FAQ – Frequently Asked Questions

PROCEDURE FOR COMPENSATION FOR RESIDENTS WHO PAY FOR THEIR SPECIALIZATION FROM THEIR OWN FUNDS

To express interest in receiving financial compensation for residents who pay for their specialization from their own funds, the following documents must be submitted through the archive of the Ministry of Health:

1. Request for expression of interest on the form attached to this procedure, which includes the doctor’s personal data, the public healthcare institution where the doctor is specializing, the university where the candidate is specializing, as well as contact details, i.e., email address and phone number.

2. Copy of the decision on the candidate’s enrollment in specialization.

3. Certificate from the Employment Agency to determine employment status.

4. Form M1/M2 – Registration/Deregistration in mandatory social insurance.

At the end of the current month, all received applications are sent to the Health Insurance Fund of the Republic of North Macedonia, where by decision of the managing board, funds are allocated for the agreed compensation to the public healthcare institution where the specialization will be carried out. After that, the Health Insurance Fund of the Republic of North Macedonia sends each public healthcare institution a notice of the list of candidates/residents eligible for financial compensation.

• The public healthcare institution informs the candidates about the further procedure and signs a contract with each resident individually. The payment of the financial compensation is made through the public healthcare institution.

For additional information, please contact the following email address: ana.dimova@zdravstvo.gov.mk

According to the Law on Health Protection, healthcare professionals with higher education in the field of medicine can specialize if, in addition to the conditions from paragraph (1) of this article, they have at least six months of work experience according to the license obtained for work in primary healthcare in a health center.

To express interest in undertaking the six-month paid internship, you need to submit the following documents through the archive of the Ministry of Health:

1. A letter of expression of interest containing the doctor's personal details, the public healthcare institution where the doctor wishes to undertake the internship, and contact details, i.e., email address and phone number.

2. A copy of the license/certificate of passing the state exam.

3. A certificate from the Employment Agency confirming the employment status.

The process to start the paid internship is as follows:

• At the end of the current month, all received applications are sent to the Health Insurance Fund, where by decision of the managing board, funds are allocated for your financial compensation to the healthcare institution where you will carry out the internship. Then, the public healthcare institution submits a request for approval from the Ministry of Finance through the Ministry of Health and HIFRNM. Once the approval is obtained, the public healthcare institution to which you applied will contact you to begin the paid internship.

For additional information, please contact: ivo.koret@zdravstvo.gov.mk

Attached is the guidance for the required documentation (form) for placing detergents on the market, according to the Law on Chemicals (Articles 121, 122, 123, 124, 125, and 126), as well as the Rulebook on Methods for Determining the Biodegradability of Surfactants in Detergents, and the Reference Methods for Testing and Analysis of Detergents (Official Gazette of RNM 74/11), and the Rulebook on the Data Regarding the Content of Detergents that Must Be Indicated on the Packaging, as well as the General and Specific Rules for Labeling Detergent Packaging (Official Gazette of RNM 84/11).

For additional information, please contact: luljeta.vela@zdravstvo.gov.mk

This matter falls under the jurisdiction of the Chemicals Sector and is regulated by the Rulebook on the form and content of the application and the required documentation for placing electronic cigarettes and/or refillable or single-use containers on the market (Official Gazette of RNM No. 238/2022), as well as the Law on Tobacco and Related Products (Official Gazette of RNM No. 98/2019). For these matters, legal entities are advised to consult the Law on Tobacco and Related Products (Official Gazette of RNM No. 98/2019).

For more specific information regarding the required documentation, please contact: maja.evrosimovska@zdravstvo.gov.mk

These matters are regulated by the Law on Chemicals (Official Gazette No. 145/10, 53/11, 164/13, 116/15, and 37/16) and the Law on Precursors (Official Gazette No. 37/04, 40/07, 62/08, 53/11, and 149/15), as well as the Rulebook on detailed conditions regarding the premises and equipment that legal entities engaged in trade of chemicals must fulfill (Official Gazette 132/08).

For more specific information and to facilitate the work of interested legal entities, the Chemicals Sector has prepared guidelines on the required documentation for obtaining permits to conduct trade in chemicals and precursors, as well as forms/applications for both activities:

• Guidelines on required documentation for legal entities conducting trade or use of chemicals.

• Guidelines on required documentation for legal entities conducting trade in precursors.

• Guidelines on required documentation for legal entities conducting production of chemicals.

1. Form/Application for obtaining a permit to conduct trade in precursors.

2. Form/Application for extension of the permit to conduct trade in precursors.

(Please circle the number that corresponds to the request)

Is vaccination mandatory in the Republic of North Macedonia?

According to the Immunization Calendar, active immunization is mandatory for individuals of a certain age (from 0 to 18 years).

