Overview

North Macedonia has a centralized health system financed through a mandatory social health insurance (SHI) scheme with a single public payer, the Health Insurance Fund. The SHI system covers the entire population with a broad benefits package, although gaps remain for individuals without regular employment and access can be limited by capacity constraints in the public sector.

In 2022, health spending was US$ 1815 per capita (adjusted for purchasing power), with out-of-pocket (OOP) payments accounting for 40.2% of total health expenditure—among the highest shares in South-eastern Europe.

Recent reforms have prioritized digital health solutions, the adoption of digital health solutions, such as the electronic health record (EHR), My Appointment, e-prescriptions and telemedicine, marks significant progress in integrating providers and treatments across care levels, enabling enhanced information sharing and an overall improvement in health care management To address workforce shortages and emigration, the government has introduced significant salary increases for health professionals and higher capitation rates for primary care doctors. Equitable access to high-quality care represents a National Health Strategy priority, but comprehensive quality improvement plans are still to be developed.