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Bosnia Herzegovina Healthcare

There were over 200,000 war-related deaths in the 1990s (120,000 in 1992 alone) and many Bosnians were permanently disabled. Besides causing hundreds of thousands of deaths and injuries, the Bosnian war destroyed much of the healthcare infrastructure. Many hospitals were destroyed and infant mortality rates increased.

The total fertility rate, 4.0 in 1960, dropped to 1.6 in 2000. In the same year, average life expectancy was 73. In 2002 the birth rate was estimated at 13 per 1,000 people and the death rate was 8 per 1,000. The infant mortality rate was 13 deaths per 1,000 live births in 2000. In 1999, an estimated 83% of children under one had a measles vaccination and 90% of children were immunised for diphtheria. In 1999, there were 87 cases of tuberculosis per 100,000 people.

Salaries for healthcare providers are low, and medical equipment is outdated (20 years old on average). As of 1999, there were an estimated 1.4 physicians and 3.7 hospital beds per 1,000 people. In the same year, outpatient visits averaged 2.7 per person. Primary care is provided through health centres (dom zdravlyas) and outpatient branches called ambulantas. As of 1999 there were 87 dom zdravlyas in the Bosnian Federation, staffed by general practitioners and nurses, providing primary care, preventive care, health education, and rehabilitation. Among the secondary and tertiary care facilities in the Republika Srpska is one in Banja Luka that has 1,327 beds and one in Sarajevo with 776 beds.

Two basic types of health insurance are defined by law in BiH: compulsory and extended/private health insurance schemes. Of these, only the former is currently operational in both Entities. In each Entity, it flows from the relevant Law on Health Insurance, and is based on a system whereby compulsory contributions should be paid for all residents who receive any kind of regular income.

These contributions are to be paid to Entity/Cantonal funds which are then responsible for ensuring the
provision of healthcare services to those insured within their area of responsibility. The vast majority of BiH residents are covered by a compulsory health insurance scheme.

Extended/private health health insurance schemes in each Entity (prosireno zdravstveno osiguranje) would allow, on a voluntary basis, those persons already insured under compulsory health insurance schemes to pay higher contributions in order to secure premium rights and services.





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