Reform of health insurance in the Federation of Bosnia and Herzegovina.
The aim of this report is to provide an overview of the reform of health insurance in the Federation of Bosnia and Herzegovina (FBH). Health financing and resource allocation policies in the FBH are also summarized. Health financing should be ensured through three types of health insurance: compulsory, supplementary, and voluntary. The revenues for the compulsory health insurance will be ear-marked through payroll taxation. Facing the scarcity of resources, the Federation authorities have decided to raise the proportion of the payroll contribution as compared to the pre-war level and engage in various arrangements of cost-sharing and priority setting in health care. The resource allocation policy underlines two key parts of the health care reform: contracting mechanisms and payment systems. We also discuss the optimal correlation between solidarity and competition in the course of the ongoing reform of the health insurance in the Federation. The social function of a competent health system, where the well-being of the population is viewed as a sociological category of the overall society's concern, requires considerable subsidization. Incentive-based market mechanisms may be introduced into some of the segments of health care system but only under government-led control of the effects of such measures. (+info)
Financing of dental health care in the Federation of Bosnia and Herzegovina.
Financing dental health care in the Federation of Bosnia and Herzegovina (FBH) over the last 10 years was analyzed with respect to time before the war, during the 1992-1995 war, and after the war. In the first period (until 1991) the system was centralized, well structured, financed through the communities of interest, and burdened with a lack of financial discipline and high inflation. By the end of 1991, all citizens in the territory of BH Federation had the right to dental health insurance and participated in the price of dental service with 10-50%. During the 1992-1995 war, insurance and financial institutions ceased their work until the establishment of civilian governing authorities. The system of dental services was legalized within the health system as its integral part, yet, because of insufficient financial support, the rights of the insured were not fulfilled. Following the Dayton Peace Agreement in 1995, two systems (Croat and Muslim) were in function in FBH, each based on different legal grounds, and dental care stagnated considerably. The 1997 FBH Law on Health Care and Health Insurance and the Law on the Privatization of companies introduced a unique health system, widening the sources of financing and categories of health insurance. The process of health care privatization has been legalized, but not yet implemented. Lack of definitions of ownership diminish foreign investments, and without foreign financial support the improvements will be slower than needs. The process of health care restructuring will thus directly depend on the solving the political crisis in the country. (+info)
Analysis of mtDNA HVRII in several human populations using an immobilised SSO probe hybridisation assay.
Several populations were typed for the hypervariable region II (HVRII) of the mitochondrial DNA (mtDNA) control region using immobilised sequence-specific oligonucleotide (SSO) probes. A total of 16 SSO probes was used to type 1081 individuals from eight different ethnic groups (African Americans, Somali, US Europeans, US Hispanics, Bosnians, Finns, Saami and Japanese). Data was compared with already published sequence data by analysis of principal components, genetic distances and analysis of the molecular variance (AMOVA). The analyses performed group the samples in several clusters according to their geographical origins. Most of the variability detected is assigned to differences between individuals and only 7% is assigned to differences among groups of populations within and between geographical regions. Several features are patent in the samples studied: Somali, as a representative East African population, seem to have experienced a detectable amount of Caucasoid maternal influence; different degrees of admixture in the US samples studied are detected; Finns and Saami belong to the European genetic landscape, although Saami present an outlier position attributable to a strong maternal founder effect. The technique used is a rapid and simple method to detect human variation in the mtDNA HVRII in a large number of samples, which might be useful in forensic and population genetic studies. (+info)
Computing for the next millennium.
Computer technology has changed our lives, even that of physicians. In a few years time, a physician can expect to have a new tool by the bedside: a hand-held computer small enough to put into a pocket and powerful enough for all everyday activities, including highly specialized and sophisticated activities such as prevention of adverse drug reactions. The Croatian Academic and Research Network (CARNet) was crucial in bringing the benefits of the information technology to the Croatian scientists. At the Split University School of Medicine, we started the Virtual Medical School project, which now also includes the Mostar University School of Medicine in neighboring Bosnia and Herzegovina. Virtual Medical School aims to promote free dissemination of medical knowledge by creating medical education network as a gateway to the Internet for health care professionals. (+info)
Challenge of Goodness II: new humanitarian technology, developed in croatia and bosnia and Herzegovina in 1991-1995, and applied and evaluated in Kosovo 1999.
