Third regional conference "Health in All Policies and Primary Health Care" and the WHO Policy Dialogue "Global Crisis and Health" will be held on 23 – 24 September, 2009 in Holiday Inn in Sarajevo. The conference is organized by the Federal Ministry of Health and CIDA Balkans Primary Health Care Policy Project in co-organization with the World Health Organization and European Observatory of Health Systems and Policies, with the participation of the World Bank.

The Balkans Primary Health Care Policy Project (BPHCPP), Ministry of Health of Republic of Serbia and Belgrade City Secretariat for Health organized a two-day regional conference "The Future of Primary Health Care in the Balkans", in "Stari Dvor" in Belgrade on 13th and 14th October 2008. Over 230 participants from Serbia and Bosnia and Herzegovina, and the region took part in the conference. Among them were high representatives from Ministry of Health of Serbia, Ministry of Civil Affairs of Bosnia and Herzegovina, Ministry of Health of Federation of Bosnia and Herzegovina, BiH, Ministry of Health and Social Welfare of Republic of Srpska, BiH, and Ministries of Health of Albania, Montenegro, Bulgaria and Romania.

Ministry of Health of the Republic of Serbia, City of Belgrade Secretariat of Health and the Balkan’s Primary Health Care Policy Project are organizing the Regional Conference “The Future of Primary Health Care in the Balkans: Responses to the Challenges” in Belgrade, October 13th and 14h, 2008. This Conference is the second regional conference within the Project implemented in Serbia and Bosnia and Herzegovina.

Three Canadian Balkan health projects funded by the Canadian International Development Agency hosted a delegation of Ministers from the governments of Bosnia and Herzegovina and Serbia to attend and present at the Canadian Public Health Association's 2008 Annual Conference "Reducing Health Inequalities Through Evidence and Action" held in Halifax, Nova Scotia in June 2008. The delegation from Bosnia and Herzegovina included the Minister of Civil Affairs of Bosnia and Herzegovina, Sredoje Novic, Minister of Health of the Federation of Bosnia and Herzegovina, Safet Omerovic, the Minister of Health and Welfare of Republika Srpska, Ranko Skrbic, Assistant Minister of Civil Affairs, Drazenka Rados-Malicbegovic, Chief of Cabinet of the Minister of Health of Federation BiH, Jasmina Cosic and Assistant Minister of Health and Social Welfare in Republic of Srpska, Amela Lolic and Slavko Nikic, Head of the Department of Health in Disctrict Brcko. From Serbia, Ivana Misic, Assistant Minister of Health attended.

Ambassador of Canada to Bosnia and Herzegovina David Hutchings, together with Minister of Civil Affairs Sredoje Nović today signed two Memoranda of Understanding for Canadian-funded projects aimed at reforming the health sector in Bosnia and Herzegovina.

HRH Planning

A series of activities were held as part of the HRH planning process. This includes completion of draft reports on human resources by entity Public Health Institutes, focus group meeting for specialists in primary health care in Republic of Srpska,  survey of key informants from 12 specialty groups in Federation of BiH, and two meetings of Expert Panels held in Banjaluka, December 3 and 4, and Sarajevo, December 15 and 16. The Panels provided their expert opinion on current norms and standards for different specialties as well as on parameters for setting the service targets for the adjusted service target planning model that will be used in BiH for the development of the HRH plan.

On September 29, 2008, the 3rd Module of Capacity Strengthening in HRH Planning: "Teams and Teambuilding" was held in Banja Luka for managers of PHC institutions.  The principles of functioning of teams within health sector, primarily within the PHC, were presented along with the strategies for managers on how to build effective teams. Workshops were attended by more than 40 participants. Third Module was also held in Sarajevo on 6th October 2008. Sally MacLean and Djenana Jalovcic facilitated the Module which was attended by 26 participants. Participants in Banja Luka and Sarajevo expressed their satisfaction with the presentations and topics. The 4th Module: Information for Policy was held in Sarajevo on November 19 and in Banja Luka on December 5. With participation of over 60 representatives of ministries of health, health insurance funds, public health institutes and health institutions, this was the last Module of the Capacity Strengthening Program in HRH Planning for participants in Bosnia and Herzegovina. Following the certificate awarding, participants expressed their gratitude for the opportunity to participate in the training program.

