefit the entire country

At the end of the project, nurses will play a major role in providing health services and will receive a salary commensurate to their skills and qualifications. They will have a more motivational work environment that encourages them to stay and work within the health system of Bosnia and Herzegovina. Preventive health services provided by nurses will result in lower costs of treatments given by specialists and for the hospitalisation of patients with noncommunicable diseases. In turn, this will generate savings for the country's healthcare system. Marginalised communities will be better informed about healthy lifestyle habits and will therefore be in better health.

Global impact

This project is related to goal no. 3 of the UN's Sustainable Development Goals: 'Ensure healthy lives and promote well-being for all at all ages'. The project is being run in cooperation with Geneva University Hospitals (HUG). It is also linked to other SDC projects (e.g. Mental Health Project and Reducing Health Risk Factors).