North Macedonia is undertaking a comprehensive health system reform anchored in the principle of Universal Health Coverage. The reform aims to ensure that all people can access affordable, quality and effective health services without financial hardship, while strengthening the resilience, efficiency and responsiveness of the health system. The UHC service coverage index was 69 in 2023, indicating the need to improve effective service coverage, quality, access and system capacity.

The Health Strategy 2021–2030, sets priorities to improve equity, quality of care, financial protection and health system performance, with a strong focus on primary health care, hospital modernization, essential medicines and digital health. These priorities are complemented by the National Development Strategy 2024–2044, which recognizes health as a driver of sustainable development, social inclusion, human capital and EU integration.

The country’s health profile is dominated by noncommunicable diseases, particularly cardiovascular diseases, cancers, diabetes and chronic respiratory diseases. Key risk factors include tobacco use, unhealthy diets, physical inactivity and air pollution. The health system also faces shortages and uneven distribution of health workers, especially in primary care, nursing, emergency care and some specialist services. These constraints are linked to workforce ageing, migration, limited multidisciplinary team-based care and gaps in workforce planning. Weak institutional capacity remains a cross-cutting bottleneck, particularly in implementation, monitoring and evaluation, procurement, health information management, quality assurance and interinstitutional coordination.