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European Region
North Macedonia

Technical Contacts

UHC Partnership Implementation

Programmatic and Financial

Status
19
Activities
Completed/Canceled
Status Product/Service Deliverables Last updated Updated by
view Completed Establishment of Policy Analysis Team in the Ministry of Health In the post-independence era, North Macedonia has strived to reform its healthcare system to meet its population's needs more effectively. Despite significant investments, reforms have fallen short, often due to incomplete implementation and limited capacity within the Ministry of Health (MoH) to lead, organize, monitor, analyze, and take corrective action. To address these challenges, the MoH, supported by the WHO, initiated capacity-building measures, including the formation of the Policy Analysis Team, to enhance evidence-informed policy development and monitoring policy or program implementation, and ensure that corrective action is taken when needed. The PA Team is established to support the Minister-of-Health’s evidence-informed decision-making by strengthening the MoH's ability to develop and ensure continual monitoring of the implementation of policies and programs towards improved health system’s performance. Its objectives are to: Monitor and analyze the health system's performance, identifying needs and ensuring implementation of corrective action. Analyze policy options, assessing their potential impact. Organize development and capacity building activities for the MOH to improve its performance. Produce policy briefs and recommendations for MOH decision-makers. vrackop@who.int
view Completed Flagship course on Health System Strengthening - Pilot The WHO CO in North Macedonia, piloted a new, leading course for health system strengthening. The three-day workshop in Ohrid (May 29 – 31, 2024) equipped stakeholders with the necessary knowledge and skills for the effective transformation of the health system. Participants gained a more detailed understanding of the core goals of the health system, its functions, and performance monitoring, with a special focus on policy and strategy development for system improvement. Participants in the training included representatives from the Ministry of Health, the Health Insurance Fund, the National Agency for Medicines (MALMED), the State Health and Sanitary Inspectorate, the Directorate for e-Health, the Agency for Quality and Accreditation of Health Institutions, the civil sector, patient organizations, UNICEF, and the World Bank. atanasovas@who.int
view Completed Hospital sector restructuringRestructuring and regionalization of the hospital sector in North Macedonia is the main health sector priority of the new Government in North Macedonia. In 2024, WHO supported the Ministry of Health in designing and establishing the governance structure for leading the reform. Health Council has been established serving as a supervisory board, and two working groups have been nominated, one for re-unification of the University clinics into University Clinical Center Skopje and the other for restructuring and reclassification of the regional hospitals. The project for reclassification of regional hospitals has been funded by the European Commission. WHO Scoping Mission on Hospitals in North Macedonia (11-15 March, 2024)From 11-15 March, 2024, the WHO Country Office, in collaboration with the Regional Office for Europe, conducted a scoping mission in North Macedonia to evaluate the hospital sector and align health service management with global objectives, particularly Universal Health Coverage. This mission aimed to support the Ministry of Health's 2030 strategic goals by identifying areas for improvement and capacity enhancement in the hospital sector. The mission focused on developing a unified vision for hospital services, identifying key areas for capacity building and technical assistance, and promoting the integration of services based on patient-centered approaches. Through targeted meetings, field visits, a workshop, policy dialogues, and consultations with international stakeholders, the mission laid the groundwork for strategic improvements in North Macedonia's hospital sector, aligning with the WHO’s Vision for Hospitals within a Primary Healthcare System and supporting the country's health sector reforms and EU integration goals. kosbayevaa@who.int

Products/Services

Start date
Product/Service Deliverables Status Programme Implementation Start date End date User Contacts Last updated Updated by
High % of total health expenditures for medicines; High out-of-pocket (OOP) expenditures for medicines. Systematic liaison with main national authorities in the Pharmaceuticals System (MoH, Health Insurance Fund, National Medicines Agency), along with other stakeholders (NPHI, academia, professional associations, patients’ associations) to identify root & system-level causes for high overall expenditures and high OOP for medicines. High-level policy dialogue on access to medicines, in the National Parliament, to gain the commitment of policymakers and stakeholders to ensure better and more equitable access to essential and novel medicines Updated the list of reimbursed medicines (Positive List), after several years.
