Nursing in North Macedonia – Opportunities and challenges

Introduction: Nursing in North Macedonia has a long tradition. Over the years, depending on the social conditions, nursing in North Macedonia developed using the opportunities and faced all the challenges. Aim: This study aimed to review and analyze the socioeconomic characteristics of the population, as well as nursing in terms of education level, staff, and career development to determine the needs of nursing care and recognize the opportunities and challenges of nurses. Methods: An analytical study was conducted by analyzing statistical publications of the State Statistics Office and the Institute of Public Health of the North Macedonia, and other relevant publications related to nursing in the period from 2012 to 2022. Results: In the study, an analysis of the population was made based on vital and socioeconomic characteristics, and nursing based on education, staff, and employment. An increase in the number of residents in 2022, in contrast to 2013, is recorded for 599 more residents per patronage nurse and 1035 residents per health professionals with higher education. In 2021, 34.5% of the total number of health professionals were nurses; the largest percentage, 80.4% had completed secondary education, 17% completed university, and 2.6% had higher education. The ratio of nurses to one doctor in North Macedonia was 1.4 nurses to one doctor, which is 0.9 less than the European average, and 4.3 nurse practitioners per 1000 inhabitants, which is far below the EU27 average of 8.2 nurses per 1000 inhabitants. A decrease in the number of health professionals was observed at the level of primary health care in the Health Centres for 86 health professionals, which is 4.5% of the employees in 2021, in contrast to 2012. Conclusion: The aging of the population requires greater capacities for nursing care. Nurses should recognize the opportunities for the development of nursing, which will help them overcome challenges and build capacity in the direction of reforms in nursing in North Macedonia.