Delegation from the Balkans participated at the CSIH Annual Conference

The Balkans Primary Health Care Policy Project organized a study tour for providers of Primary Health Care (PHC) in The Republic of Serbia and a policy maker working on PHC issues from The Republic of Srpska, Bosnia and Herzegovina (BiH). Unfortunately, our colleagues from Federation of BiH were not able to join us during this visit. During the visit, delagation took part at he CSIH Annual Conference which was held in Ottawa from 26th to 29th of October 2008.

Meeting with WCPT representatives

On 9th of October the meeting of associations of physiotherapists in Bosnia and Herzegovina and Worlds Confederation was held in Sarajevo. The meeting was attended by 15 participants. Malcolm Peat led the meeting. WCPT was represented by Secretary General Brenda Myers and Antonio Lopez, Chair of the European Region of WCPT and Chair of the Region’s working group on education. Meeting was a forum to highlight the priorities for physiotherapists in Bosnia and Herzegovina. One of hindrance to further development is absence of the BH association. Project will support the initiative to establish BH association of physiotherapists. Next meeting was held on November 8, 2008 in Brcko.

Project Steering Committee Meeting in Serbia

Project Steering Committee meeting took place on September 30th in Project office in Belgrade. Apart from official representatives in the Committee – CIDA Health Officer and Assistant Minister of Health of Serbia, CIDA Team and Project team – meeting was attended by the representatives of other major CIDA funded “sister projects”, as well as representatives of partner regulatory and health institutions and consumers. At the meeting, project activities have been reported and reviewed and the annual work plan was approved.

Meetings of the Advisory Groups

In September the Advisory Groups for each entity met in preparation of the Fall activities. The Project team presented the report on activities and workplan for the upcoming period. The meeting of the FBiH Advisory Group for Development of Human Resources in Health Sector was held on September 17th, 2008, in Sarajevo.  The Group had very good discussion on the project report for the period September 2007 to September 2008, and  they agreed that plan of activities has been successfully realized. The meeting of the RS Advisory Group was held on September 29, 2008 in Banja Luka. Minister of Health and Social Welfare, Dr. Ranko Skrbic, attended one part of the meeting. Past and future activities have been reviewed and it was concluded that the project is progressing well according to the plans.

Accreditation of PHC Centers in Demonstration Sites

Closing Conference on Accreditation of health institutions in Serbia took place in Nis, on September 23rd and 24th. This event was the final activity in the process where the Ministry of Health of Serbia has tested and surveyed draft accreditation standards for hospitals and PHC centers (dom zdravlja) in Serbia. 4 hospitals and 16 DZs participated in this process.

PHC Policy Dialogue in Serbia

Third PHC Policy Dialogue in Serbia took place between July 30th and August 1st, 2008, in Mokra Gora on mountain of Tara. The topic of this dialogue was the scope and content of primary health care and it was organized for representatives of the Ministry of Health, Standing Conference of Cities and Municipalities of Serbia, Local Self Governances, Institutes of Public Health, Demonstration Sites PHC Centers (dom zdravlja), Consumers’ Groups and International Development Partners.

Role of Providers

Sally MacLean led the major workshop, organized jointly by the Serbian Chamber of Nurses and Technicians and the Project where the representatives of all leading nursing organizations took part. The purpose of having the meeting was the presentation of Background Paper “Education and Organization of Nurses and Midwifes in Serbia” and agreement on further steps for different leaders in nursing profession. Main goal of the meeting was to discuss the position of different nursing associations and representatives of the profession in regards to nursing education in Serbia.

HRH Planning: "Evidence for HRH Plan: Initial Reports"

The third HRH planning meeting "Evidence for HRH Plan: Initial Reports", was held on June 24 in Banjaluka, with representatives of Public Health Institutes, RS Ministry of Health and Social Welfare, Federal Ministry of Health, Ministry of Civil Affairs and CIDA. Preliminary results of HRH data gathering by Public Health Institutes were presented and reviewed as well as framework for discussing targets and benchmarks to be used in the agreed planning model, the adjusted services target approach.

