BiH: Healthy Communities in BiH

The high prevalence of smoking, unhealthy diets, physical inactivity and alcohol missuse leads to 90% of deaths in Bosnia and Herzegovina and a loss in quality of life caused by preventable non-communicable diseases. This overburdens the health system which is mostly providing expensive curative services. The project will support the health authorities in reforming the health system to focus more on health promotion and disease prevention and ensuring citizens improve health literacy and adopt a healthier lifestyle.

Pays/région Thème Période Budget
Bosnie et Herzégovine
Renforcement des systèmes de santé
Maladies non transmissibles
Éducation sanitaire
Système de santé primaire
Participation démocratique et société civile
01.02.2023 - 31.10.2027
CHF  10’575’000
Contexte Bosnia and Herzegovina experiences one of Europe's highest premature mortality, poor health and disability rates from non-communicable diseases (NCDs). NCDs account for over nine in every ten deaths in the country, with 19.3% of the population dying of one of the four main NCDs (cardiovascular diseases, cancers, chronic respiratory diseases, diabetes) before 70 years of age. Reduction of unhealthy diets, physical inactivity, tobacco use and alcohol misuse, key causes of NCDs, significantly reduce premature deaths and disability. WHO formally recognized mental health (extremely relevant in a post-war country) as a core component of the response to NCDs. The highly fragmented health sector in BiH is expensive, inefficient, and suffering from poor service quality and limited skills of health providers, particularly related to health promotion and disease prevention. Disadvantaged, and uninsured citizens (about 16%) lack the financial and educational resources to prevent diseases and access treatment. 
Objectifs The overall goal is to contribute to a reduced burden of disease and improved health status for women and men, by strengthening the focus of the health system to disease prevention and the promotion of healthy lifestyles. 
Groupes cibles
  • Entity and cantonal Ministries of Health, Ministries of Education and Public Health Institutes 
  • Entity Associations of Municpalities and Cities 
  • 21 Municipalities and local communities 
  • 21 Primary Health Care Centres 
  • NGOs, Media, Schools, private sector 
  • Entity Health Insurance Funds 

Approx. 1 mio citizens in 21 municipalities will directly benefit of health promotion and prevention services, incl. the socially excluded such as the elderly, Roma women and youth living in rural areas.

Effets à moyen terme Outcome 1: Health-literate women and men, particularly the socially excluded, actively and meaningfully participate in and advocate for health promotion and disease prevention activities and adopt healthier lifestyles. Outcome 2: Municipalities take actions for the improvement of health and well-being of citizens and engage in health promotion and disease prevention. Outcome 3: Health and non-health authorities collaborate in the design and implementation of integrated and sustainable reforms for better health and wellbeing of citizens. 

Principaux résultats attendus:  

  • Citizens, with special attention to the socially excluded, are aware of their own influence on health and are practicing healthier lifestyles. 
  • Integrated responses to NCDs (detection, screening, and treatment) are successfully established in 21 municipalities (out of 145). 
  • Health councils, which care about the health and well-being of citizens and influence local health policy and strategies, are strengthened in 21 municipalities. 
  • Evidence-based health promotion and disease prevention programs are implemented and evaluated in 21 municipalities with the support of NGOs, media, schools and private sector. 
  • Health and non-health authorities introduce sustainable health promotion and disease prevention services. 
  • Health promotion and disease prevention units are in place and operational in 21 municipalities. 
  • Improved health promotion and disease prevention services at the primary healthcare level are recognized and paid for by financing institutions. 
  • Capacities of public health institutes in the field of health promotion and disease prevention (including for no smoking campaigns) are strengthened. 
  • Preventive programs (including sexual reporductive and mental health) that promote healthy lifestyles are implemented in educational and preschool institutions. 

Principaux résultats antérieurs:  

  • NCDs account for 90% of the country’s annual deaths and dominate the overall burden of disease and disability. 
  • NCDs are caused by well-defined behavioural risk factors (tobacco use, unhealthy diets, physical inactivtiy, harmful use of alcohol). 
  • Smoking contributes heavily to poor health as nearly 38% of adults smoke (25.1% in EU). 
  • The health sector is inefficient and mainly focused on expensive curative services, largely lacking preventive and promotional activities and services. 
  • The treatment of the most common NCDs (cardiovascular disease, cancer, diabetes and respiratory diseases) burdens the health system with high direct costs both for inpatient care and outpatient medicines.  

Direction/office fédéral responsable DDC
Crédit Coopération avec l'Europe de l'Est
Partenaire de projet Partenaire contractuel
ONG internationale ou étrangère
Secteur privé
Institution universitaire et de recherche suisse
  • Autres instituts suisses universitairs ou de recherche
  • Secteur privé suisse

Coordination avec d'autres projets et acteurs Project interventions will be aligned with the World Bank-led health reform intervention. Coordination and synergies within the Swiss Cooperation Programme will be ensured with ongoing projects in particular in the portfolios health as well as Local Governance & Municipal Services. 
Budget Phase en cours Budget de la Suisse CHF    10’575’000 Budget suisse déjà attribué CHF    962’758 Budget y compris partenaires de projet CHF    5’575’000 Projet total depuis la première phase Budget de la Suisse CHF   75’000 Budget y compris partenaires de projet CHF   16’375’001