The National Platform on Access to Medicines was established, bringing together all stakeholders. Initiated the revision of the medicines pricing mechanisms, analysis and streamlining of the medicines purchasing channels and established transparent monitoring of medicines expenditures
On track
80%
 Jan 01,2024 Dec 22,2025 downeyc@who.int
Hospital sector restructuringRestructuring and regionalization of the hospital sector in North Macedonia is the main health sector priority of the new Government in North Macedonia. In 2024, WHO supported the Ministry of Health in designing and establishing the governance structure for leading the reform. Health Council has been established serving as a supervisory board, and two working groups have been nominated, one for re-unification of the University clinics into University Clinical Center Skopje and the other for restructuring and reclassification of the regional hospitals. The project for reclassification of regional hospitals has been funded by the European Commission. WHO Scoping Mission on Hospitals in North Macedonia (11-15 March, 2024)From 11-15 March, 2024, the WHO Country Office, in collaboration with the Regional Office for Europe, conducted a scoping mission in North Macedonia to evaluate the hospital sector and align health service management with global objectives, particularly Universal Health Coverage. This mission aimed to support the Ministry of Health's 2030 strategic goals by identifying areas for improvement and capacity enhancement in the hospital sector. The mission focused on developing a unified vision for hospital services, identifying key areas for capacity building and technical assistance, and promoting the integration of services based on patient-centered approaches. Through targeted meetings, field visits, a workshop, policy dialogues, and consultations with international stakeholders, the mission laid the groundwork for strategic improvements in North Macedonia's hospital sector, aligning with the WHO’s Vision for Hospitals within a Primary Healthcare System and supporting the country's health sector reforms and EU integration goals.
Completed
65%
 Mar 11,2024 Dec 31,2024 kosbayevaa@who.int
 Strengthening HRH planning and developmentA mission on HRH Planning and Governance, May 2024A workshop on Effective Health Workforce Planning and Data Management, September 2024Moving towards establishing a HRH/HWF strategic planning and development function at MoH. Consolidating National HWF Register, to be used for HRH/HWF planning.HRH Strategy Development: WHO Expert Mission CompletedFollowing a comprehensive health labor market assessment, the WHO Country Office in North Macedonia, in collaboration with the WHO Regional Office for Europe, has successfully organized an expert mission to North Macedonia. This mission, aligned with the Ministry of Health's commitment to HRH strategy formulation, involved a two-day national induction workshop to shape and initiate the process of developing North Macedonia's first Human Resources for Health (HRH) Strategy. This effort underscores the collective commitment to advancing North Macedonia's health workforce and aligning with global health objectives.
Ongoing
0%
 Nov 28,2023 Dec 31,2024 vrackop@who.int
Master plan for PHC and a Roadmap for implementation To strengthen the health system, the Ministry of Health in North Macedonia, with support from the WHO, is initiating a process of formulating a comprehensive Primary Health Care (PHC) Master Plan and an accompanying Roadmap for Implementation. Building on the foundations laid by the 2019 PHC Reform and subsequent policy documents, these strategic initiatives aim to enhance the quality, accessibility, and sustainability of PHC services and support the PHC reform implementation.
On track
0%
 Feb 15,2023 Aug 16,2024 vrackop@who.int
Technical Support to advance Nursing and Midwifery Professions in North Macedonia by reforming education and introducing regulation of the professions- Discussions with Slovenian Embassy in North Macedonia and the Ministry of Foreign Affairs of the Republic of Slovenia for extension of the existing project.- Joining of UNICEF to the project, by ensuring funding for the work of Working Groups members.- 3-day workshop with the Working Groups and other professional and policy making stakeholders on what needs to be done and how to advance nurses and midwives education and to establish regulatory body for both professions. - A scoping mission on nurses and midwives education in North Macedonia in September 2024, by full-professor of nursing from Slovenia.- A Nursing Task Force and 4 Working Groups (education, regulation, legislation, promotion) have been established in the MoH with the objective to serve as a national counterpart in implementing the bilateral development project with the Republic of Slovenia called "Advancing Nursing and Midwifery Profession in the Republic of North Macedonia 2024-2025."- From 2-5 June 2024, study visit of the national nursing team and the WHO CO to Slovenia was conducted as part of the project "Advancing Nursing and Midwifery Profession in the Republic of North Macedonia." The visit aimed to learn from Slovenia's successful models in nursing and midwifery, engage with key stakeholders, and identify collaboration opportunities. Insights gained will inform the project's implementation and support the professional development of nurses and midwives in North Macedonia.
