Background/Objectives: Contemporary health systems continue to face persistent challenges in financing, equity, and governance, particularly under conditions of limited resources, workforce shortages, and demographic pressures. While the World Health Organization calls for strengthening social participation to achieve universal health coverage, evidence suggests that such participation often remains largely symbolic. Existing global examples of social participation in health are limited either by their short duration of implementation or by their limited scope. In contrast, the experience of former Yugoslavia (1945–1991) represents a distinctive case. In the early post-war period, health reforms were directed towards the development of a decentralised, self-managed health system that emphasised universal coverage, participatory governance, social solidarity, and local autonomy. The trajectory of these reforms was further shaped by global economic and political pressures, including neoliberal trends, international debt, and the oil crises, which constrained resources and exposed systemic vulnerabilities. The so-called Yugoslav Experiment may offer an alternative to existing market-oriented and, at times, inefficient health systems. This review aims to synthesise evidence on the governance, financing, organisation, and outcomes of Yugoslavia’s self-managed health system and to evaluate its relevance to contemporary debates on health system resilience, decentralisation, participatory governance, equity, and sustainability. It examines power relations, stakeholder interests, and resource allocation, and assesses the lessons that the Yugoslav experience offers for contemporary debates on participatory governance and the sustainability of healthcare systems, while identifying areas of convergence, debate, and gaps in the existing scholarship. Methods: We conducted a systematic narrative review of peer-reviewed articles, book chapters, conference papers, and commentaries published in English or Bosnian–Croatian–Montenegrin–Serbian that covered the period 1945–1991. Scopus, PubMed, and EBSCOhost (including CINAHL Plus with full text, Medline and PsychInfo) were searched on 19 January 2026. Studies were included if they addressed health system reform, self-management, governance, financing, or institutional continuity. Contextual studies of selected services—primary care, mental health, reproductive health, and vaccination—were included only if they illuminated reform trajectories. Data synthesis focused on reform phases, institutional transformations, financing arrangements, governance mechanisms, and power relations, with particular attention to continuity, path dependence, and critical junctures. Given the heterogeneous and predominantly historical, analytical, and policy-oriented nature of the literature, we did not apply conventional study-design-specific risk-of-bias tools. Instead, we used an overarching framework to classify and contextualise the included evidence according to five dimensions: source type, nature of contribution, evidentiary role, temporal context, and health-system domain. The protocol was not registered. The study was financed by the Provincial Secretariat for Higher Education and Scientific Research, Autonomous Province of Vojvodina, Republic of Serbia. Results: The database searches yielded 265 records, of which 193 were selected for title and abstract screening after removing 72 duplicates. At this stage, 133 publications were excluded because they did not meet the eligibility criteria and 60 publications were selected for full-text review. Application of the predefined inclusion and exclusion criteria resulted in 22 eligible publications. An additional 18 studies were identified through citation chaining and targeted Google Scholar searches. Twenty-two publications were coded as primary studies, directly examining health system reform, governance, or self-management, while 18 were classified as contextual studies addressing specialty areas. The analysis identified key reforms that followed the social participation, i.e., ‘self-management’, approach, which expanded primary care, preventive services, and local participation. It revealed institutional changes, as well as the role of power and health financing in health reforms aimed at strengthening social participation. Nonetheless, challenges—including bureaucratic and managerial elitism, unequal professional authority, resource scarcity, and tensions between market-oriented policies and social solidarity—were amplified by global economic forces and neoliberal trends, ultimately contributing to the system’s collapse by the late 1980s. This review was limited by its search strategy, the exclusion of grey literature, the potential omission or inaccessibility of relevant studies, and its focus on selected aspects of health reform, namely post-war recovery and self-management. Conclusions: The Yugoslav experience illustrates both the promise and the fragility of socially oriented, participatory health systems, demonstrating how international political alignments and global economic pressures can profoundly shape domestic health reform trajectories. Lessons from this case remain relevant to contemporary efforts to strengthen social participation for universal health coverage through designing sustainable, resilient, equitable, and socially accountable health systems under complex global conditions.

