Attending the 2nd National Health Forum last week alongside North Macedonian Minister of Health Dr Venko Filipche, WHO Regional Director for Europe Dr Hans Henri P. Kluge welcomed the reforms taking place in the country’s health-care system.
Focusing on perinatal health service delivery, the new model aims to ensure quality, appropriate care at the right health facility and at the right time for all mothers and newborns.
“There are no quick wins when transforming a health system, as you are aiming to do here. But the approach you are taking is the only sustainable option: joining forces across all relevant sectors and working together to identify not only the challenges but, above all, the realistic, attainable solutions,” said Dr Kluge.
The proposed reforms to perinatal health service delivery were met with enthusiasm by participants at the National Health Forum. They include the classification of all relevant facilities according to the level of maternal and newborn care they provide, and the linking of these facilities into networks to improve continuity of care and offer risk-stratified care pathways.
In addition to further improvements to infrastructure and equipment, the master plan for perinatal health calls for investment in the health workforce and improvements to the transportation of mothers and newborns between hospitals.
To enhance clinical governance, the country is also planning to develop, collect and analyse new quality metrics for maternal and newborn health, launch quality improvement initiatives, and facilitate shared learning within and between the networks of facilities.
North Macedonia has also launched 2 primary health care (PHC) pilot sites as part of the PHC reforms begun last year with support from WHO. The reforms capitalize on the country’s strong points, including full demonstration of the capacity of the nurses and doctors working in PHC facilities, integration at all levels of care, and the electronic health information system Moj Termin. The new model centres on meeting the health needs of families and communities.
Dr Kluge visited one of the pilot sites to discuss changes in practices and the needs of the health workforce with the health workers themselves.
Health as an economic benefit and accelerator for development
Prime Minister Mr Oliver Spasovski and Minister of Finance Ms Nina Angelovska both expressed appreciation for Dr Kluge’s emphasis on the link between health and the growth of the national economy. They explained that, while more money is needed for health, there is also a need for more health for the money invested.
Dr Kluge added that there is evidence that investment in health in North Macedonia is benefitting the national economy, with a positive impact on local employment rates, working conditions and household-level income.
The Prime Minister agreed that investing in health provides direct economic gains and helps to ensure a healthy, economically active and sustainable workforce. Dr Kluge acknowledged the country’s efforts and the Prime Minister’s commitment to ensuring the right conditions for health workers – including prioritizing a salary increase.
Taking air pollution seriously
Dr Kluge also met with President Mr Stevo Pendarovski, who underlined how seriously he is taking the issue of air pollution. The President has placed air pollution on the national security agenda to engage a wide range of sectors – including nongovernmental organizations – that will make a difference to the health of North Macedonia’s citizens.
President Pendarovski also highlighted the need to first quantify the level of air pollution, collect credible data and monitor the effects of exposure to air pollution on public health. Dr Kluge explained that WHO can offer support through the European Centre for Environment and Health located in Bonn, Germany.
In addition, Dr Kluge praised the President’s project “MKD 2030 – a strategic development framework for the country for the next 10 years”. The project, which is based on the Sustainable Development Goals, will be launched by June 2020.
Dr Kluge expressed that he was pleased that digitalization is an important pillar of MKD 2030, noting that digital health and innovation will be a flagship initiative at WHO/Europe.
COVID-19
Throughout the visit, the ongoing COVID-19 outbreak dominated media coverage. Speaking with the media alongside Minister Filipche, Dr Kluge reiterated that people should be alert, stay informed, follow personal protective measures and avoid fake news.
Dr Kluge also expressed support for the North Macedonian Government, saying that they had implemented all of WHO’s guidance on COVID-19 and that he stands ready to continue to support the Minister of Health.