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Wednesday, February 25, 2026

How North Macedonia’s Digital Health System Fails Its Most Vulnerable Patients

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As North Macedonia accelerates its push towards a fully digitised healthcare system, concerns are mounting over the technology’s impact on the country’s most vulnerable patients. While digital platforms promise streamlined services and improved efficiency, critics warn that the shift risks marginalising those with limited access to technology, including the elderly, rural residents, and low-income communities. This article explores how North Macedonia’s rapid health digitisation is exposing gaps in accessibility and what it means for the future of equitable healthcare in the Balkans.

North Macedonia’s Digital Health Shift Risks Deepening Inequality Among Vulnerable Groups

The recent overhaul of North Macedonia’s healthcare system towards a fully digitised model promises improved efficiency and streamlined patient services. However, this transition has inadvertently marginalized several vulnerable groups, including the elderly, rural residents, and those with limited digital literacy. Many find themselves unable to navigate complex online platforms for appointments, prescriptions, or medical records, resulting in disrupted care and heightened health risks. Digital disparities are not merely technical glitches but represent deep-rooted inequalities that threaten to widen the existing healthcare gap.

Healthcare providers and advocacy groups have highlighted several critical barriers faced by these populations:

  • Limited internet access: Remote areas suffer from poor connectivity, making online health portals inaccessible.
  • Language and literacy challenges: Complex medical jargon and lack of multi-language support create confusion.
  • Inadequate training: Older patients often lack the digital skills necessary to use e-health tools effectively.
Vulnerable GroupMain Digital BarrierReported Impact
ElderlyLow digital literacyMissed appointments, medication errors
Rural ResidentsPoor internet infrastructureDelayed diagnostics and treatment
Low-income FamiliesLack of device accessLimited preventive care visits

Lack of Infrastructure and Digital Literacy Hinders Access to Essential Medical Services

Despite significant strides in digitising its healthcare system, North Macedonia faces persistent challenges that disproportionately affect vulnerable populations. Many regions, especially rural and remote areas, suffer from insufficient infrastructure, including unreliable internet connectivity and outdated hardware in medical facilities. This digital divide effectively sidelines patients who rely on these essential services, limiting their ability to benefit from telemedicine, electronic health records, and online appointment systems.

Moreover, a widespread lack of digital literacy compounds these barriers. Older adults and marginalized communities often struggle with navigating online platforms, leaving them dependent on traditional, less efficient methods of accessing care. The situation is exacerbated by limited training for healthcare workers in digital tools, which hampers the delivery of seamless services. Key obstacles include:

  • Poor internet access in rural clinics
  • Low digital skills among patients and medical staff
  • Language barriers in digital interfaces
  • Limited availability of multilingual support
FactorImpact on AccessPrevalence (%)
Internet AvailabilityConnectivity issues hinder telemedicine38%
Digital LiteracyDifficulty using e-health services45%
Healthcare Personnel TrainingInconsistent use of digital platforms60%

Calls for Inclusive Policies and Targeted Support to Bridge the Healthcare Digital Divide

Amid the rapid digital transformation of North Macedonia’s healthcare system, voices from civil society and health advocates are urging the government to implement inclusive policies that address the widening gap for vulnerable populations. Elderly patients, rural residents, and individuals with limited digital literacy face significant barriers when navigating digital health platforms, resulting in unequal access to essential medical services. Experts stress that without targeted support and tailored initiatives, the digitisation efforts risk entrenching existing disparities rather than alleviating them.

Calls for action include:

  • Deployment of community-based digital literacy programs focusing on elderly and marginalized groups.
  • Investment in infrastructure to improve internet connectivity in remote areas.
  • Creation of simplified user interfaces designed with accessibility in mind.
  • Provision of offline or assisted digital services through local clinics and social workers.
Vulnerable GroupPrimary Digital BarrierSuggested Support Measure
ElderlyLow digital literacyHands-on training workshops
Rural CommunitiesPoor internet accessInfrastructure upgrades
Disabled IndividualsNon-accessible platformsAdaptive technology integration
Economically DisadvantagedLack of digital devicesDevice lending programs

Wrapping Up

As North Macedonia pushes forward with the digitisation of its healthcare system, the experiences of vulnerable patients reveal critical gaps that risk leaving the most marginalized behind. While technological innovation promises greater efficiency and accessibility, the challenges faced by those lacking digital literacy or access underline the urgent need for inclusive policies. Bridging this divide will be essential to ensure that digital health advances serve all citizens equitably, rather than deepening existing inequalities in a country still grappling with healthcare reform.

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Samuel Brown

Samuel Brown

A sports reporter with a passion for the game.

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