1. J. Karadzinska-Bislimovska, S.Risteska-Kuc Institute of Occupational Health -WHO Collaborating Center for Occupational Health,Skopje National health policy and the ongoing reforms in the field of occupational health in the Republic of Macedonia

2. Process of economical and political transition with reform directions in all sectors, including health care system SOCIOECONOMIC CONDITIONS HIGH RATE OF UNEMPLOYMENT IMPACT OF POLITICAL AND WAR CRISIS CURRENT STATUS INTRODUCTION OF MARKET ECONOMY Official statistic data of RM (2005) Total population 2,022 547 Working (active) population (age 15-65) 854,620 Unemployment rate 37,4%

3. RECOGNIZED PROBLEMS OLD AND NEW SPECIFIC OCCUPATIONAL RISKS INADEQUATE FUNCTION OF OCCUPATIONAL HEALTH SERVICES AND LABOUR INSPECTION SERVICES INSUFFICIENT OCCUPATIONAL HEALTH INFORMATION SYSTEM FUNDAMENTAL CHANGES IN THE PRINCIPLES OF OCCUPATIONAL HEALTH AND SAFETY MANAGEMENT MODERN OCCUPATIONAL HEALTH SERVICES ESTABLISHMENT INTRODUCTION OF NEW MECHANISMS FOR SOCIAL DIALOGUE AS VISION FOR THE FUTURE

4. NEW REFORM CONCEPTS ADAPTATION OF THE POLICY, SYSTEM AND SERVICES TO THE NEW POLITICAL AND SOCIOECONOMIC CONDITIONS INTERNATIONAL CRITERIA (WHO, ILO, EU)

5. OCCUPATIONAL HEALTH SYSTEM SPECIFIC OH ACTIVITIES Occupational Health Services (Health Centers, Enterprises, Military Hospital) Health Protection Institute Institute of Occupational Health,WHO Cc Inspections, Insurance funds, MOH 120 OM SPECIALISTS HIGHLY EDUCATED AND QUALIFIED STAFF AN INTEGRAL PART OF THE GENERAL HEALTH CARE SYSTEM SINCE 1950 s

6. CURRENT SITUATION REDUCED NUMBER OF THE OH UNITS WHICH CARRY SPECIFIC OH ACTIVITIES TRANSFORMATION OF THE OH SPECIALISTS TO GP OR FAMILY DOCTORS

7. INSTITUTE OF OCCUPATIONAL HEALTH WHO COLLABORATING CENTER LEADING ROLE IN EDUCATIONAL, SCIENTIFIC AND SPECIFIC HEALTH CARE ISSUES IN OCCUPATIONAL HEALTH MEMBER OF THE GLOBAL NETWORK OF THE WHO COLLABORATING CENTERS IN OCCUPATIONAL HEALTH REALIZATION OF THE SPECIFIC WHO PROGRAM ACTIVITIES AT NATIONAL AND INTERNATIONAL LEVEL IMPORTANT ROLE IN ONGOING REFORMS IN THE OCCUPATIONAL HEALTH SECTOR

8. NEEDS AND DEMANDS CRUCIAL MOMENT TO EMPHASIZE THE NEED FOR ORGANIZATION AND ESTABLISHMENT OF ADEQUATE NEW MODEL OF OHS AND NEW RULES IN OCCUPATIONAL HEALTH SYSTEM AND POLICY “OCCUPATIONAL HEALTH AND SAFETY AT WORK” ISSUE SUPPORTED BY MINISTRY OF HEALTH/WHO REGIONAL OFFICE FOR EUROPE

9. OHS ROLE AND FUNCTION NATIONAL STRATEGY FOR HEALTH, HEALTHY ENVIRONMENT AND SAFETY AT WORK directed by Ministry of Health in the Governmental procedure LABOUR AND WORK PROTECTION CODE HEALTH PROTECTION CODE ENVIRONMENTAL PROTECTION CODE INTERNATIONAL DOCUMENTS: ILO CONVENTIONS WHO GLOBAL STRATEGY ON OCCUPATIONAL HEALTH FOR ALL

10. NATIONAL STRATEGY ADOPTION AND IMPLEMENTATION BY THE GOVERNMENT INTERSECTORIAL COLLABORATION OF DIFFERENT STAKEHOLDERS IN THE FIELD OF OCCUPATIONAL HEALTH AND SAFETY MINISTRIES AND AUTHORITIES INSPECTIONS OCCUPATIONAL HEALTH PROFESSIONALS SCIENCE AND EDUCATION EMPLOYERS AND EMPLOYEES ORGANIZATIONS NGOs

11. BASIC PRINCIPLES primary prevention and safe technology innovation and harmonization to the legislation and standards in the area optimization of the work conditions integration of all measures and activities tripartite approach adequate information and participation of employees in decision making surveillance and promotion of the health, safety and protection systems development of registration and data systems NATIONAL STRATEGY FOR HEALTH, HEALTHY ENVIRONMENTAND SAFETY AT WORK based on WHO HESME program 2001

12. PRIORITIES AND LEADING POINTS New model-OHS MULTIDISCIPLINARY APPROACH TO STRENGTHTEN BASIC OHS TO EXPAND OHS COVERAGE TO IMPROVE OHS CONTENT AND ACTIVITIES NATIONAL, LOCAL AND ENTERPRISE LEVEL PUBLIC OHS NETWORK

13. INTERNATIONAL SUPPORT NEW APPROACH NEW PERSPECTIVE IN THE DEVELOPMENT OF OH POLICY, SYSTEM AND SERVICES WHO CCs MEETING, STOKHOLM, 2004 WHO-ILO PROJECT PROPOSAL “Strengthening social dialogue for improving occupational health and safety in SE Europe”

14. ELABORATION AND IMPLEMENTATION OF THE NEW KEY ELEMENTS IN OCCUPATIONAL HEALTH AND SAFETY CHALLENGE FOR NATIONAL HEALTH POLICY INITIATION OF REGIONAL APPROACH FOR SOCIAL COHESION IN THE FIELD OF THE WORKPLACE HEALTH POLICY