Background: The Health in All Policies (HiAP) approach promotes the systematic integration of health considerations into policymaking across non-health sectors to address social determinants of health and improve population health outcomes. Although increasingly recognized internationally, the extent of its legislative implementation in the Republic of Srpska remains unclear. Objective: To assess the extent to which HiAP principles are embedded in sectoral legislation in the Republic of Srpska and to identify strengths and gaps in current legal frameworks. Methods: A structured content analysis of the text of laws was conducted across ten priority sectors. Twenty-two laws were reviewed using an analytical framework based on five core HiAP components: health outcomes, intersectoral governance, health equity, evidence-informed policymaking, and monitoring and accountability. The presence and distribution of these components were systematically examined across sectors. Results: Health considerations were frequently reflected in the text of the analysed legislation. Explicit references to health outcomes and intersectoral governance were identified in more than 60% of laws. However, integration was uneven across sectors. Health equity principles were inconsistently incorporated, while monitoring, evaluation, and accountability mechanisms were insufficiently developed, with explicit provisions found in fewer than half of the laws. No analysed law formally mandated Health Impact Assessment as a policy instrument. Conclusions: The Republic of Srpska has an existing legislative basis for advancing HiAP, but implementation remains fragmented rather than systematic. Addressing identified gaps-particularly in health equity, Health Impact Assessment, and health-oriented monitoring mechanisms-through targeted legislative reforms could improve policy coherence, accountability, and long-term sustainability. To our knowledge, this is the first systematic content analysis of HiAP integration in the sectoral legislation of the Republic of Srpska; it applies a replicable analytical framework derived from the WHO HiAP Framework for Country Action that is transferable to other decentralised and transitional governance settings.

Over the past decade, microplastics (MPs) have emerged as a major global environmental and public health concern due to their persistence and accumulation across ecosystems (Ali et al. 2024; Ghosh et al. 2023). Addressing this issue is particularly challenging for countries such as the Republic of Serbia, which are still in the process of aligning national legislation with EU environmental standards (Prokić et al. 2025). Life Cycle Assessment (LCA) evaluates environmental impacts throughout the entire life cycle of products or processes, making it a valuable tool for evidence-based policymaking (Bicalho et al. 2017; Fang et al. 2025). However, its application to microplastic pollution is still evolving and requires further investigation (Prokić et al. 2025; Hunt et al.1996; Xayachak et al. 2024). This paper explores key barriers and potential opportunities for integrating LCA into microplasticrelated policy and decision-making in Serbia, within the broader context of global efforts to strengthen environmental governance, particularly in EU-associated countries.

EU accession countries, including the Republic of Serbia, are under growing pressure to align their plastic waste management systems with EU environmental directives. Despite this, significant challenges remain, including inadequate infrastructure, a limited recycling capacity, and weak enforcement mechanisms. This study employs life cycle assessment (LCA) to evaluate the environmental impacts of polyethylene terephthalate (PET) packaging waste in Serbia, focusing on three end-of-life scenarios (EoL): landfilling, recycling, and incineration. Using GaBi Professional v6.0 software and the ReCiPe 2016 methodology, the results indicate that mismanaged PET waste contributes notably to terrestrial ecotoxicity (3.69 kg 1.4-DB eq.) and human toxicity (non-cancer) (2.36 kg 1.4-DB eq.). In 2023, 14,967.8 tons of PET were collected by authorized operators; however, unreported quantities likely end up in landfills or the natural environment. Beyond the quantified LCA results, this study highlights microplastic pollution as an emerging environmental concern. It advocates for the development of Serbia-specific characterization factors (CFs) for PET microplastics, incorporating localized fate, exposure, and effect data. Tailored CFs would enhance the precision of impact assessments for Serbian terrestrial ecosystems, contributing to more effective, evidence-based environmental policies. These insights are crucial for supporting Serbia’s transition to sustainable waste management and for meeting EU environmental standards.