The series of workshops for capacity building of professional organizations of health care workers continued with Module 2: How to Develop Business Plans: How to Think of Your Chamber as a Business which was held on April 2 in Sarajevo and April 4 in Banjaluka. All participants highly appraised the contribution of the Project consultant Larry Nestman who led the second workshop of the training program for professional organizations.

Module 3: Role of Consumers/Public Participation in Organizations of Health Professionals was held on June 13 in Banjaluka and June 17 in Sarajevo. It gathered representatives of professional organizations as well as representatives of the Ministry of Health, Health Insurance Fund, health care centers and the university sector. The exchange of experiences was immense – Canadian examples presented by the Project consultant, Malcolm Peat, were complemented with examples of good local practices presented by users of services. There is a consensus that active users’ participation, ranging from creating policy, shaping curricula and being part of teaching process, up to the self-help groups, is extremely beneficial for all stakeholders in the health care system. In RS she workshop encouraged discussion between Health Insurance Fund and representatives of the Association of Family Physicians which will submit proposal for the round table on responsibilities of users in the context of the preventive programs in the PHC.

This workshop was an excellent opportunity to join forces with the Canadian Public Health Association Project (CPHA) in BiH since public participation was identified as a key issue by the CPHA local partner in FBiH, Partnership for Public Health. Dr. Bakir Nakas, President of the Assembly and Svjetlana Fabijanc Grbic, President of the Partnership for Public Health were among the group of local speakers who contributed to this workshop. More about this Partnership for Public Health can be found in the pages of this Newsletter.

Accreditation surveys (external evaluation) of PHC Centers (Demonstration Sites) in Obrenovac, Uzice, Backa Topola, Nis, Novi Sad and Doljevac took place throughout May and June. Each survey was performed by a team of 4 accreditation surveyors from other Demonstration Sites and it was led by Snezana Manic and Olivera Jovanovic, The Local Consultants for Accreditation and Continuous Quality Improvement. More than 100 health workers are involved in each survey process. The same methodology and procedures, established by the Ministry of Health of Serbia, were applied to BPHCPP Demonstration Sites.

The third and fourth Modules of the Keele University Master’s Program were held in Sarajevo in April and Banja Luka in June. Leading change, leadership, human resources management and action learning were main issues explored during these Modules. During the wrap up meeting all sides, the Project, students and Keele University representatives expressed their satisfaction with pace and results of the program achieved so far.

Following the Module in June Jean Robson, Program Director, and students met with Dr. Ranko Skrbic, Minister of Health and Social Welfare of RS and Dr. Amela Lolic, Assistant Minister, who expressed their interest in themes for Master’s theses and publishing them in peer reviewed journals. Following this recommendation, Project Director, Project Manager and graduate students had a preliminary discussion about use of data collected by the Project and possible students’ research questions.

Voice of Consumers

A one day workshop on Community Participation in PHC was delivered for the Project Working Group for Voice of Consumers on May 14th in the Canadian Embassy in Belgrade. Ken Hoffman, BYHP Consultant delivered the workshop for NGO leaders, representing the PHC consumers and vulnerable groups.

Strengthening Management Capacities in Demonstration Sites

Module 4: Team Building and Conflict Resolution, within the Strengthening Management Capacities of Demonstration Sites Program took place in Fruska Gora, near Novi Sad, May 7 – 8, 2008. The training was delivered to participants from all 12 Project Demonstration Sites in Serbia. Training was delivered by Orvill Adams, Project Director, Erszebet Acs Nikolic and Snezana Ukropina, professors at the Institute of Public Health and Medical School, University of Novi Sad.

Module 5: Leadership, within the same program was organized in the same way, for 5 representatives from each of 12 Demonstration Sites. Training took place in Zrenjanin, June 17 – 18, 2008. Training was delivered by Sally MacLean, BPHCPP Consultant, Miodrag Stefanovic, Technical Coordinator for Demonstration Sites in Serbia and Orvill Adams, Project Director. During the first part of the workshop, Robert McDougal, Ambassador of Canada in Serbia and Tomica Milosavljevic, Minister of Health of the Republic of Serbia gave presentations on their perspectives and experiences of leadership within international environment and the health sector.

