NURSEPRENEURS Needs Analysis: Strengthening VET Pathways for Community-Based Care and Nurse Entrepreneurship

Introduction

At the start of the year 2026, a group of organisations from the Western Balkans and the EU came together with a shared objective: to better understand the structural challenges affecting the nursing and care sectors, and the role of vocational education and training (VET) in addressing them. The organisations involved in this joint effort include Employment Promotion Agency Kosovo (APPK), DATEY Eyrich GmbH (Germany), European Medical College (Bosnia and Herzegovina), Zenos (Bosnia and Herzegovina), ipcenter.at GmbH (Austria), ÖJAB – Austrian Young Workers Movement (Austria), Health Insurance Institute of Zenica-Doboj Canton (Bosnia and Herzegovina), and NGO Glas (Montenegro).

As part of the preparation of the NURSEPRENEURS project proposal, partners conducted a comprehensive needs analysis focusing on the intersection between VET systems, labour market dynamics and the growing demand for home- and community-based care services across Bosnia and Herzegovina, Kosovo and Montenegro.

The analysis combines desk research, national partner insights and primary data collection among VET learners, providing an evidence-based foundation for future capacity-building interventions.

Key Findings

1. Growing demand for care, but insufficient services

Demographic ageing and changing family structures are rapidly increasing the need for long-term and community-based care. However, care systems remain heavily reliant on informal care, while formal home-based services are still underdeveloped across the region.

2. Workforce shortages and high migration pressures

Despite increasing demand, the care sector faces significant workforce challenges. A large share of nurses and future professionals are considering emigration, driven by limited career opportunities, low wages and poor working conditions.

At the same time, available human resources are not fully utilised, pointing to systemic inefficiencies in linking education, employment and service provision.

3. Strong gender dimension of the sector

The care sector is highly feminised, with women representing the majority of the workforce while also carrying a disproportionate burden of unpaid care work. This limits their access to stable and sustainable employment and highlights the need for more flexible and accessible career pathways.

4. Mismatch between VET and labour market needs

Current VET programmes remain largely oriented towards institutional healthcare settings and do not sufficiently reflect emerging trends such as:

  • home- and community-based care
  • preventive and patient-centred approaches
  • decentralised service delivery

This limits graduates’ ability to access new and growing segments of the care economy.


5. Lack of entrepreneurial and transversal skills

Entrepreneurship is rarely integrated into nursing education, despite its potential to unlock new employment opportunities. In addition, gaps remain in key transversal skills such as communication, adaptability and digital competences.

6. Untapped potential for new care models

The analysis highlights a clear opportunity to develop alternative, locally grounded care models, including community-based services and self-employment pathways, which remain largely unexplored within existing systems.

Conclusion

The findings point to a systemic mismatch between growing care needs, available workforce potential and existing education and employment structures.

Addressing these gaps requires stronger alignment between VET systems and labour market needs, the development of flexible and innovative training pathways, and the creation of new career opportunities that can support both workforce retention and the expansion of care services at local level.

The full Needs Analysis is available here:
👉 [Download the NURSEPRENEURS Needs Analysis]

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