In 2025, Macedonia has implemented several significant health reforms aimed at improving healthcare quality, access, and efficiency.
In 2025, Macedonia has implemented several significant health reforms aimed at improving healthcare quality, access, and efficiency. Here are the key changes:
Strengthening the National Health Strategy (2021–2030)
As part of it’s long term National Health Strategy the Macedonian government has renewed its focus on improving healthcare quality, access, and efficiency. This initiative has been ongoing since 2021, with intensified implementation during 2024 and beyond. It affects public and private healthcare providers, the pharmaceutical industry, and the health insurance sector. The pros of this change include reducing premature mortality and improving the treatment of noncommunicable diseases, as well as encouraging better planning of health workforce needs. However, the lack of a comprehensive action plan with defined performance indicators and high out-of-pocket costs remain challenges.
Expansion of Private Primary Care Providers
All primary care practices have been privatised and now operate under contracts with the Health Insurance Fund (HIF). This change was fully implemented by 2024 and affects private healthcare providers and the Health Insurance Fund. The pros of this reform include potential increased efficiency and patient choice, as well as encouraging competition and innovation in primary care. However, there are risks of unequal access, especially in rural areas, and challenges related to oversight and quality control.
Health Workforce Planning Initiative
The Ministry of Health has launched a process to assess and plan for long-term health workforce needs. This initiative was initiated in 2024 and affects medical education and training institutions, as well as public health administration. The pros of this initiative include addressing shortages and emigration of health professionals and supporting strategic workforce development. However, it is still in the early stages, and its impact depends on execution. It may also require significant investment and policy coordination.
Zoran Georgiev
General Manager
GrECo North Macedonia
T +38977889088
