Prevalence of behavioral risk factors of non-communicable diseases among urban and rural population in the Federation of Bosnia and Herzegovina

Introduction The objective of the paper is to analyze and to assess prevalence of the major behavioral risk factors among adult population (25-64 years of age) in the rural and urban areas in the Federation of Bosnia and Herzegovina (FBIH).Methods Data were taken from cross-sectional population survey on the health status population in the FBIH. To ensure a sample representative for the adult population in the FBIH it was applied the two-stage stratified systematic sample. The survey covered a total of 2735 adult population aged 25-64 years, of which 1087 in the urban areas and 1648 in rural areas.Results. The prevalence of smoking among men in rural areas is significantly higher than among men in urban areas (69% vs. 55%), while the prevalence of smoking among women is higher in urban than in rural areas (45% vs. 31%). There is no statistically significant difference in prevalence of obesity and physical activity according to the age groups among men and women in the urban and rural areas. The frequency of changes in behavior related to acquiring healthy living habits in the rural areas is statistically significant among men and women, while in the urban areas there is no statistical significance among the sexes.Conclusions. The results indicate that there are no significant differences in prevalence of factor risks in urban and rural areas. Prevalence of unhealthy lifestyles is high, and the results should be used to improve standard planning of health promotion-prevention programs

Awareness, treatment, and control of hypertension among adult population in the Federation of Bosnia and Herzegovina over the past decade

Background. Many studies throughout the world show that hypertension is not effectively treated and controlled, which continued to pose an important challenge in health systems in the world. Design and methods. Population surveys were carried out in 2002 and 2012 in the Federation of Bosnia and Herzegovina (FBIH) on representative sample at the age of 25-64. The surveys used systematic stratified sample. Questionnaires and anthropometric measure protocols were adapted from internationally recommended surveys. Results. In the past ten years there has been a slight increase in hypertension prevalence in researched population (41% vs. 42%). Percentage of hypertensive male and female respondents who are not aware of their hypertension actually dropped in the past decade from 54.3% to 51.4%. In 2002 total number of hypertensive respondents aware of their hypertension included 8.1% of male respondents and 10.3% female respondents whose condition was not treated and this rate effectively dropped during the 10-year period. Number of hypertensive, treated, and uncontrolled respondents dropped as reported in the 2012 survey; consequently percentage of hypertensive, treated, and controlled respondents in the 2012 survey increased, in particular in female population.Conclusions. Investments in primary health care, improved availability, and improved quality of health care in the FBIH in the past 10 years can explain increased rate of hypertension detection and treatment; however, efforts should be continued to introduce hypertension screening programs and hypertension control programs

Pravci razvoja sestrinstva kao samostalne zdravstvene profesije: komparativna analiza legislative u sestrinstvu Bosne i Hercegovine i zemalja u regiji

