The deinstitutionalization process in North Macedonia continues, with all young people under 18 without parental care now residing in small group homes. The Ministry of Social Policy, Demography and Youth is actively working to enhance services for these young people by improving coordination between institutions and expanding support programs.

As of early 2025, around 119 children and youth—primarily infants under three years old and children with disabilities—remain in large-scale institutions. Efforts are being intensified to place them in family-based care settings and prevent further institutionalization. UNICEF and the government are collaborating on reforms that strengthen national systems for child protection, aiming to create a more efficient legal framework and reinforce support for children without parental care.

Additionally, financial assistance and employment incentives remain in place for young adults who have aged out of institutional care. However, challenges persist in ensuring sustainable social and economic inclusion for these individuals, particularly in terms of housing and job security​.