Ongoing
0%
 Jun 15,2024 Dec 16,2025 vrackop@who.int
Establishment of Policy Analysis Team in the Ministry of Health In the post-independence era, North Macedonia has strived to reform its healthcare system to meet its population's needs more effectively. Despite significant investments, reforms have fallen short, often due to incomplete implementation and limited capacity within the Ministry of Health (MoH) to lead, organize, monitor, analyze, and take corrective action. To address these challenges, the MoH, supported by the WHO, initiated capacity-building measures, including the formation of the Policy Analysis Team, to enhance evidence-informed policy development and monitoring policy or program implementation, and ensure that corrective action is taken when needed. The PA Team is established to support the Minister-of-Health’s evidence-informed decision-making by strengthening the MoH's ability to develop and ensure continual monitoring of the implementation of policies and programs towards improved health system’s performance. Its objectives are to: Monitor and analyze the health system's performance, identifying needs and ensuring implementation of corrective action. Analyze policy options, assessing their potential impact. Organize development and capacity building activities for the MOH to improve its performance. Produce policy briefs and recommendations for MOH decision-makers.
Completed
0%
 Jan 15,2024 Sep 15,2024 vrackop@who.int
Expert support to produce a health account studies for 2021 and 2022 for North Macedonia initiated and ongoing Health account studies for 2021 and 2022 for North Macedonia
Completed
0%
 Apr 02,2023 Dec 31,2023 spasenoskad@who.int atanasovas@who.int
Workshop about how data-driven evidence from tracking health spending can inform and influence policy decisions in the North Macedonia is planned in the period 19-20 December 2023. The workshop aims to explore the critical role of health spending data in shaping evidence-based policies. Emphasis will be given on tracking Primary Health Care (PHC) spending, Mental Health spending, and other non-communicable diseases spending (i.e. diabetes). The objectives is to enhance the capacity of policy makers in effectively monitoring and managing health spending using the heath accounts studies.
Completed
0%
 Nov 28,2023 Nov 29,2023 atanasovas@who.int
Asthma Training for Pharmacists in Primary Health Care Reform. As part of the Ministry of Health's reform to strengthen primary health care, a key focus is on implementing clinical protocols and pathways to ensure a high standard of care. This is in line with updates to legislation, the positive medicines list, health information system digitization, and performance-based reimbursements. In addition, the renewed primary health care model emphasizes multidisciplinary team collaboration, including pharmacists. A training program was delivered to empower pharmacists with skills in asthma management, early symptom recognition, referral procedures, education on risk factors, and inhalation therapy administration, aligning with the Ministry's priority health conditions.
Completed
0%
 Nov 28,2023 Nov 29,2023 atanasovas@who.int
Flagship course on Health System Strengthening - Pilot The WHO CO in North Macedonia, piloted a new, leading course for health system strengthening. The three-day workshop in Ohrid (May 29 – 31, 2024) equipped stakeholders with the necessary knowledge and skills for the effective transformation of the health system. Participants gained a more detailed understanding of the core goals of the health system, its functions, and performance monitoring, with a special focus on policy and strategy development for system improvement. Participants in the training included representatives from the Ministry of Health, the Health Insurance Fund, the National Agency for Medicines (MALMED), the State Health and Sanitary Inspectorate, the Directorate for e-Health, the Agency for Quality and Accreditation of Health Institutions, the civil sector, patient organizations, UNICEF, and the World Bank.
