Health System Preparedness And Response For COVID-19 Pandemic In North Macedonia

Abstract

Objectives: Health systems are the first defense line against epidemics and pandemics. However, in the past two decades, several epidemics including the SARS-CoV-2 virus pandemic have shown unprecedented challenges for the health system’s response and the need to strengthen national capacities and preparedness plan in terms of sustainability and financing. The main objective of this study was to explore the preparedness of the health system and to evaluate the national health -care response to COVID-19. Material and Methods: World Health Organization’s (WHO) toolkit was used for assessing health-system capacity for crisis management and emergency preparedness. Assessment of essential attributes and key components for health system function: a) leadership and governance; b) health workforce; c) medical products vaccines and technology; d) health information; e) health financing; f) service delivery. Data was retrieved from legislation and policy documents, reports, and publications published at the official websites of the Ministry of Health, Institute of Public Health, and Government of the Republic of North Macedonia. Results: The national risk management was led by the Government and the Ministry of Health based on the national plan for preparedness and response of the healthcare system in emergencies, crises and disasters as well as an adapted version of the WHO’s strategic preparedness and response plan, according to which the country was classified as level 3 preparedness. Shortage in laboratory testing capacity, personal protective equipment and healthcare capacity as ICU ventilators and health workforce capacity were the main challenges for the national health system. Informing the public community was an important component of the national response which included risk communication, key prevention and preparedness measures to ensure individuals adopt protective behaviors and daily infographic statistics. Conclusion: COVID-19 is a public health emergency that tested the resilience of the national healthcare system as well as other sectors of government and the whole society. We identified a great need to increase capacity to identify suspected cases of COVID-19 in the general population, to introduce participatory community interventions, and to ensure sustainable financing in the health sector for crises and epidemics. An absolute priority in the pandemic is hospital preparedness and health workforce training and coordination.