7.1 General context
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Since the independence in 1991, Republic of North Macedonia has made important progress during its transition from a socialist system to a market-based system, particularly in reforming the organization, financing and delivery of health care and establishing a mix of private and public providers. Although total health care expenditure has risen in absolute terms in recent decades, it has consistently fallen as share of GDP, and high levels of private health expenditure remain. Despite this, the health of the population has improved over the last decades, with life expectancy and mortality rates for both adults and children reaching similar levels to those in ex-communist EU countries, though death rates caused by unhealthy behavior remain high.
Data on health conditions of young people is not systematically collected, particularly on behavior related variables. However, there are numerous studies done in the past that can provide an insight into the health status of youth in the Republic of North Macedonia.
Health is defined in accordance with World Health Organization definition as a state of complete physical and mental wellbeing and not merely absence of disease or infirmity. It is considered to be influenced by many external factors such as environmental, social and economic factors, and by factors related to lifestyles and to other sectors in the society.
A health system definition fully complies with the World Health Organization definition, as including all the actors and activities the primary purpose of which is to promote, improve or maintain the health of the citizens. It includes organized health services, i.e. the health care system, as only one of the many factors for maintaining good health, recovering from ill health, or making the life with chronic illness easier.