The health care system in North Macedonia is primarily governed by two central institutions — the Ministry of Health and the Health Insurance Fund. The Ministry of Health is responsible for developing health policies, organizing the health care system, and enforcing health legislation, while the Health Insurance Fund manages the purchasing of services from both public and private providers on behalf of the insured population.

The overarching policy framework guiding the country’s health sector is the Health Strategy of the Republic of North Macedonia 2021–2030 (Стратегија за здравство на Република Северна Македонија 2021–2030). This strategy outlines the vision for improving the population’s overall health and strengthening the health care system to ensure it remains responsive to citizens’ needs — including those related to mental health.