Purpose To anticipate the impact of illegal landfills, development of new models should become a part of environmental risk management strategies. One of such approaches includes applications of the artificial neural network (ANN). The main objective of this study was to elucidate the impact of illegal landfilling on the surrounding soil environment and human health, as well as to establish an artificial neural network (ANN) models for predicting the hazards of illegal landfilling as an effective tool in decision-making and environmental risk management. Methods The identification of heavy metals source in soil was performed by principal component analysis (PCA). To assess the sensitivity of the soil ecosystem to heavy metal concentrations, Soil Quality standards and quantitative indices were used. The possible health effects were valued using the average daily doses (ADDs), hazard quotient (HQ), hazard index (HI), and carcinogenic risk (CR). ANN modeling was used for the prediction of heavy metal concentrations in the soil based on landfill size, municipality size, the number of residents, plant species, soil, and landform types. Results The average values of the pollution indexes for Cd were in the moderately contaminated and very high contamination categories. The HQ values were lower than the safe level. Cr and Pb posed a significant CR for adults and children, and Ni for children. The ANN models have exhibited good generalization power and accurately predicted the output parameters with a high value of the coefficient of determination. Conclusion Concerning heavy metal concentrations, illegal landfills near agricultural soil have a significant impact on the soil ecosystem and people’s health. The developed ANN models can be applied generally to anticipate the heavy metal concentrations in soil, according to the before mentioned input parameters, with high accuracy.

The management of Construction Waste (CW) presents a significant challenge in sustainable development efforts. This study employs data modeling techniques to predict the annual quantities of various types of construction waste, encompassing total waste, metal waste, plastic waste, wood waste, mineral waste, and soil/concrete waste (CW1 - CW8, respectively). The study has mainly focused on reusable construction waste. For this purpose, 7 models were developed for each type of construction waste - 5 polynomials (from the first to the fifth degree), Artificial Neural Network (ANN) and Support Vector Machine (SVM) models. The ANN models were found to be the most effective for all types of CW compared to the other models developed. The ANN models developed for CW1, CW6 and CW7 had a high R-2 value (> 0.85), indicating their potential for predicting the amount of these types of CW in the future. The ANN models developed for the remaining types of CW had weaker performance (R-2 < 0.60), but their performance could be improved in the future investigations with an increase in the amount of data on CW generation. This research underscores the importance of employing advanced data modeling techniques in addressing the challenges of construction waste management. By providing accurate predictions of CW generation, stakeholders can better strategize waste reduction, recycling, and disposal efforts, thereby contributing to the sustainable development goals of minimizing environmental impact and promoting resource efficiency in the construction sector.

The efforts toward reducing air pollution are influenced by a multifaceted interplay of sociological, psychological, demographic, and economic factors. Mathematical models have been developed to bridge the gap between theoretical concepts and practical actions, providing insights into consumer behaviour (BEH) within specific contexts. One such model, Ajzen’s Theory of Planned Behavior (TPB), stands as a valuable conceptual framework for understanding attitudes (ATT), subjective norms (SN), and personal behaviour control (PCB). Motivation: Data were collected via Google Forms to capture insights into the perceived importance of air quality monitoring and the public’s awareness of pollution issues. These data are expected to contribute to a deeper understanding of public perceptions regarding air pollution and the necessity of advanced monitoring technologies in urban environments. Hypothesis (H): H1 suggests that reducing air pollution involves various contributing factors. Subsequent H proposes that the overall ATT H2, SN H3, and PBC H4 significantly influence intention (INT) to reduce air pollution. Furthermore, H5 concerning SN and H6 associated with PBC aims to elucidate their impacts on fostering a sense of being a responsible provider (GPI). Hypothesis H7 indicates the influence of GPI on INT to reduce air pollution. The final two hypotheses H8 delve into the impact of INT on air pollution reduction on BEH, and H9 explores the influence of GPI on BEH. Method: Statistical software IBM SPSS was utilized to analyze the questionnaire outcomes. Additionally, IBM Amos statistical software was employed for Structural Equation Modeling (SEM). Results: INT emerged as the most influential factor driving actual BEH, while the sense of responsibility as a caretaker also significantly influenced participants’ actions concerning air pollution. Conclusion: The model is positioned to inform policy-makers and stakeholders by identifying key points, in this case, ATT and BEH, can be targeted to effectively influence public toward air quality management.

