Event highlights
More than 30 key stakeholders from health authorities across Bosnia and Herzegovina gathered on 29 April 2025 in Sarajevo to discuss new evidence on financial protection in 40 countries in Europe and across the Federation of Bosnia and Herzegovina (BiH) and the Republika Srpska – the two entities that make up the country.
The conference provided a platform to discuss the findings of the first comprehensive analysis of financial protection in both entities, assessing the extent to which people face financial hardship when accessing health services and medicines. Covering the period 2004–2025, the study draws on household budget survey data and explores 3 key coverage dimensions: population coverage, service coverage and user charges/co-payments.
“This conference is an opportunity to review key health financing policy options – such as levels of health expenditure, financial protection, co-payment policies, access to outpatient medicines and sustainable revenue generation – drawing on lessons learned from across Europe,” said Erwin Cooreman, WHO Special Representative in Bosnia and Herzegovina.
The number of households experiencing impoverishment or further impoverishment due to out-of-pocket health payments has declined. In the Federation of BiH, it dropped from 7% in 2015 to 6% in 2021. In Republika Srpska, the figure decreased from 8.5% to 4.3% over the same period. These rates are lower than in other Western Balkan countries, though still higher than in many European Union member states. Notably, catastrophic health spending remains heavily concentrated among the poorest households.
“Our aim is to support countries in building more equitable and resilient health financing systems. This new evidence provides a foundation for identifying practical policy reforms to improve financial protection for the people of Bosnia and Herzegovina,” said Tamás Evetovits, Head of the WHO Barcelona Office for Health Systems Financing.
Participants also reviewed the draft report “Reimagining Governance for Strategic Purchasing II: evidence from southeast Europe”. The study examines the evolution of strategic purchasing across the region and highlights experiences from the Federation of BiH and Republika Srpska, offering concrete insights to improve the efficiency and equity of health financing.
The conference was organized by the WHO Barcelona Office for Health Systems Financing, in collaboration with the WHO Country Office in Bosnia and Herzegovina. The financial protection analysis is part of a broader initiative – Strengthening Health Systems Financing for Universal Health Coverage in the Western Balkans (2021–2025) – funded by the European Commission’s Directorate-General for Neighbourhood and Enlargement Negotiations.
Event notice
On 29 April, the WHO Barcelona Office for Health Systems Financing, in cooperation with the WHO Country Office in Bosnia and Herzegovina, will host a 1-day conference titled: “Can people afford to pay for health care?” in Sarajevo. The event will focus on financial protection in the Federation of Bosnia and Herzegovina (BiH) and the Republika Srpska and will feature a presentation of the first comprehensive analysis of the extent to which people experience financial hardship due to out-of-pocket spending on health services and medicines in both entities.
Over 30 senior representatives will take part in the conference, including officials from the Ministry of Health and Social Welfare of Republika Srpska, Ministry of Health of the Federation of BiH, cantonal ministries of health in the Federation of BiH, the Department of Health and Other Services of Brčko District of BiH, and health financing authorities and health insurance funds from across the country.
The conference will serve as a platform for policy dialogue, evidence-sharing and exploring actionable reforms to improve financial protection and progress toward universal health coverage in Bosnia and Herzegovina.