Improving maternal, neonatal and child health in the former Yugoslav Republic of Macedonia


Medical nurse, Ms Zagorka Kostadinova, taking care of the newborns in the neonatal section of Štip Clinical Hospital

A team of international and national experts have joined efforts to identify strategies to reverse the current neonatal mortality trends and improve pregnancy outcomes and child health in the former Yugoslav Republic of Macedonia.

On 19–22 March 2018, the team, made up of experts from WHO, the Ministry of Health, the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA) conducted an initial assessment of the situation which has led to the relative lack of recent progress in reducing maternal, neonatal and child mortality and morbidities. The team then presented options and possible immediate strategies that would contribute to positive pregnancy outcomes in the country.

The recommendations covered how to:

  • strengthen reproductive, maternal, neonatal and child health;
  • improve the organization of health-care settings in accordance with population needs;
  • improve the development and monitoring of evidence-informed and context-specific programme interventions to avert future deaths.

This assignment is in line with the commitment from the government, which has set maternal, neonatal and child health among the highest priorities. The Minister of Health and the government have formally requested WHO, UNICEF and UNFPA to coordinate their technical assistance in this area to support the implementation of health strategies and action plans.

Site visits and interviews

During the assignment, the team visited a wide range of institutions, which allowed the group to observe patient pathways and health services, as well as identify challenges and difficulties.

In the capital city of Skopje, a visit to the University Clinic for Obstetrics and Gynaecology – tertiary care facility, allowed consultants to observe first-hand the patient pathways and associated health services. With the head of the Gynaecology Clinic and heads of services, the midwives, neonatologists and nurses discussed the quality of care measures and continuing education of health-care workers. These discussions also provided the opportunity to identify the challenges and difficulties they faced.

The team also undertook field visits at general hospitals in the city of Tetovo, in the north-west, and the city of Štip, in the eastern part of the country, where they visited primary and secondary health-care facilities and met with the health workforce.

The team also met representatives of the most relevant institutions and associations to capture their views on the overall situation. In particular, the team interviewed representatives of:

  • the association of neonatologists
  • family/primary care physicians
  • the association of nurses and midwives
  • the association of obstetricians.

Interagency collaboration

Effective cooperation between WHO and other United Nations agencies will continue to pursue the objective of building capacities in critical areas such as essential newborn care, management of complications, and perinatal death reviews, to mention a few. Maternal, neonatal and child health, well-being and survival must remain an investment priority for the Government of the former Yugoslav Republic of Macedonia as it seeks to attain the Sustainable Development Goals.