Completed
0%
 Aug 15,2024 Aug 16,2024 atanasovas@who.int
Ambulatory Care Sensitive Conditions (ACSC) Analysis The ACSC analysis has been launched to build upon previous work conducted in 2017. The objective of this activity is to annually compare trends in referrals and hospitalizations related to ACSC from 2017 onwards. ACSC are conditions that can be effectively prevented, diagnosed, and treated in primary health care, including acute, chronic, and vaccine-preventable conditions. As these conditions serve as a proxy for the quality of care, this analysis aims to identify unnecessary hospital admissions, which may indicate inconsistencies in referral and admission practices among healthcare providers. The findings from this analysis will help improve the uniformity and effectiveness of primary health care services.
On track
0%
 Aug 15,2024 Aug 16,2024 atanasovas@who.int
Health Financing Assessment Mission in North Macedonia (7-12 April, 2024) The WHO CO and the WHO Barcelona Office for Health Financing conducted a mission in North Macedonia from 7-12 April, 2024, to assess the effectiveness of the country's health financing system, with an emphasis on primary care provider payment mechanisms. The mission evaluated the system's capacity to deliver universal health coverage, identifying strengths, weaknesses, and areas for improvement. It also reviewed the performance of primary care financing, focusing on coverage policies, budgeting practices, provider payments, and incentive alignment. Based on these assessments, the mission provided actionable recommendations to strengthen the overall health financing system, particularly in primary care.
Completed
0%
 Apr 01,2024 Apr 25,2024 atanasovas@who.int
Case study on tracking mental health spending (MHF) in North Macedonia developed.
Completed
0%
 Nov 28,2023 Nov 29,2023 atanasovas@who.int
Health accounts (HA) validation process for 2021 and 2022 for North Macedonia completed.
Completed
0%
 Apr 01,2023 Dec 31,2023 spasenoskad@who.int atanasovas@who.int
Successful Completion of PHC Communication Campaign In response to the Ministry of Health's commitment to strengthen primary health care (PHC), a communication strategy was initiated in 2023. WHO supported the national efforts in presenting the PHC reform through a press conference, developing a leaflet, and creating a documentary video. As part of the campaign the national expert team also organized TV appearances, regional visits of primary health centers, and preparatory meetings, overseeing the campaign's implementation.
Completed
0%
 Nov 28,2023 Nov 29,2023 atanasovas@who.int
Enhancing Patient Safety: Training in North Macedonia The WHO Country Office in North Macedonia, alongside the WHO Athens Office and local experts, has crafted two key training packages. These cover Leadership and Management for Patient Safety and Measures and Activities for Patient Safety at the Hospital Level. The primary goal of these training packages is to enhance the prioritization of patient safety within hospitals by increasing awareness, imparting crucial measures and activities for patient safety, and presenting strategies for delivering superior and safer care in each hospital in North Macedonia. This initiative also shares valuable insights from experiences in the European Region. Note: UHC initiative supported only the development of the training package, while it’s implementation was supported with the USAID funds.
Completed
0%
 Nov 28,2023 Nov 29,2023 atanasovas@who.int
Study tour to NHS Scotland. Four national stakeholders participated the study visit with the objectives to a) learn about how NHS Scotland approaches the delivery of PHC services and seeks to recruit and retain HRH in remote and underserved areas, b) learn from other countries/nations how they have addressed similar issues.  
Completed
0%
 Apr 23,2023 Apr 30,2023 atanasovas@who.int
Follow up on the implementation of the national Master plan for perinatal care and the perinatal network of care model, by performing field visits, identification of challenges and organization of a national workshop for presentation of the findings from the latest perinatal mortality audit (2020) and for identification of next steps strengthening the functioning of the perinatal care network sites
Completed
0%
 Apr 01,2023 Dec 31,2023 spasenoskad@who.int atanasovas@who.int
National participation to the 5th Subregional meeting on tracking health spending, 4-6 April 2023, Istanbul, Turkiye (MKD) supported aiming at capacity building of the key national team working on tracking health spending
Completed
0%
 Apr 01,2023 Dec 31,2023 spasenoskad@who.int atanasovas@who.int
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