Strengthening Nursing in BiH
Nurses are key actors in providing basic health care and have the potential of significantly improving the health status of the population in Bosnia and Herzegovina. The Strengthening Nursing in BiH project focuses on supporting nurses to reach the most vulnerable groups and provide quality services, but also on protecting the interests of the nursing workforce and ensuring their recognition in the health system.
Nurses of BiH have a crucial role in improving health care services
Although Bosnia and Herzegovina invests significant resources into its health system, the population’s health is continuously deteriorating. The health system reform focuses on ensuring accessible and cost-effective primary healthcare services. However, in this process the education and the practice of nurses are not sufficiently addressed, which in fact hinders reform progress. Around 19’000 nurses are employed in BiH’s health care system. They are predominant in the healthcare workforce but their potentials are currently unused, especially in working with vulnerable groups who have limited access to health care. The formal education of nurses is inadequate, their competences are not clearly defined, and the licensing system for nurses is not in place.
Better position of nurses, imperative for success
The project supports processes of increasing the quality of nursing service and enabling better access to these services, especially for vulnerable groups. These include the elderly, disabled, internally displaced, unemployed and uninsured persons, minorities, people living in remote areas, single mothers, young parents, children and youth. Community nursing services will be developed and will include disease prevention, health promotion and counselling, and care for patients in terminal phases of a disease and those with chronic health conditions.
Within the project the reform of the formal education of nurses is also addressed, in order to ensure that competences nurses are gaining are in line with the European standards. Additionally, it is highly important that the health authorities recognize nurses as an important resource for improving the quality, safety and efficiency of services. In order to improve the position of nurses in the health system the project works on developing standards of nursing practice and the regulation for continuous education of nurses and their licensing. Resource centres for nurses will be established at the entity level, and nurses’ associations strengthened to regulate the profession and advocate for the interests of nurses.
The project’s primary target group is the nursing workforce in BiH, especially nurses active at the primary health care level. However, the major impact is focused on the users of health services, estimated on 900’000 people, and more importantly the vulnerable groups who have limited access to health care services.
Experiences from Bijeljina a model for the rest of the country
Within the Health Care Centre Bijeljina 40 family medicine nurses were educated in community nursing and provided with the equipment. In only three months, these 40 community nurses visited over 900 homes and attended to patients. More than 2’000 chronic patients received an annual check-up by nurses and will continue receiving regular follow-up. In addition, health promotion activities are being organized in the community for the population. This successful pilot activity from Bijeljina municipality will be rolled out to other parts of the country with the project’s support.
Support to the reform of nursing in BiH
The project idea of the Strengthening Nursing in BiH project was prepared by two entity Ministries of Health and the Swiss Agency for Development and Cooperation (SDC). It was developed based on an analysis of the needs in the country and lessons learnt during implementation of the former SDC-funded Family Medicine Implementation Project in BiH.