The seconf phase of the project "Strengthening Nursing in Bosnia and Herzegovina"
Duration: December 2017 – November 2021
Generally, although a significant progress has been made in the Project’s Phase 1, there is much more to do in order to see the changes because most of the factors that were identified in the beginning as obstacles for nursing force development, still exist. We can summarize them in the following way:
• Nurses do not have enough authority, influence or power to affect decision making, during the patient care or at political forums. The entity level nursing associations still have a long way ahead before they become strong to have a say in policy creation.
• We still face a lack of data on the exact number, education profiles and the work nurses perform as the largest group of health workers, which makes difficult to plan their education and employment, as well as to assess the sustainability and effect of the development agencies’ support.
• Most of the employed nurses in BIH have completed four-year high school education following curricula that differ in content and number of hours taught in different schools. Due to the increased migration trend of nurses, overproduction in this profession has been noted. At the same time, the health care system does not recognize university graduate nurse degree.
• The process of nursing studies curricula revision and use has just started at the universities in order to align them with the relevant EU directives. The lack of professors with PhDs in the field of nursing who teach at these institutions is still evident.
• The issue of alignment of private universities’ curricula with nursing studies with EU directives and more comprehensive application of the accreditation standards are issues that need to be tackled as well.
• Although nurses provide services directly to patients they also do a lot of administrative work for doctors. Assessment, planning, implementation and evaluation of nursing care and other procedures done by nurses are rarely recorded as such; as consequence, the current system of financing in the health sector in BIH hardly recognizes their role in health care provision.
Therefore the Project in Phase 2 will continue with the support having as a goal better quality services available to all, especially to vulnerable and socially excluded groups. The Project will continue with its intervention simultaneously through three components, as pillars that carry the nursing profession.
Component 1: Nurses professional environment
Nurses professional environment in Bosnia and Herzegovina will be improved via regulatory mechanisms which, among the rest,
include forming live register of nurses’ work force, developing standard operating procedures and obligatory nursing documentation for all levels of health care, expanding the existing list of nursing services and supporting development of nurses associations.
Component 2: Access to community nursing
Standardized health care services provision recognized by health care system, in combination with improved access to these services for the whole population, especially vulnerable and socially excluded groups will help respond comprehensively to their health needs. Improved access to nursing services will be provided using the CN model tested during the project Phase 1. Adapted and officially recognized models will define the scope of community nursing services and the ways they will be offered, which will contribute to their recognition by the health system and ensure cooperation with other departments and organizations within and outside health sector.
Component 3: Public education in nursing
Quality service provision requires educated and competent nurses. That can be achieved by strengthening BIH education system, which will be accomplished by supporting the reform of secondary nurse education in public nursing high schools, aligning nursing study programs with EU standards, building teaching capacities by encouraging graduate nurses to enter the second and third education cycle, and developing strategies to introduce nurse specialist programs.