Background The main goal of the paper is to review the existing state and propose a model solution for the introduction of the waste-to-energy concept in the Republic of Serbia and Bosnia and Herzegovina, as these Balkan countries are a source of high pollution due to the inefficient use of fossil fuels and the operation of coal-fired power plants. Besides, these countries have very low level of waste management, which results in the uncontrolled disposal of a large amount of waste which consists of plastic and microplastic materials which are difficult to decompose in natural ecosystems. Methods Considering the type and objectives of the study, a mixed research method was chosen as a combination of exploratory research, descriptive research, explanatory research, and modeling. Results The main result of the research shows the unfavorable situation in the field of waste management in the Republic of Serbia, as well as in Bosnia and Herzegovina. Both countries have adopted adequate strategies and plans, but waste management is not implemented accordingly, Nevertheless, numerous problems create considerable opportunities for improvement, especially regarding the potential for energy production from waste, which is an important approach to implementing the circular economy model. The study showed that the situation is particularly unfavorable in rural areas. Hence, the research proposes (a) a novel model for waste-to-energy governance and (b) a novel model for waste-to-energy management in rural areas. The research was done, and models were developed based on the examples of the Republic of Serbia, and Bosnia and Herzegovina. However, the results can be used in countries with a similar level of waste management and with a larger share of rural areas. Conclusions The paper emphasizes the importance of a holistic and systemic approach to waste management, with emphasis on using waste-to-energy concept as particularly applicable in the transition to circular economy. This study proposes a model for the integration of waste management (with emphasis on plastic and microplastic) and energy efficiency, presenting a model of approach that can be used in countries that are at the beginning of introducing a circular economy.

The main objective of this study is to determine the possibility of predicting the impact of land use and soil type on concentrations of heavy metals (HMs) and phthalates (PAEs) in soil based on an artificial neural network model (ANN). Qualitative analysis of HMs was performed with inductively coupled plasma–optical emission spectrometry (ICP/OES) and Direct Mercury Analyzer. Determination of PAEs was performed with gas chromatography (GC) coupled with a single quadrupole mass spectrometry (MS). An ANN, based on the Broyden–Fletcher–Goldfarb–Shanno (BFGS) iterative algorithm, for the prediction of HM and PAE concentrations, based on land use and soil type parameters, showed good prediction capabilities (the coefficient of determination (r2) values during the training cycle for HM concentration variables were 0.895, 0.927, 0.885, 0.813, 0.883, 0.917, 0.931, and 0.883, respectively, and for PAEs, the concentration variables were 0.950, 0.974, 0.958, 0.974, and 0.943, respectively). The results of this study indicate that HM and PAE concentrations, based on land use and soil type, can be predicted using ANN.

This study aimed to investigate the impact of road and rail traffic on the soil through the analysis of the presence of heavy metals in soil samples collected next to a busy highway, local roads, and next to an active railway line. Results showed that cars emitted higher levels of heavy metals than trains. Soil samples near the highway had higher levels of Cu, Ni, and Hg. The values of the calculated indices like geo-accumulation index, potential toxicity response index, ecological risk factor, contamination factor, pollution load index, Nemerow's pollution index, and degree of contamination confirm that the soil samples sampled near the highway are the most polluted and highway have the greatest negative impact on the soil environment. These results suggest that controlling car emissions through strict regulations and promoting public transportation could effectively reduce the heavy metal concentrations in soil, particularly from highway emissions.

