ABSTRACT
We have reviewed the health system challenges and opportunities in the former Yugoslav Republic of Macedonia for improving core services for the prevention, early diagnosis and management of noncommunicable diseases(NCDs). The outcomes of most of these diseases have been improving, while mortality from diabetes has been increasing, and there are significant regional differences in the rates of premature mortality. The success achieved is partly due to progress in core population interventions (e.g. tobacco control) and individual services, although these could be further strengthened. It is recommended that, to further strengthen the health system response to NCDs, the Government should consider the following areas: strengthening governance and coordination mechanisms; investing in strengthening the evidence base and using evidence-based actions; empowering the population and patients; and optimizing models of care, aligning incentives and establishing mechanisms for continuous quality improvement.