This paper presents improvements of the humanitarian proposals of the Challenge of Goodness project published earlier (1). In 1999 Kosovo crisis, these proposals were checked in practice. The priority was again on the practical intervention - helping people directly - to prevent, stop, and ease suffering. Kosovo experience also prompted us to modify the concept of the Challenge of Goodness. It should include research and education (1. redefinition of health, 2. confronting genocide, 3. university studies and education, and 4. collecting experience); evaluation (1. Red Cross forum, 2. organization and technology assessment, 3. Open Hand - Experience of Good People); activities in different stages of war or conflict in: 1. prevention (right to a home, Hate Watch, early warning), 2. duration (refugee camps, prisoners-of-war camps, global hospital, minorities), 3. end of conflict (planned, organized, and evaluated protection), 4. post conflict (remaini ng and abandoned populations, prisoners of war and missing persons, civilian participation, return, and renewal). Effectiveness of humanitarian intervention may be performed by politicians, soldiers, humanitarian workers, and volunteers, but the responsibility lies on science. Science must objectively collect data, develop hypotheses, check them in practice, allow education, and be the force of good, upon which everybody can rely. Never since the World War II has anybody in Europe suffered in war and conflict so much as peoples in Croatia, Bosnia and Herzegovina, and Kosovo. We should search for the meaning of their suffering, and develop new knowledge and technology of peace. (+info)
Building peace from scratch: some theoretical and technological aspects.
A peace-building process is based on activity, acceptance, understanding of political reality, communication, and empowerment. Acceptance means accepting everybody as he or she is and let each know it. This is at the heart of peace work, it is the prerequisite for effective communication, and includes accepting other even in cases of severe disagreement. Peace work requires both an understanding of political reality and the expression of one's own political opinion. Acceptance and the expression of political opinion are not at variance but complementary. Combining acceptance and understanding of the political context provides hope for real communication in which messages are both sent and received, with appreciation and interest. Empowerment implies overcoming of the feeling of powerlessness, often present in conflict by all sides and in all social groups. It includes recovery of self-respect and respect for others. Education and economic independence are important facets of the empowerment concept. Essential principles of peace-building process are responsibility, solidarity, cooperation, and nonviolence. Responsibility encompasses caring for human rights, the suffering of others, and for consequences of our own intended and unintended actions. Solidarity allows learning through listening and understanding. Even with the best intentions on both sides, cooperation may be difficult and painful. Nonviolence is a way of life. (+info)
Aftermath of war experience: impact of anxiety and aggressive feelings on the group and the therapist.
AIM: Analysis of some anxious and aggressive features stemming from the highly traumatic war experiences and having as a consequence chronic posttraumatic stress disorder (PTSD). METHOD: Group psychotherapy was applied as a therapeutic approach of choice. RESULTS: During the psychotherapeutic process, the possibility to name and express anxiety and aggressiveness was uncovered not only as the sequels of highly traumatic war experiences but even the transgenerational transmission of frustrations and aggressive feelings. These features have constantly very strong influence on the therapist's countertransference. Some of the most prominent characteristics of these processes are described through clinical vignettes. CONCLUSION: Longer group psychotherapy is required for patients suffering from serious PTSD to develop the possibility to externalize their deep traumas and to work them through in order to reestablish connections with everyday life. During that process, the countertransferential issues disclose the most important traumatic features and encapsulations, and indicate the main topics to be addressed in patients and the therapist as well. (+info)
Psychoanalytic psychotherapy with migrant war victims: transference and countertransference issues.
This report raises questions about the relevance of the psychoanalytic theory and method with migrant war victims, and addresses the issue of personal limits of the psychotherapist who treats these often very ill patients. A clinical vignette and its psychoanalytic understanding introduce the question of transference and counter- transference in the therapeutic work with traumatized war victims. Psychological treatment of war victims is a very important issue. On the one hand, patients who have been tortured or otherwise traumatized are often considered to be reluctant to accept psychological help, even if they are severely disturbed. On the other hand, the psychotherapists who agree to work with such patients must be prepared to face very specific difficulties. Psychoanalytic psychotherapy may be very efficient in treating war victims, but requires not only motivated but, above all, well-trained therapists. Otherwise, the therapist may become the next victim of the patient's trauma and, for his or her own sake, work towards immediate repression instead of working through the traumatic event ending up in the repetition compulsion. (+info)