Bosnia and Herzegovina: SDC project as a model for health reform

Thanks to a model Swiss project, more patients in Bosnia receive inexpensive access to careful diagnosis and treatment. In conjunction with the Bosnian government, SDC experts are training specialists in family medicine. The partnership between Swiss and local institutions is a boost for the Bosnian health services.

Modest health-care budget – costly specialists
Bosnia and Herzegovina spends just 200 CHF per person per year on medical care. Despite this modest health-care budget, many specialists have high tariffs, and at the same time, there is a shortage of general practitioners (family doctors), although the latter could work independently and much more cheaply.

Specialists are retrained as general practitioners
The project supported by SDC provides fundamental impulses for reforming health services in Bosnia. Until the end of 2007, it was managed by the NGO 'Fondation PH – Partnerships in Health' and Geneva's University Hospital. Since 1998, it has retrained hundreds of doctors and nurses to work in general medicine in family practice teams, and many medical centres have been renovated and refitted. At the beginning of 2008, responsibility for the project was transferred to the local organization "fami", thus securing local participation in the project.

The model project is having a considerable impact. Its objectives have been adopted by the Bosnian authorities and broadly implemented as part of health-service reform. The growing number of family doctors working with cheaper tariffs means that more patients can now afford careful diagnosis and treatment, and at the same time the quality of services has improved. In contrast to specialists who focus on treating acute symptoms, family doctors take a longer-term view of caring for their patients and consider the social environment.

Furthermore, the new project phase is designed to promote systematic cooperation between general practitioners, social services and civil society. In a country where part of the population suffers from war trauma, this holistic approach satisfies a real need.

The Bosnian government is participating
The ambitious aim of health reform in Bosnia is to increase the proportion of general practitioners to 70% of all practising doctors. The Bosnian government is contributing a substantial sum to the cost of the project, thus emphasizing its reform commitment. The success of this model project is recognized not just in the partner country but also in the West Balkan region and by international organizations.