Macedonia is facing heavy challenges in establishing and restructuring the provision of user-centred social and health care services. The realisation of defined visions and aims of the national government between 2005 and 2007 has been heavily jeopardised by the global financial and economic crises. In fact, new challenges have surfaced, including political instability and the refugee crisis.
The social context of the FYR of Macedonia encompasses a number of challenges, namely relatively low income levels among a great share of its population, limited access to care services, migration coupled with high unemployment rates. These challenges are even more acute in rural areas of the country.
Workshop participants identified several key areas in which interventions and innovation would be necessary. However, 'services for children with special needs', 'social inclusion of people with disabilities' and 'improving accessibility' were identified as the most important priorities.
Participants were relatively optimistic about the feasibility of these projects, although funding will be needed (proposals will be made to various funding bodies) and sustainability will remain a challenge. In Macedonia, this can mean for successful bottom-up projects to be taken over by statutory authorities that will then be ‘politicised’.
It will be a key task of workshop participants to continue the initiated collaboration across institutional and organisational boundaries. The Local Action Group with its most engaged members as well as the Municipality of Krivogaštani are in a good position to further advance social care issues in this region. However, further support is needed to not only build capacities but to facilitate tangible improvement.