Introduction. The rising need for quality health care, increased workload, accountability and healthcare reforms, are factors that resulted in growing requirements for recognition of the nursing profession, which are clearly defined in the Munich Declaration (2000). Unfortunately, in the current health care system in most of the transition countries of the Region of the South East Europe, nursing is still not adequately validated as a special profession. Aim. Presentation of legal solutions related to nursing profession in Bosnia and Herzegovina (B&H) from the aspect of definition of nursing activities, education standards, licensing and labor mobility. Methods. Desktop analysis as a method of quality research of legislative and strategic documents related to nursing in B&H. Analysis of the directive and legislation in the countries of the region and the EU. Comparison with the legislation of B&H. According to the constitutional solutions, within the competence of the Entities (Republic of Srpska), the area of health care in B&H is divided by the competencies of the entities and cantons (the Federation of B&H), that is, within the competence of the Brčko District of B&H, therefore, there is also a separate entity legislation. In 2013, the Government of the Federation of B&H adopted the Law on Nursing and Midwifery and secretly defined the nursing domains in accordance with the EU directives. In the Republic of Srpska and the Brčko District, this is partly defined in the systemic health care laws (amended in 2015). Conclusions. In all the legal acts reviewed, there are still shortcomings in the defined domains for the nursing profession. By addressing these issues, the progress of nursing development would speed up, strengthen and modernize the health system, which would undoubtedly increase the quality of health care to a higher level.Uvod. S povećanjem potreba za kvalitetnom zdravstvenom njegom, povećanjem obima posla i odgovornosti te reformama u zdravstvu rasli su i zahtjevi za determiniranjem domena u profesiji sestrinstva, što je jasno definirano u Minhenskoj deklaraciji (2000.). Nažalost, u sadašnjem sustavu zdravstvene zaštite u većini tranzicijskih zemalja regije jugoistočne Europe sestrinstvo i dalje nije adekvatno validirano kao posebna profesija. Cilj. Prikaz zakonskih rješenja povezanih sa sestrinstvom, a ponuđenih kroz legislative u Bosni i Hercegovini (BiH) s aspekta definicije sestrinske djelatnosti, standarda obrazovanja, licenciranja i mogućnosti mobilnosti radne snage. Metode. Desktop analiza legislativnih i strateških dokumenata povezanih sa sestrinstvom u BiH. Rezultati. Oblast zdravstva u BiH prema ustavnim je rješenjima u nadležnosti entiteta (Republika Srpska), podijeljenoj nadležnosti entiteta i kantona (Federacija BiH), odnosno u nadležnosti Brčko Distrikta BiH, stoga postoji i zasebna entitetska legislativa. Vlada Federacije BiH 2013. godine donijela je Zakon o sestrinstvu i primaljstvu te tako jasno definirala domene u sestrinstvu, u skladu s direktivama EU-a. U Republici Srpskoj i Distriktu Brčko ovo je dijelom definirano u sustavnim zakonima o zdravstvenoj zaštiti. Zaključak. U svim pregledanim zakonskim aktima još uvijek postoje nedostaci u definiranim domenama za sestrinsku profesiju. Rješavanjem ovih nekompletnosti, progres razvoja sestrinstva ubrzao bi, ojačao i modernizirao zdravstveni sustav, što bi nesumnjivo podignulo kvalitetu zdravstvene zaštite na višu razinu

The impact of organizational culture on patient satisfaction

Introduction: Managing organizational culture has been increasingly viewed as a lever for health care improvement. The aim of this study was to investigate the correlation between the type of organizational culture and patient satisfaction in the selected health care centers in the Federation of Bosnia and Herzegovina (FBIH). Methods: We conducted a cross-sectional survey in two municipal primary health care (PHC) centers in the FBIH, referred as Primary health care (PHC) center A and Primary health care (PHC) center B. A validated questionnaire, known as the Organizational Culture Assessment Instrument (OCAI), was used for the assessment of organizational culture. The questionnaire was distributed among the family health care teams at the two PHCs. Simultaneously, we carried out a survey about patient satisfaction among patients during their visits to the family health care teams. Results: We observed the differences in the type of the organizational culture between the health care centers. The hierarchical culture was found the dominant culture in PHC center A, whereas the market culture was the dominant culture in PHC center B. Also, the statistical significance (t test) was recorded in the overall patient satisfaction in the health care center with the dominated hierarchical culture followed by the clan culture (PHC center A). Conclusions: Considering the lack of similar surveys in Bosnia and Herzegovina, we believe that this study might be a good starting point for education of human resource managers in health care

Cardiovascular Risk Factors Research in Bosnia and Herzegovina

This study describes the current situation of cardiovascular risk factors research in the Bosnia and Herzegovina, with special emphasis on the Herzegovina region. The available data for the analysis includes various secondary sources, including project reports, official vital statistics data and other sources. Currently, there is a substantial lack of relevant information, which is available from occasional surveys or isolated studies. One of the main problems in detailed analysis is the lack of detailed and reliable census data, which causes problems in calculation of various rates and disables the creation of representative population samples for the field work and subsequent analysis. Comparison of the available information with neighbouring Croatia indicates interesting mixture of relatively high prevalence of some risk factors and rather low prevalence of others; almost 50% of men reported smoking on a daily basis, while only 16.5% of men were obese, while 40% of them had blood pressure over 140/90 mmHg. The results provide useful but incomplete information for the policy, thus suggesting that broader scope of public health research is needed in the region coupled with the census data, in order to provide better information for health policy and ultimately delivery of the optimal health care to the entire population