Construction products based on brick clay have been intensively used for the construction of buildings in the Republic of Serbia. The basic raw material for the manufacture of these products is brick clay, which is a natural mineral resource. However, the natural origin of clay provides no guarantees as to whether this group of construction products is eco-friendly. The production of baked clay construction products significantly affects the environment and cannot be neglected. The existing eco-labels used for this group of products are not uniform, in the world or in Serbia. The aim of this paper is to present a new approach to eco-labelling of construction products based on baked clay in the Republic of Serbia. Eco-labels can be given to products which meet certain authentic criteria. The criteria is based on an innovative set of 24 indicators which connect the production of construction products and the impact on the environment. Indicators were defined for the most commonly used construction products—facade brick, standard block and energy block. The research was conducted on leading producers of baked clay construction products in three regions—Northern Serbia, Western Serbia and South Pomoravlje. The obtained results indicate that one of the producers meets the criteria for innovative eco-labelling. The remaining two producers do not meet the requirements for the eco-label at the moment because there is not enough available data on the grounds of which certain indicators could be valued in a more complete manner. The data are unavailable to third parties because they are treated as a trade secret. Further research and an upgrade of the indicator set would create an opportunity to expand the number of baked clay construction products which could obtain the eco-label based on indicators.

Based on the UNEP Food Waste Index Report 2021, approximately 931 million tons of food waste were generated in 2019, with nearly 570 million tons of that waste occurring in households. Hunger affects more than 800 million people worldwide. Furthermore, the non-consumption of food accounts for 8-10% of global greenhouse gas emissions. Therefore, food waste generation has significant environmental, societal, and economic consequences. The circular economy (CE) is an economic model that seeks to reduce waste and extend resource life. The purpose of this study is to examine and present the connections between the CE, the Sustainable Development Goals (SDGs), and food waste management. Food waste management is commonly regarded as an environmental issue. Still, it also offers vital economic and social benefits for sustainable development. The first section of the research looks at the function of food waste management in the transition to a circular economy. The second part of this study examines the SDGs in food waste management and circular economy. The findings revealed that the most significant connections and synergies between food waste management, circular economy practices, and SDG targets could be found in SDG 2 (Zero Hunger) and SDG 12 (Responsible Consumption and Production). Both goals have high scores for direct and indirect contributions.

The interactions of heavy metals and cement phases in the solidification/stabilization (S/S) pro-cess have been examined. The S/S method was applied to the waste sludge contaminated with heavy metals to determine the conditions under which the treated materials can be safely disposed of at land-fills for inert, non-hazardous, or hazardous waste. Sludge samples were mixed with soil and sand to simulate improper sludge disposal directly into the soil. S/S technology was selected using different cement fractions to treat these contaminated samples. The use of Portland cement or mixtures of dif-ferent types of cement for the treatment of sludge containing heavy metals is widespread. Samples of leached content were analyzed for the presence of the following metals: arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), nickel (Ni), and zinc (Zn). The study results lead to the conclusion that the sludge contaminated with heavy metals after the application of S/S with the addition of different cement fractions is transformed into non-hazardous, monolithic material.

Dimethachlor is an herbicide used for oilseed rape protection. Previous studies have demonstrated its high mobility in the soil, which could lead to water contamination. This research aimed to determine the occurrence of dimethachlor and its metabolites (dimethachlor ethanesulfonic acid ESA and dimethachlor oxalamic acid OA) in surface water using a recently developed analytical method. This article is one of the first to document dimethachlor and its metabolites’ presence in surface water samples. The samples were collected from the Danube river and Tisza river. The quantitative determination of dimethachlor and its metabolites in the obtained extracts was done by high-performance liquid chromatography. Descriptive statistical methods, including correlation analysis, cluster analysis, and principal component analyses, were utilized to analyze method validation experimental results. In addition, the artificial neural network (ANN) model was applied as an optimization tool. The developed ANN model adequately predicted observed variables, suggesting the optimum results were obtained at a pH value 7, spike value 1, and injection volume equal to 0.5 μL. The average concentrations in Danube River samples were 1.51 µg/L for OA 0.01 µg/L for ESA, and 0.63 µg/L for DMC, while the average concentrations of chloroacetanilide herbicides detected in Tisza River samples were 1.43 µg/L for OA, 0.08 µg/L for ESA and 1.82 µg/L for DMC.