Vaccination is legally regulated by the Law on the Protection of the Population from Infectious Diseases (Official Gazette of the Republic of Macedonia No. 66/04, 139/08, 99/09, 149/2014, 150/15, and 37/16, and Official Gazette of RNM No. 257/20) and the Rulebook on Immunoprophylaxis, Chemoprophylaxis, the persons subject to these measures, the method of implementation, and keeping records and documentation (Official Gazette of the Republic of Macedonia No. 177/15).

What is the vaccination and revaccination coverage of children with the vaccines from the Immunization Calendar?

The Institute of Public Health of the Republic of North Macedonia is responsible for preparing the annual reports on the implementation of immunization in the country.
Below is a link to the reports (from 2015 to 2022): https://iph.mk/mk/home/izvestai?cookieS=1

Why should children be vaccinated?

Immunization can save your child’s life.
Thanks to advances in medical science and the development of new vaccines, your child can now be protected from more diseases than ever before. Some diseases that in the past infected or killed thousands of children are now completely eliminated, and others are close to being eradicated — primarily due to safe and effective vaccines. Polio is one example of the great impact vaccines have had. In our country, the last case of polio was recorded in 1987, and since June 2002, the Republic of North Macedonia has received a Certificate of Polio Eradication (Polio Free Country) from the WHO, along with other countries in the European region.

Vaccination is very safe and effective.
Vaccines may cause some discomfort, pain, redness, or tenderness at the injection site, but these symptoms are minimal compared to the pain, discomfort, and trauma caused by the diseases these vaccines prevent. Serious adverse reactions to vaccination, such as severe allergic responses, are very rare. The benefits of vaccines in preventing diseases far outweigh the possible side effects in almost all children.

Immunization protects others you care about.
Children in the Republic of North Macedonia still get diseases that can be prevented by vaccines. In fact, we have seen a resurgence of measles in the past few years. While some infants are too young to be protected by vaccination, others may not be able to receive certain vaccines due to severe allergies, weakened immune systems caused by conditions such as leukemia, or other reasons. To protect them, it is important that you and your children who can be vaccinated are fully immunized. This not only protects your family but also helps prevent the spread of these diseases to your friends and loved ones.

Immunization can save your family time and money.
A child with a vaccine-preventable disease may be prohibited from attending daycare or school, which also means absence of the parent/caregiver from work. Some vaccine-preventable diseases can result in long-term disabilities and may impose a financial burden due to work absence, treatment costs, or long-term care for disability. In contrast, vaccination against these diseases is the most cost-effective investment and is free for all children.

Immunization protects future generations.
Vaccines have reduced and even eliminated many diseases that killed or seriously disabled people just a few generations ago. If we continue to vaccinate now and achieve full immunization, parents in the future may be able to believe that some diseases of today will no longer harm their children.

Is it safe to vaccinate babies at a very young age?

Answer: Yes. Vaccines help children fight certain serious and deadly diseases that their bodies are not yet able to handle. Although the baby receives maternal antibodies during pregnancy, it does not receive antibodies for pertussis, tetanus, hepatitis B, and Haemophilus type b, so it is not protected from these infections in the first months. That is why it is important to start immunization at 2 months of age. Children start vaccination early because they are most vulnerable to diseases during this period. Vaccines strengthen their immune system. According to our Immunization Schedule, vaccinated children are protected from 12 potentially serious diseases by the age of 1.

Can a baby’s immune system respond to more than one vaccine at the same time?

Vaccines strengthen the immune system and make it strong and ready to fight vaccine-preventable diseases. From birth, babies are exposed to thousands of bacteria, and only a small part of the immune system is used to respond to vaccines. Numerous studies have shown that combined vaccines are just as effective as single vaccines and do not have a higher risk of adverse effects.

Why is it crucial to follow the Immunization Schedule?

• The vaccine schedule is scientifically based

• The schedule is safe and well-functioning

• It reduces the risk of the baby developing fear and anxiety from injections

• The risk of side effects is the same whether vaccines are given together or separately

• You will reduce the number of visits and the time spent going for vaccination

What is herd immunity?

Herd immunity occurs when a sufficient number of people are immunized (either naturally or artificially) against a certain infectious disease, which reduces the chance of susceptible individuals getting sick or remaining unprotected. To achieve herd immunity, the immunization coverage threshold varies depending on how contagious the disease is. For example, for measles, which is extremely contagious, 95% of the population needs to be vaccinated to achieve herd immunity.

Does the MMR vaccine cause autism?

No, the MMR vaccine, nor any other vaccine, causes autism or autistic disorders. Many studies have shown that there is no link between receiving vaccines and the development of autism, and that vaccine ingredients (such as Thimerosal) do not affect the development of autism. On the contrary, children who are not vaccinated have the same risk of autism as vaccinated children. A study conducted in Denmark in 2002 involving 537,303 children showed that there is no connection between vaccination and the occurrence of autism spectrum disorder.

What is the benefit of the HPV vaccine?

The HPV vaccine is the only vaccine that protects against precancerous infections and cancer. According to our Immunization Schedule, girls at the age of 12 should receive two doses of the HPV vaccine, six months apart. In some countries, HPV vaccination is given from the age of 9. Early protection works best. You should protect your child well before they come into contact with the virus.

