Macedonia is facing heavy challenges in establishing and restructuring the provision of user-centred social and health care services. The defined visions and aims of the “Health Strategy of the Republic of Macedonia 2020” (Ministry of Health, 2007) are based on the World Health Organisation’s “Health for all in the 21st century” strategy for the European region, the Millennium Declaration of the United Nations, the public health policy of the EU and other international declarations, but their realisation has been heavily jeopardised by the global financial and economic crises. In fact, new challenges have surfaced, including political instability and the refugee crisis. ‘These factors contributed to a situation where decisive performance indicators show stagnation, if not aggravation, with respect to the quantitative and qualitative development of services, resulting in consistent high values of infant mortality, unequal access to services and a lack of health and social care professionals, in particular in rural areas.