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EACEA National Policies Platform
Republic of North Macedonia

Republic of North Macedonia

4. Social Inclusion

4.6 Access to quality services

Last update: 22 December 2023
On this page
  1. Housing
  2. Social services
  3. Health care
  4. Financial services
  5. Quality assurance


Low standard of young people and the economic situation in the country makes young people dependent on their parents. Young adults continue to live with their parents, even after getting married.

According to data from Eurostat, since 2010, the percentage of young adults (18-34) living with their parents is constantly high. In 24 of the 29 European countries studied, more than one-in-three adults ages 18 to 34 lived in their parents’ home in 2021. Young people are claiming that they would like to live without their parents, but due to financial reasons they can’t afford to live independently. 

The Republic of North Macedonia is among the first countries in Europe where the percentage of young people aged 18 to 34 living with their parents is alarmingly high. According to the data produced by the European Commission, Macedonia rises to the fourth place (according to the last available data for 2020 year) in the list of European countries with a rate of 42.6 %. Almost like there hasn't been any change in the numbers since 2011. 

In the Law on Social Protection from 2009, it is specified that the Ministry of Labor and Social Policy offers monetary compensation for housing to only two risk groups, namely: a beneficiary of guaranteed minimum assistance and a person who until the age of 18 had the status of a child without parents and without parental care, i.e. even after termination of guardianship, and at most up to 26 years of age.

For young people who do not belong to either of the two groups and do not aspire to be beneficiaries of permanent financial assistance, such as students, people from marginalized communities (LGBTI, Roma population, people with disabilities) in Macedonia there is no option for some kind of social or open housing if they decide to leave the parental home.

In September 2018, the Government of the Republic of North Macedonia on its 88th session, adopted the National Strategy for Deinstitutionalization 2018-2027 “Timjanik” and Action Plan (Национална стратегија за деинституционализација во Република Македонија 2018-2027 “Тимјаник” и Акциски план). The main implementation body of the Strategy is the Ministry of Labor and Social Policy. The purpose of the Strategy is to transform the bulky social institutions that offer institutional care for different categories of users in social services in the local community. With the process of deinstitutionalization, which will last in stages over a period of 10 years, institutions such as "11 October", "May 25", "Ranka Milanovic", Banja Bansko, the Infant Home in Bitola, the Special Institution "Demir Kapija" no longer exist. Instead, people and children who are accommodated inside will be distributed in small group homes, that is, in apartments and houses throughout the country. These homes accommodate young people without parental care until their age of 18 years. The MLSP started opening small group homes even before the adoption of the new Strategy, as this program was foreseen many years ago. Young caregivers are in constant 24-hour contact with social workers and psychologist. Also, supervision in small group homes and foster families is carried out by the Institute for Social Activities and the Sector for Inspection Supervision in the Ministry.

The Government makes efforts in enabling and encouraging young people’s independence when it comes to housing through lot of programmes and projects:

  • Social buildings for socially vulnerable groups (Станови за социјално ранливи категории)– this measure is available for young people users of social welfare. The state is building social flats, that are being awarded to people at social-economic risk through open call. In 2021 the Ministry and Transport and Communications promised that it will build over 660 social buildings all over the country.
  • Project “Buy a house, buy an Apartment” (“Купи куќа, купи стан”)– with a model of “75% and/or 50% of the monthly loan installment” support by the Government for building/buying a new house, apartment, in the first five years of mortgage payment – the Government together with the North Macedonian banks are implementing this project through special credit line. The Government is contributing in the monthly loan installment for building or buying a new house or apartment. The measure is available for the general population (including young people) with low income.
  • Project “Buy a house for youth” (“Купи куќа за млади”)– this measure is particularly intended for young people not older than 35 years of age. In order to apply for the "Buy a house for youth" project, the person should fulfill the following conditions:

- To be less than 35 years of age

-To meet the criteria for obtaining a loan for a house prescribed by the bank,

 - The salary of the person who applied and the spouse to be less than 1,300 euros, or if the person is not married the salary should be less than 900 euros,

 - No other apartment or house in its own name or if it is married and on behalf of the spouse

 - No other housing loan was raised

 - The repayment period of the loan should be at least 20 years (with a possibility of repayment after 12 years).

When it’s about homeless people, within the Red Cross of city of Skopje in the Republic of North Macedonia (Црвен крст на Република Северна Македонија) there are two programs to help the homeless, one of which is directed exclusively towards the homeless and meeting some of their needs through the Homeless Station, while the other covers a wider group of vulnerable people, including the homeless.

1.Station for Homeless (Пункт за бездомници) is located in Momin Potok, it’s operating since 2008 and is open every working day for a consultation, while bathing, changing dirty clothes, getting a hot meal, receiving medication, doctor's examinations as well as obtaining personal documentation and a number of other activities are performed twice a week. 

The station is regularly visited by homeless people. Since the establishment of the station in 2008 so far, there are 170 homeless people who use services there. Most of them live in parks, abandoned buildings, railway / bus stations, basements, garages, etc. The persons in the station receive free primary health care and free medications, as well as psychological assistance. The social worker prepares social updates about the new homeless, as well as update of the existing files, realization of expert-advisory talks, extracting personal documents, issuing certificates for all users of the station, assistance and support in writing / filling out documents, forms for illiterate homeless people, free services from donors such as dental, legal services, as well as support for the employment of the working people, organizing regular sale of the street magazine "Face to face". The magazine comes out from September 2012 and promotes the model of social entrepreneurship. Its sellers are representatives of the most vulnerable layers in society, including homeless people, with half of the selling price going directly to the seller, and the second half is used for printing and for activities that improve the lives of marginalized people who are part of the program "Face to face".