Are the vaccines provided by the state safe?

The vaccines provided by the state are safe and effective. The Ministry of Health continuously and timely provides vaccines from world-renowned manufacturers that must meet strict quality criteria. For each vaccine, MALMED issues approval for each batch placed on the market, further guaranteeing the safety of the vaccines. With the latest update of the Immunization Schedule in 2019, by introducing the rotavirus and pneumococcal vaccines, alongside European countries, we provide protection against a total of 13 infectious diseases.

Are the ingredients in the vaccines safe?

Vaccines can be live attenuated or inactivated vaccines. Live attenuated vaccines contain weakened bacteria or viruses created under laboratory conditions, which cannot cause disease or may cause a very mild form of the disease. Inactivated vaccines contain inactivated bacteria or viruses, parts of bacteria, or toxoids that cannot cause disease. Some substances in vaccines are necessary to ensure their effectiveness and to keep them stable and safe. These ingredients are carefully tested and safe and are present in vaccines in very small amounts.

Question: Which vaccines are currently used for mandatory immunization and who are their manufacturers?

According to the Law on Biomedical Assisted Fertilization, Article 12-g, paragraph 1, the gestational carrier has the right to give birth to a live child/children for another person only once.

A woman, to be a gestational carrier in the procedure for assisted fertilization (BPO), must meet the following conditions:

• To be a citizen of the Republic of North Macedonia;

• To be in good psycho-physical and general health condition;

• To be at least 25 years old and up to the age at which the woman is in good psycho-physical and general health condition allowing a healthy pregnancy and birth of a healthy child;

• To be a mother of at least one child at the time of starting the BPO procedure;

• Not to have parental rights revoked or restricted;

• Not to have been sentenced to an effective prison sentence of more than six months for a criminal offense;

• Not to have limited or revoked business capacity;

• Not to be mentally ill or a person with intellectual development disabilities;

• Not to be addicted to drugs or other psychotropic substances or alcohol;

• Not to have a severe chronic disease or an incurable infectious disease.

The right to initiate a BPO procedure with a gestational carrier is given to a married man and woman who are citizens of the Republic of North Macedonia. Persons in extramarital cohabitation or any other form of partnership cannot initiate a BPO procedure with a gestational carrier.

The married couple has the right to submit a request to initiate a BPO procedure with a gestational carrier if the woman in the marriage has congenital/acquired absence of the uterus or a congenital anomaly of the uterus that cannot be corrected by modern surgical procedures based on evidence-based medicine or irreparable damage to the uterus.

The married couple has the right to submit a request to initiate a BPO procedure with a gestational carrier if the woman also simultaneously has congenital or acquired absence of ovaries or a congenital anomaly of the ovaries that cannot be corrected by modern surgical procedures based on evidence-based medicine or irreparable damage to the ovaries.

The married couple has the right to submit a request to initiate a BPO procedure with a gestational carrier if the man has infertility that cannot be cured by modern procedures based on evidence-based medicine, while the woman has the two aforementioned conditions.

At least three unsuccessful attempts at conception by the woman are recognized as a reason to submit a request for initiating a BPO procedure with a gestational carrier, when all other causes and factors for failure have been excluded except uterine damage.

Also, the existence of a disease in the woman contraindicated for pregnancy due to possible severe life-threatening complications and consequences, including death, is recognized as a reason to submit a request for a BPO procedure with a gestational carrier.

Married couples wishing to register in the Register of Married Couples must submit the following documents:

• Certificate of citizenship (original or notarized copy);

• Extract from the marriage register (original or notarized copy);

• Copy of ID card (notarized);

• Medical documentation as proof that conditions for starting the procedure are met (original).

For registration in the Register of Gestational Carriers, the following documents must be submitted:

• Certificate of citizenship (original or notarized copy);

• Extract from the birth register (original or notarized copy);

• Extract from the birth register for the child/children (original or notarized copy);

• Copy of ID card (notarized).

The applications for registration in both registers can be printed and submitted to the Ministry of Health by interested parties.

To the Commission for evaluation of the fulfillment of conditions regarding space, equipment, and staff for obtaining approval for cultivating cannabis for medical purposes, it is necessary to submit an application for approval for cultivating cannabis for medical purposes, as well as a report, i.e. a cultivation plan for cannabis for medical purposes.

Documents to be attached to the application:

1. Proof of registration of the legal entity in the Central Registry of the Republic of North Macedonia (not older than six months)

2. Proof of ownership of the space/area where cannabis for medical purposes will be cultivated or a lease agreement or property deed

3. Report/plan for cultivating cannabis for medical purposes

4. Proof of paid administrative fee and fees for processing the application

5. Proof of staff

6. Proof of 24-hour physical security provision

Documents must be originals or notarized copies.

General guidelines for preparing the report/plan for cultivating cannabis for medical purposes.

If you need additional information, please contact: dragana.petrusevska@zdravstvo.gov.mk