The Capacity Strengthening Program in Human Resources for Health in BiH was launched in April 2008. The first in a series of four modules focused on "Human Resources Planning" was held in Sarajevo on 14 and 15 April, and Banja Luka on 16 and 17 April and 22 and 23 April.

The workshop in Sarajevo gathered representatives of Federal and Cantonal Ministries of Health, Public Health Institutes and Health Insurance Funds who have responsibilities for planning of human resources for health. In Banja Luka workshops were organized in collaboration with Dom Zdravlja Banja Luka which provided workshop facilities in the newly opened Family Medicine Teaching Centre. Participants in the workshops in Banja Luka were directors from Dom Zdravljas, representatives of the Ministry of Health and Social Welfare and Public Health Institutes. In these participatory workshops, participants demonstrated abilities of critical analysis and finding feasible solutions.

The second module "Human Resources Management (HRM)" was held on June 25 in Banja Luka in the RS government building with Minister of Health participating at the opening of the workshop. On June 26, the second module was held in Sarajevo. During this one day workshop an overview of the principles of HRM were presented along with the specific strategies to the performance of the health workforce. Gender and equity issues were reviewed and discussed within the context of HRM. Orvill Adams led both modules. Vern Hicks, Consultant for HRH Planning, took part in the first module and Susan Phillips, Gender and Equity Consultant, participated in the second module. Attendance on all workshops was very good, with over 90 participants taking part in these activities.

Strengthening the Capacity of Professional Organizations
Gender Policies in Professional Organizations

The Third Module of the Capacity Building for Professional Organizations Program on Gender Policies was delivered by Susan Phillips, BPHCPP Gender Consultant and Biljana Maletin, Local Gender Consultant in Belgrade on April 15, 2008. Workshop was attended by 22 participants (2 men and 21 women). Management teams of all five Chambers in Serbia (medical doctors, nurses, dentists, pharmacists and biochemists) and leading professional associations attended the training.

The Second Policy Dialogue Understanding and Improving Access to PHC Services in Serbia will take place in Zrenjanin on April 7th – 8th, 2008. This Policy Dialogue brought together representatives of providers (DZs), Ministry of Health, Local Self Government, and Consumers to discuss the key factors affecting access to PHC services in Serbia.
A Draft Guide for an effective collaboration between the municipal authorities (self-governances), providers and consumers of the primary health care services was presented and circulated for comments during the same event.

Business Planning for Professional Organizations, Module 2 of the Capacity Building for Professional Organizations was held on April 2, 2008 in Sarajevo and April 4, 2008 in Banja Luka.
The first module of the human resources for health capacity building for planners, policy makers and practitioners focusing on Principles of Human Resources Planning was held on 14 and 15 April, 2008 in Sarajevo and 17 and 18 April, 2008 in Banja Luka. Round Table "Education of Physiotherapists" was held in Banja Luka on March 28, 2008, with participation of representatives of Association of Physiotherapists, PT Programs at the University Level, Ministry of Education and Ministry of Health.

Local self-governance task group had series of workshops in February and March 2008, in order to develop the Guide for an effective collaboration between the municipal authorities and providers and consumers of the primary health care services. Members of the Task Group are representatives of local self-governances, providers, consumers, Standing Conference of Cities and Municipalities of Serbia and the Project. Draft of the afore mentioned Guide was presented for comments during the Policy Dialogue Series 2, in Zrenjanin on April 7th and 8th, 2008.

Project Working Group for PHC Policy Development in Serbia had a meeting on March 14th, 2008 in Belgrade, chaired by the Assistant Minister of Health for Health Services Organization and Health Inspection, dr Ivana Misic. Background Papers developed in the Project were presented and discussed by the Working Group. Following discussion facilitated by Karen Gibbons, on proposed vision, goals and principles for PHC system in Serbia also took place in order for the members to reflect and comment on submitted draft. Project Working Group for Education had a meeting on March 18th, 2008 in Belgrade. Meeting was facilitated by Susan Phillips. She presented the draft "Road map" for Patient Centered Practice and facilitated the following discussion. G The objective of this activity is to develop the education tool that would be institutionalized in Serbia in the coming months.