2.Patrol social service- In the Red Cross of the City of Skopje patrol social workers are engaged to reveal people and families at risk, among which is the category of homeless people. Their role is through meetings with individuals and families at risk to recognize the problems they face and then refer them to all existing resources in the community and in the city.

The temporary shelter is always ready to receive a homeless person who is in a serious state of health, and for which there is no urgent solution for accommodation in an appropriate institution. Also for the winter period, a plan for action in extremely low temperatures has been prepared, and when the temperatures are lower than -10 degrees Celsius, there is a 24-hour team of the Red Cross.

Social services

Every year the Government is introducing Programme for subsidizing the electricity costs (Програма за заштита на ранливи потрошувачи на енергија за 2022 година). The Programme usually offers financial aid to families, including young people and young couples, receiving social welfare support and constant social financial support in paying electricity bills. Also, through the programme the financial debts upon electricity of these target groups will be deleted by simple request by the families. 

In 2004, the Government introduced a Programme for dealing with the problems of the socially excluded persons (Програма за справување со проблемите на социјално исклучените лица). This programme is focused on four target groups:

  • Drug abusers and their families
  • Children on the streets and their parents
  • Victims of domestic violence
  • Homeless people.

This programme should contribute in ceasing the trans-generation chain of exclusion. Moreover, through the programme it is expected to strengthen and support the target groups in their active participation in the community, through the application of new practices for social inclusion of vulnerable groups.

Health care

Health care programmes in North Macedonia are usually targeting the general population and not particularly youth.

Still, there are 2 youth centers (Младински центри) in the city of Skopje offering free gynecological examinations and counseling, psychological counseling, HIF tests, counseling for drug use prevention. These centers were founded by CSO HERA, but since 2018 they have entered in prevention programs of the Ministry of Health.

Action Plan for Sexual and Reproductive Health of the Republic of Macedonia 2018-2020 (Акциски план за сексуално и репродуктивно здравје на Република Македонија 2018-2020) have general focus but also covers sexual and reproductive health of adolescents and young people. Targeting youth, the Plan foreseen following goals:

Goal 1: To improve access to information and education for adolescents and young people in terms of sexual and reproductive health

Goal 2: To improve access to services and the quality of care for the sexual and reproductive health of adolescents and young people that are friendly and tailored to their needs

Goal 3: To reduce the rate of unplanned teenage pregnancy and to maintain a low prevalence of STI and HIV in adolescents and young people.

CSO HERA in 2013 started with service Mobile gynecological clinic. Its goal is to improve the access and quality of services in the field of sexual and reproductive health among women from hard-to-reach populations (sex workers and drug injectors), as well as women from rural areas who have limited access or do not have access to gynecological services. Field activities are carried out with a terrain vehicle, appropriately adapted for offering gynecological services, equipped with gynecological chair, ECHO apparatus and necessary medical instruments. Gynecological services are offered by an expert team, composed of a specialist gynecologist and nurse. This service is covering youth but also the older population.

National Drug Strategy of the Republic of Macedonia 2021-2025 (Национална стратегија за дрога на Република Македонија 2021-2025), recognizing the vulnerability of young people, put special emphasis on them, even though the Strategy has general focus. The Strategy emphasizes that there is a need to improve the access to measures for early intervention, especially for young people using drugs.

The Report on the Assessment of Minimum Standards for Quality of Drug Addiction Treatment Programs in the Republic of Macedonia (Извештај за проценка на минимум стандарди за квалитет на програмите за третман на зависност од дрога во Република Македонија) states that there are no specific programs for young people in health institutions. It also states that there are many young people who are misusing glue and tramadol, but there is still no special programme for dealing with that issue.

The Government adopted Programme for the protection of the HIV/AIDS population in Macedonia for 2023 (Програма за заштита на населението од ХИВ инфекција во Република Македонија за 2023 година). As many other programmes, this programme also targets the whole population, but as well as Macedonian youth. Main aim of the programme is to maintain the low prevalence of HIV, through universal approach of prevention, health care and support, based on respect of human rights and non-discrimination.

Project Roma Health Mediators (Ромски здравствени медијатори) started to be implemented in 2010 by the CSO HERA, supported by the foundation Open Society Macedonia and the Ministry of Foreign Affairs of Norway. The same year a multisectoral working group was formed composed of representatives from the relevant ministries and non-governmental organizations, for the preparation of the Strategic Framework for the Introduction of Roma Health Mediators in the Republic of North Macedonia. On the initiative of the Ministry of Health in 2011, in order to improve the health status of the Roma population, the Strategic Framework was adopted by the Government of the Republic of North Macedonia. The first working engagements of the Roma health mediators were financially supported by the Ministry of Health in 2012. The Ministry of Health provided financial means for engaging the Roma Health Mediators, as well as offices for their accommodation in health centers in several municipalities throughout Macedonia. Health mediators are a link between the health system and the Roma population. They inform the Roma community about their health rights, how important is regular immunization, receiving regular therapy, going to a gynecologist, possession of personal documents, and hygiene. This project is not particularly intended for young people, but it also covers them.

Financial services

The Government offers scholarships and student loans to young high school and university students. All possibilities are published on the web site of the Ministry of Education and Science.

Aiming to support young people to overcome the negative effects imposed on them by the COVID-19 crisis, in June 2020, the Ministry of Finance issued 87 014 “Domestic cards”. These cards were given to young people and could be used for buying domestic goods and obtaining services in the amount of 3,000 denars. The cards were entitled for persons aged 16 to 29 years that were active participants in the state formal secondary education and higher undergraduate education, as of May 22, 2020.

Social financial support to vulnerable groups is described under section 4.4.   

Quality assurance

 No available information.