Overview

Bosnia and Herzegovina consists of two entities (the Federation of Bosnia and Herzegovina and the Republika Srpska) and one autonomous district (the Brčko District of Bosnia and Herzegovina), and has complex health systems, with 13 health insurance funds and 14 ministries in charge of health. The main source of public funds for the health systems of Bosnia and Herzegovina is mandatory health insurance contributions collected and pooled at entity/district or canton level. The benefits packages are relatively comprehensive, but coverage is not universal and entitlements are not harmonized across health systems.

Public spending on health as a share of GDP is much higher than the South-Eastern European average and even exceeds the European Union (EU) average. Despite a continuous decrease in recent decades, about one third of health spending (30%) was private in 2019, almost entirely consisting of out-of-pocket payments which are mainly spent on medicines and therapeutic appliances.

The country faces a high burden of noncommunicable diseases and mortality from stroke and ischaemic heart disease, and cancer has increased in recent years. Tobacco consumption is a major public health concern and there remains major scope for more stringent tobacco-control measures. It is believed that the COVID-19 pandemic had a profound impact on average life expectancy rates in Bosnia and Herzegovina, but official data are not yet available.