Land exploitation directly affects the physico-chemical characteristics of the soil. Agricultural land can often be seen near the landfills. The question is how much waste affects the production potential of land. The research in this paper is focused on the influence of the municipal waste landfill on the physico-chemical characteristics of the soil. In soil samples were analyzed: pH in KCl, pH in H2O, CaCO3, humus, total nitrogen, P2O5, K2O and organic carbon. The obtained results indicate a negative impact of waste on the content of OC and the content of easily accessible phosphorus and potassium.

The optimal conditions for the extraction of eight polybrominated diphenyl ethers (PBDEs) were determined using 32 factorial design of experiments (DOE). The independent variables were coded at three levels and their actual values were selected on the basis of the preliminary experimental results. DOE consisted of nine runs with three replicates at the central point. A second-order polynomial model was used for predicting the response. After the optimization of the duration of extraction, the ratio of solvents and purification and instrumental parameters, the optimized conditions were applied on the samples taken from the surface layer of soil from 24 potentially contaminated locations (landfills, ex marshalling yard, dump of secondary raw materials and automotive waste). The gas chromatographic analysis with electron capture detection (GC-ECD) was used for the determination of PBDEs. The recovery values of BDE congeners at five concentration levels ranged between 80% and 115%. The total PBDEs concentrations ranged from 4.4 to 729 ?g kg-1 of absolutely dry soil. The suitability of the experiment was proved by comparing the experimental and predicted values of the variable parameters.

The aim of this study was to use the life cycle assessment (LCA) instrument to assess the different municipal solid waste (MSW) management scenarios for the South Bačka region. LCA has proven to be a very effective instrument for identifying strategies that minimize negative environmental impacts. A comparative analysis is very important for decision makers and planners in the waste sector. This paper presents the application of the LCA model described in the Part I of this study. This model combined life cycle inventory model (IWM2) and life cycle impact assessment method (Impact2002+) to compare and evaluate the municipal solid waste system with the purpose of identifying environmental benefits and disadvantages, as well as the economic cost of defined scenarios of waste management systems that could be implemented. The model was applied to a regional municipal waste management system in South Bačka (The Republic of Serbia). Four scenarios of waste management are defined. The scenarios include the combination of different treatments of waste (biological and thermal), and a sanitary landfill. The results show clear differences between the scenarios in the selected indicators and quantify the relative advantages and disadvantages of different waste management scenarios. The model is a useful tool to support decision-makers to choose the technology of solid municipal waste treatment. Also, the participants in the planning of solid waste management will enable a better understanding of the importance of LCA method. Finally, it will help the improvement of the strategic planning process in the field of environmental protection, without which it is impossible to achieve the concept of sustainable development in the AP Vojvodina.

Overuse of fertilizers can have harmful effects on the environment. The Nitrates Directive aims to protect water quality by preventing nitrates from agricultural sources polluting ground and surface waters and by promoting the use of good farming practices. The paper is based on research about agricultural producers’ awareness about the impact of fertilizers overuse on the environment. Data were collected by face to face interviews with farm owners on 39 farms in Serbia. Analysis of the collected data showed that all farmers use fertilizers. It is important to notice that 79.4% of farmers use chemical fertilizers more than recommended, and 87.1% use organic fertilizers more than recommended. Furthermore, 66.6% of farmers do not know specific harmful pollution effects of nitrates on soil and water. 71.7% of farmers have not heard about the Nitrates Directive. Therefore, it can be concluded that farmers are not sufficiently aware of fertilizers impact on the environment and it is necessary to provide education on this.