1. Education of Nurses and Other Health Care Professionals in Republic of Srpska, B&H Jasminka Vučković

2. General information on the Republika Srpska ▪ citizens ▪ area ▪ municipalities ▪ cities ▪ 2012 estimate 1 429 290 ▪ 24 641 km 2 ▪ 57 ▪ 6

3. Results: ▪ The European Union's 2008 IPA Programme, Infrastructure Projects Facility - Technical Assistance Window (IPF TA) - EuropeAid/128073/C/SER/MULTI ▪ Sub project: WB5-BIH-SOC-03: MEDICAL FACULTY, CENTER FOR EDUCATION AND RESEARCH, FACULTY FOR HEALTH CARE SCIENCES AND SECONDARY MEDICAL SCHOOL ▪ Phase 2:PRELIMINARY DESIGN ▪ Design Discipline: GUIDELINES FOR EDUCATION OF NURSES AND OTHER HEALTH CARE PROFESSIONALS IN RS ▪ October 2013

4. ▪ majority of medical technicians have only secondary school education ▪ 4.091 medical technicians with secondary degree ▪ 524 medical technicians with secondary degree who were educated on specific clinical area (obstetrics, children health care). ▪ number of practicing nurses (medical technician) on 1.000 population is 3,58 nurses with secondary degree Some indicators on human resource in health system in the RS

5. The existing education system in the RS ▪ nurses and other health care professionals on secondary (vocational) and higher educational level (tertiary) do not comply with education approaches the EU countries; ▪ on secondary level of education for health care professionals in the RS has: – 29 classes on five professional spheres, in 10 secondary public schools and – 13 classes education for health care technician; ▪ 2.200 unemployed health care professionals with secondary school were registered in 2012.

6. Education for registered nurses (higher educational level on universities, colleges) ▪ RS has 145 entry places in 2013/2014 for regular studies and 50 entry places for part time study in nursing. ▪ The study programs on 5 schools (public and private) which perform education for nurses are not comparable with EU Directive 2005/36/ES.

7. The main findings ▪ all programmes have too much of biomedical orientation and are not holistic, ▪ the faculty (professors and instructors) are doctors of medicine and not nurses, ▪ there is no evidence who is clinical mentor in clinical area, ▪ no programme has 4.600 hours including half of them in clinical settings, ▪ 68 nurses with university degree were unemployed in 2012. In health institutions in RS there is no work place/job description for nurses with university degree who are available on work market from 2011.

8. Recommendations for secondary education (period 2014 – 2020): ▪ reduction in number of secondary schools and classes, ▪ reduction in number of pupils in each class, ▪ Cessation of secondary school level education in obstetrics and physical therapy. Both professions (midwifes and physiotherapist) need to go on higher educational level, ▪ on secondary level only one educational programme should be developed for health care (health care assistant/technician) as a general education, ▪ the entry places for each study year need to be regulated by government, ▪ the priority is public education and not private education, ▪ decision makers need to know that there is no condition to have secondary medical school to become a nurse or other health care worker with Bachelor or Diploma degree.

9. Recommendations for tertiary education (period 2014 – 2020): ▪ the degree programme in nursing need to reach demand from the EU directive, ▪ diploma degree (180 ECTS) education for health care professionals is adequate background for development of each profession (nursing, midwifery, physiotherapy, radiological technology), ▪ 180 ECTS is minimal required educational level for someone to be lecturer and senior lecturer, ▪ avoidance of practice that doctors are teachers for nurses, because this is not in harmony with EU directive.

10. Recommendations for health system politics (period 2014 – 2020): ▪ RS needs to equalize competences in clinical work between nurses with 3 years or 4 years degree and nurses who have 2 years graduate school (which was the way of education of RN in former Yugoslavian countries). ▪ Ministry of Health needs to prepare new job description for graduate nurses and nurses with secondary school (HCA). ▪ On national level to prepare list of competences for HCA and list of competences for graduate nurses. ▪ RS needs national study of needs for nursing and midwifery care in all levels of health care and social system.

11. Recommendations for legislation (period 2014 – 2020): ▪ legislation needs to support : – establishing of diploma degree programs (180 ECTS), – teacher’s development and accreditation process of schools and programs and, – establishing of nursing chamber.