Cardiovascular Risk Factors Research in Bosnia and Herzegovina

This study describes the current situation of cardiovascular risk factors research in the Bosnia and Herzegovina, with special emphasis on the Herzegovina region. The available data for the analysis includes various secondary sources, including project reports, official vital statistics data and other sources. Currently, there is a substantial lack of relevant information, which is available from occasional surveys or isolated studies. One of the main problems in detailed analysis is the lack of detailed and reliable census data, which causes problems in calculation of various rates and disables the creation of representative population samples for the field work and subsequent analysis. Comparison of the available information with neighbouring Croatia indicates interesting mixture of relatively high prevalence of some risk factors and rather low prevalence of others; almost 50% of men reported smoking on a daily basis, while only 16.5% of men were obese, while 40% of them had blood pressure over 140/90 mmHg. The results provide useful but incomplete information for the policy, thus suggesting that broader scope of public health research is needed in the region coupled with the census data, in order to provide better information for health policy and ultimately delivery of the optimal health care to the entire population

The 2019 measles epidemic in Bosnia and Herzegovina: What is wrong with the mandatory vaccination program?

Measles are a highly contagious and communicable viral disease which may be prevented by a sustained vaccination program. Due to missed vaccination, two major epidemics of measles (1997–1999 and 2014–2015) have been recorded after the war in Bosnia and Herzegovina (BH) with over 10,000 patients registered. According to the World Health Organization, BH is categorized as a country with endemic transmission of measles. The last measles epidemic was between 2014 and 2015, with 5,083 documented patients in the Federation of BH. In the first four months of 2019, more than 700 measles cases were registered in the same region. Significant transmission rate has been observed in Sarajevo Canton (SC) with 570 documented measles cases. Out of 570 measles cases in SC, 92.5% were unvaccinated. The most affected were children up to 6 years of age (62.8%), with one documented case of death (7-month old infant). In addition to this report, we discussed key stakeholders and possible circumstances responsible for the epidemic. The measles epidemic is still ongoing

Canton Sarajevo journey through COVID-19 pandemic

Introduction: Sarajevo is the capital city of Bosnia and Herzegovina, with the population in Canton Sarajevo of 438,443 people. The first cases of COVID-19 in Canton Sarajevo were on 20th March. On that day, we had three positive cases. These days at the beginning of the COVID-19 epidemic in Canton of Sarajevo around 2500 citizens were in self-isolation at home. The aim of this paper is to show the journey of Canton Sarajevo in the fight against COVID-19 infection, the impact of measurements that were taken to stop the infection spreading and to compare pre- and post-lockdown stats.Methods: During the period March-July 2020, we have analyzed daily newly cases and followed them through the period of at least 14 days. All data were analyzed using SPSS 25.0 (IBM Corp. Released in 2019. IBM SPSS Statistics for Windows, NY: IBM Corp.) and MS Office 2019 suite (Excel). For comparison, we have used the Chi-square test.Results: In the period of 10 weeks from the beginning of March to the 25th of May in Canton of Sarajevo, we had a total of 113 cases of COVID-19 infection. The number of conducted tests was 7515. In total, with positive retests, we had only 161 positive tests, which is 2.14% of all analyzed tests. From that number of patients, 58 (51.3%) were male and 55 (48.7%) were female. Regarding age distribution, under 65 years were 91.1% of patients.Conclusion: Choosing the best method to fight against COVID-19 is hard to determine. Staying at home would decrease the infection rate, but in the long term, it is not sustainable. Perhaps the mix of methods that we had in Sarajevo is the best option. Fighting against one epidemic cannot be the source for other epidemics