The former Yugoslav Republic of Macedonia HiT (2017)

Since its independence in 1991 population health in the former Yugoslav Republic of Macedonia has improved significantly, with life expectancy and mortality rates for both adults and children reaching similar levels as in ex-socialist EU Member States. However, death rates caused by unhealthy behaviour remain high.

The country has also made important progress in transitioning from a centrally-steered to a more market-based health system. Having inherited a large health care infrastructure, good public health services and well-distributed health service coverage, the country after independence reverted to a social health insurance system. Despite the broad benefit package, the levels of private health expenditure are still quite high and satisfaction with health care delivery is very mixed. Primary care providers were privatized and new private hospitals were allowed to enter the market. The public hospital sector in particular is characterized by inefficient organization and service delivery. However, significant efficiency gains were achieved through the introduction of a pioneering health information system that has reduced waiting times and led to the better coordination of care.

More broadly, the impact of professionals moving to other countries and to the private sector is being felt. This is also why future reforms will need to focus on sustainable planning and management of human resources as well as enhancing quality and efficiency of care.

HiT health system reviews are country-based reports that provide a detailed description of a country's health system and of reform and policy initiatives in progress or under development.