Women’s Health and Mapping of Health System Capacity for Cervical and Breast Cancer Prevention in the Federation of Bosnia and Herzegovina
1
Institute of Public Health of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Women’s health outcomes related to cervical and breast cancer depend on equitable access to preventive services and organized screening. In decentralized health systems, uneven resource distribution and fragmented governance lead to inequalities in early detection and care. In the Federation of Bosnia and Herzegovina (FBiH), organized population-based screening is not uniformly implemented, indicating the need for mapping health system capacities.
OBJECTIVES:
To comprehensively map the availability, distribution, and organization of health resources and services for cervical and breast cancer prevention within the framework of women’s health in FBiH, and to support development of organized screening programs.
METHODS:
A cross-sectional mapping study was conducted in 2023–2024 by the Institute for Public Health of the Federation of Bosnia and Herzegovina. Using a structured questionnaire, the study assessed human resources, infrastructure, equipment, clinical procedures, patient pathways, health information systems, preventive-promotional activities, and financing. A total of 140 public and private health institutions across primary, secondary, and tertiary levels of care in FBiH were included. Descriptive analysis and comparison with a previous mapping study from 2012 were performed.
RESULTS:
The mapping revealed pronounced regional and organizational disparities in women’s health services related to cervical and breast cancer prevention. Organized screening programs were fully implemented in only three cantons. Significant gaps persisted in trained personnel, standardized protocols, cytology and imaging capacity, medical documentation, and referral pathways. Despite improvements since 2012, inequalities continue to limit early detection and timely access to care.
CONCLUSIONS:
Mapping of women’s health system capacity identified critical structural and organizational barriers to effective cervical and breast cancer prevention in FBiH. Strengthening organized screening requires coordinated governance, targeted investment in human resources, standardized procedures, and improved health information systems. This approach provides a robust evidence base for reducing inequalities and improving women’s health outcomes in decentralized health systems.
Women’s health outcomes related to cervical and breast cancer depend on equitable access to preventive services and organized screening. In decentralized health systems, uneven resource distribution and fragmented governance lead to inequalities in early detection and care. In the Federation of Bosnia and Herzegovina (FBiH), organized population-based screening is not uniformly implemented, indicating the need for mapping health system capacities.
OBJECTIVES:
To comprehensively map the availability, distribution, and organization of health resources and services for cervical and breast cancer prevention within the framework of women’s health in FBiH, and to support development of organized screening programs.
METHODS:
A cross-sectional mapping study was conducted in 2023–2024 by the Institute for Public Health of the Federation of Bosnia and Herzegovina. Using a structured questionnaire, the study assessed human resources, infrastructure, equipment, clinical procedures, patient pathways, health information systems, preventive-promotional activities, and financing. A total of 140 public and private health institutions across primary, secondary, and tertiary levels of care in FBiH were included. Descriptive analysis and comparison with a previous mapping study from 2012 were performed.
RESULTS:
The mapping revealed pronounced regional and organizational disparities in women’s health services related to cervical and breast cancer prevention. Organized screening programs were fully implemented in only three cantons. Significant gaps persisted in trained personnel, standardized protocols, cytology and imaging capacity, medical documentation, and referral pathways. Despite improvements since 2012, inequalities continue to limit early detection and timely access to care.
CONCLUSIONS:
Mapping of women’s health system capacity identified critical structural and organizational barriers to effective cervical and breast cancer prevention in FBiH. Strengthening organized screening requires coordinated governance, targeted investment in human resources, standardized procedures, and improved health information systems. This approach provides a robust evidence base for reducing inequalities and improving women’s health outcomes in decentralized health systems.
| eISSN: | 2654-1459 |
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