First national report on social determinants of health developed for the former Yugoslav Republic of Macedonia


A priority for the WHO Regional Office for Europe in the biennium 2016–17 is to strengthen work that directly contributes to uptake of the findings and recommendations of the Review of social determinants of health and the health divide in the WHO European Region in Member States’ policy processes and implementation strategies.

The former Yugoslav Republic of Macedonia’s Ministry of Health, with technical and financial support from the WHO Country Office, has initiated development of the first national report on social determinants of health. Its aim is to support engagement of all technical capacities, relevant sectors and civil society in a policy dialogue to implement the country’s National Health Policy 2020 and its action plans, while taking into consideration the Sustainable Development Goals. The report will provide an overview of the influence of diverse social determinants – such as education, income, geographical location and so forth – on the health and well-being of the population, in an approach sensitive to gender, human rights and equity dimensions.

Discussions about developing a national report on social determinants of health have taken place between WHO and the Ministry of Health since the beginning of 2016. To support this initiative, in the first half of 2016 an overview of relevant national data, reports and information was undertaken at the national level. Its conclusion was that significant further research was necessary, both to understand the social inequalities pertaining to health outcomes in the former Yugoslav Republic of Macedonia and to grasp the current situation regarding upstream measures that need to be taken to tackle inequalities in health stemming from social and economic determinants outside the health system.

The process was initiated in November 2016 with a fact-finding visit from the WHO Regional Office for Europe, during which the key drivers, stakeholders and data sources for development of the report were identified. Throughout early 2017 a national core team gathered and analysed the data and developed a first draft that was shared for discussion with diverse stakeholders in a workshop on 9 June 2017. The outcomes of these discussions will be incorporated into the draft to produce the country’s first national report on social determinants of health, which will be finalized and launched by the end of 2017.

Both the Ministry of Health and the Institute of Public Health considered this process essential for addressing health and well-being through a whole-of-government and whole-of-society approach. They therefore suggested that this report should become one of the Institute of Public Health’s regular activities.