Country report for Macedonia - Mobility of healthcare workers from Western Balkans


September 14, 2015 Healthgrouper (Skopje)

Executive summary

International research project Healthgrouper with its headquarters offices based in Skopje, Macedonia was a winner of a research grant from University of Fribourg over the Regional Research Promotional Program. Healthgrouper international research team analyzed the causes, consequences, and policies that were undertaken by the countries in relation to the increasing trend of health workforce migration from the countries of Western Balkans. The awarded grant was in amount of 114 330 CHF funds that was allocated for realization of the research in four participating countries (Macedonia, Serbia, Kosovo and Albania). It was one year project, starting from July 2014, involving team of 10 researchers divided in country teams responsible for realization of the research in their countries. The whole project was coordinated by the Healthgrouper headquarters offices in Skopje in close collaboration with professional medical and nursing associations.

The need for this type of research was seen in the ever increasing problem of migration of the healthcare workforce. The migration of healthcare personnel in the region is becoming a rising phenomenon that can jeopardize the stability of the healthcare systems in these countries with its rising intensity. According to the unofical data in the last years around 1.700 doctors from Macedonia, Serbia, Kosovo and Albania left their countries to work and live abroad.

This regional research was conducted using the same methodology and instrument-questionnaires in all four countries. The research was divided into several phases, each of which uses qualitative and quantitative research techniques. This research outlines and groups the problems and causes for the health workforce migration in five categories: economic, professional, political, personal and social factors for migration, including questions concerning the index of satisfaction for the profession. Focus groups were conducted with young and older, more experienced doctors in all four countries. In addition also interviews with key members of the educational and healthcare systems from these countries were conducted. Moreover, the re­search team contacted embassies of recipient countries and made inter­views on their policies of recruitment of health personnel.

The heart of this research was the Survey which was conducted among doctors in all four countries, with aim to understand the reasons behind their thoughts or decision to leave their home country.  The Survey was conducted in the period December 2014 – March 2015 and was aimed to doctors that have already migrated, as well as those who were still at the country. Around 1.600 doctors from Macedonia, Serbia, Kosovo and Albania participate in this research.

This country report, we present the findings for Republic of Macedonia during the one year research. We give an overview of the health system in Macedonia, the challenges that the system is facing, the results from the interviews and from the conducted Survey. In this country report, we also present the policies and regulations behind the process of migration.

The results from the research conducted among the Macedonian doctors showed that the economic and professional reasons are the main drivers for their decision to leave their home country. Also, a political influence on the process of finding job or professional promotion was reported by the doctors. One of the main reasons why the doctors are still in their home country, is not that their optimist, but cause of family circumstances. Also, one of the most worrying resulte was that the doctors that left R.Macedonia are not thinking to come back. More detail results and explanations for the Survey are available in this country report.

With this research was accomplished the main goal of the project: For the first time, the voice of the health care workers in Macedonia, Serbia, Albania and Kosovo on the resonses behind the migration was heard. We hope that we contribute even for just a little, in raising the awareness of the worrying trend of the migration of the health care workers which is present on Western Balkan in the last years. 


Project coordinator and main researcher: Vladimir Lazarevik
Researchers for Macedonia: Neda Popovska Kamnar, Blashko Kasapinov, Sanja Spasova
Researchers for Serbia: Maja Krstic, Miljan Lubichic
Researchers for Albania: Ardita Kongjonaj, Gazment Koduzi
Researchers for Kosovo: Teuta Demjaha Agai, Vlera Shpatia


This country report has been prepared in the framework of the Regional Research Promotion Programme in the Western Balkans implemented by University of Fribourg upon a mandate of the Swiss Agency for Development and Cooperation (SDC), Federal Department of Foreign Affairs.

The views expressed in this press release are those of the authors and do not necessarily represent opinions of the Swiss Agency for Development and Cooperation and the University of Fribourg.