Health Systems Improvement Project

Project: P171150 - Health Systems Improvement Project Financing: World Bank GENERAL PROCUREMENT NOTICE BOSNIA AND HERZEGOVINA Federation of Bosnia and Herzegovina Health Systems Improvement Project (HSIP) Health Sector GENERAL PROCUREMENT NOTICE Loan No. IBRD-93510 Project ID P171150 Bosnia and Herzegovina has applied for financing in the amount of US$ 75 million equivalent from the World Bank toward the cost of the Health Systems Improvement Project, and it intends to use part of the proceeds for payments for goods, works, non-consulting services, and consulting services to be procured under this Project. The Project consists of Component 1 , which will be implemented in Republika Srpska, and Component 2 , which will be implemented in the Federation of Bosnia and Herzegovina. Component 1: Increasing health system performance in Republika Srpska Sub-component 1.1. Improving the efficiency and quality of health care This sub-component will address constraints (a) and (b) by investing in goods, equipment, and minor works to optimize the service network, including strengthening preventive health care and health system preparedness; increasing primary health care and day-care where appropriate; studying patient pathways to determine the actual cost of health care for four prevalent diseases and based on this, repricing selected services within the Diagnostic Related Group (DRG) system; and, enhancing citizen engagement to gather users' feedback on health care and health insurance. Specifically, this sub-component may include activities and investments described below. Support the Ministry of Health and Social Welfare and the Public Health Institute (PHI) to strengthen preventive health care and health system preparedness, through activities and investments that: Develop/strengthen capacity for disease surveillance, on-time data analysis, and decision-making by enhancing systems and protocols for data reporting, analysis, and dissemination, including linking primary care providers to public health surveillance systems; and, Support epidemiological investigation by expanding the number of public health workers trained to undertake disease detection and contact tracing. Support primary health care providers and the Ministry of Health and Social Welfare to strengthen primary care and reduce unnecessary use of hospitals, through activities and investments that: Support the implementation of updated clinical guidelines and care pathways to strengthen preventative health care and shift management of complex, chronic conditions such as hypertension from hospitals to primary health care, thereby avoiding unnecessary hospitalization. Expand the provision of outpatient and ambulatory services for less-invasive diagnostics and procedures, such as hernia repair and cataract surgery; and, Support the implementation of plans to optimize the numbers and distribution of the healthcare workforce (both clinical and administrative) to improve productivity. Support hospitals, the Ministry of Health and Social Welfare, and the Health Insurance Fund (HIF) to ensure efficient provision of inpatient hospital care, when unavoidable, through activities and investments that: Support the implementation of repriced selected services within the DRG system so that reimbursement from the HIF to health care providers represents actual cost, and to incentivize the use of ambulatory and outpatient care where appropriate. Build capacity in and expand the use of health technology assessment in the HIF to ensure that only cost-effective services are included in the benefits package. Support the HIF, Agency for Certification, Accreditation and Health Care Quality Improvement (ASKVA), the Ministry of Health and Social Welfare, and health care providers to improve the quality of care and patient satisfaction through activities and investments that: Develop systems and structures for the regular collection, verification, and reporting of health care quality, safety, and patient satisfaction indicators at the facility level; Where possible, merge and concentrate specialist services and diagnostics into fewer hospitals/ clinics/laboratories. Sub-component 1.2. Strengthening the management and financial sustainability of healthcare institutions This sub-component will support activities and investments to improve the financial stability of healthcare providers and the HIF, thereby addressing constraints (c) and (d). Complementing the activities and investments in sub-component 1.1, this sub-component will focus on investments that build providers' capacity and strengthen their incentives to avoid budget overruns and arrears. Specifically, this sub-component may include activities and investments to: Improve the publicly accessible database of arrears by the health care provider. Purchase hardware and software to allow health care providers and the HIF to implement IZIS - Integrated Health Information System or the treasury financial information system, and