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BRIEFDecember 19, 2023

Enhancing Social Protection in North Macedonia: Reforming Disability Assessment

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North Macedonia is partnering with the World Bank to advance reforms in its social protection system, including in the disability segment of its social insurance system. These reforms are driven by two key objectives:

  1. There is a strong emphasis on improving the efficiency and effectiveness of the disability assessment system across all areas of social protection. To achieve this, the country has established a Central Disability Certification Coordination Unit (CDCCU). 
  2. The Government of North Macedonia is committed to promoting greater inclusion of persons with disabilities in the labor market by reforming the employment system designed specifically for individuals with disabilities.

To achieve these goals, the country is seeking to streamline and centralize processes related to disability assessment. 

    Streamlining Disability Assessment

    The new administrative framework for disability assessment in North Macedonia aims to make the system more efficient and user-friendly for those seeking assistance or benefits related to their disability. Currently, there are five different types of disability assessments, each with its own requirements and certifications. This fragmented approach has led to high administrative costs, inefficient processes, and sometimes contradictory results. North Macedonia aims to develop a unified disability assessment methodology that combines medical criteria with the International Classification of Functioning (ICF). This comprehensive approach will encompass all necessary information, including the level of disability, work ability, and service needs.

    Centralized Assessment Process

    To streamline the disability assessment process, the Government of North Macedonia advocates for a single assessment process managed by the CDCCU. This centralized approach will reduce administrative costs and improve the efficiency of assessments, benefiting both applicants and service providers. Additionally, the Government aims to bring the assessment process closer to beneficiaries by establishing committees at regional and local levels, reducing costs and enhancing overall satisfaction with the services.

    Creating a Registry of Persons with Disabilities

    Currently, the interconnection between parallel disability assessment systems in North Macedonia is insufficient, hindering coordination and access to complete information. A solution to this is the creation of a single National Registry of Persons with Disabilities that would be connected to relevant databases. This unified registry would improve data exchange and coordination across different systems, ensuring timely and targeted policies for individuals in need of assistance.

    Implementation and Future Plans

    The establishment of the CDCCU, National Registry of Persons with Disabilities, and the unified disability assessment methodology has been regulated by the Law on Disability Assessment System published in the Official Gazette on October 5, 2023. The Law entiers into force in January 2024. Additionally, the government aims to improve the employment opportunities for persons with disabilities by exploring policy options such as redistribution of subsidies, professional rehabilitation, and the introduction of quotas in corporate employment rules. A draft Law on Employment and Rehabilitation of Persons with Disabilities is anticipated to undergo public consultations in Q1 2024.

    World Bank Support through SIAP

    The North Macedonia Social Insurance Administration Project (SIAP) was approved by the World Bank Board of Directors on February 6, 2020, and extended in mid-2022. This project seeks to improve the quality of services in administering social insurance and strengthen the regulatory framework for people with disabilities and hazardous occupations. SIAP is projected to disburse EUR 13.8 million to helping support North Macedonia’s reform efforts by i December 31, 2024.