On February 27, 2008, a workshop "Planning of human resources in health" was held in Sarajevo with participation of 30 representatives of Ministries of Health and PHIs of both entities, Ministry of Civil Affairs, and CIDA. The main goal of the meeting was to review the progress of the activities, and discuss the HRH planning models, select the comparative indicators and present the simulation of needs by using physician’s model.

Strengthening the Capacity of Professional Organizations
Professional Regulation: What it is and How it Works?

Second module in the Capacity Building for Professional Organizations on professional regulation and protection of public was presented by Sally MacLean in Belgrade on February 26, 2008. Workshop was attended by 22 participants (7 men and 15 women), mainly directors and management teams of all five Chambers in Serbia (medical doctors, nurses, dentists, pharmacists and biochemists) and leading professional associations.

Working Group for Voice of Consumers had a meeting on February 14th in Canadian Embassy in Belgrade. Karen Gibbons facilitated the meeting. Discussion took place in order to agree on the survey on consumers’ view on access to PHC services in Serbia. Representatives of the NGO "Partner" from Banja Luka, BiH also attended the meeting and contributed by sharing their experience with other participants. Lepojka Čarević Mitanovski, representative of the Voice of Consumers WG and Dr. Mirjana Živković Šulović, representative of the Institute of Public Health of Serbia participated at the International Conference Quality of primary health care: the perspective of patients in Ljubljana, Slovenia, March 28th – 29th, 2008. Both participants submitted the papers on BPHCPP activities in regards to consumers’ voice that are accepted by the Conference.

Strengthening the Capacity of Professional Organizations
Professional Regulation: What it is and How it Works?

The first of five modules in the Capacity Building for Professional Organizations - ‘Professional Regulation: What it is and How it Works’ was presented by Sally MacLean in Sarajevo and Banja Luka on February 12 and 15, 2008. Fifty eight participants were representatives of chambers, professional associations and trade unions and the Ministry of Health from both entities. The group included medical doctors, dentists, pharmacists, nurses/ medical technicians and physiotherapists. The concept of professional self-regulation and training itself will be further presented the Journal of the RS Medical Chamber and the Popular Medical Journal in RS.

Nursing Association at the State Level
Working Group meeting - Sarajevo, February 8 - 9, 2008

The meeting of the State Nursing Association Working Group was held on February 8 - 9, 2008 with 14 representatives from Bosnia and Herzegovina. The main purpose of this two day meeting was to review and discuss a proposed draft statute for a state nursing association. The Project will support harmonization of draft statute with ICN requirements. Parallel to this, nursing associations in Federation of BH will be established. Next steps are approval of the proposed statute by all three nursing association in BiH and establishment of an umbrella association which will be registered as a State Nursing Association.

Accreditation of PHC Centers in Demonstration Sites

Training workshop for accreditation surveyors and accreditation coordinators in PHC centers took place in Subotica, February 9 – 12, 2008, for teams from 7 PHC Centers in Demonstration Sites. The training was delivered to 32 participants (12 men and 20 women) by Local Consultants for Quality Improvement and Accreditation, Dr. Snežana Manić and Dr. Olivera Jovanović, following the same methodology and procedures established by the Ministry of Health of Serbia.

Strengthening Management Capacities in Demonstration Sites

Module on Human Resources Management, within the Strengthening Management Capacities of Demonstration Sites Program took place in Niš, February 4 – 6, 2008. The training was delivered for 55 participants (20 men and 35 women) from all 12 Project Demonstration Sites in Serbia. Training was delivered by "Bonex", Biljana Maletin, Local Gender Consultant and Orvill Adams, Project Director.

Regional Conference "Human Resources for Effective PHC Service Delivery"
Banja Luka, Bosnia and Herzegovina October 8 - 9, 2007

The purpose of this Regional Conference is to share experiences and examine the relationships between the planning, management and use of the health workforce and the delivery of PHC services. Countries in the region have taken different routes to the organization and delivery of primary health care services. The model chosen have an impact on the type of providers in the system. Similarly, the type of providers and the scopes of practice can define the nature of the services provided. The Conference will provide an opportunity to critically examine some of the key PHC issues in the region. Speakers from Croatia, Slovenia, Hungary, United Kingdom, Canada, Serbia and Bosnia and Herzegovina will offer their perspectives on relevant HR issues.