Beside so frequent usage of the word reform in Macedonia, the link between governance reform and health reform is not yet conceptualized. It appears to me that the essence of one complex political process for implementation of new forms of governance and ways how it can be implemented is not reached. Neither a clear relation is set between one wider political reform and health reform. Things that have been done already as a reform, in best case, have been done only to improve the capacity of certain institutions.

Questions on which I am trying to give an answer are: why reform? Why there is a need for reform and how to conduct the same, in order to present the complexity of the reform in modern environment.

Reforms in Macedonia have large implementation deficit. Economy reforms, reforms of the public sector, of the judiciary, of the health sector – all of them are presenting insufficient results. Why is this happening?

My answer is that, actually, there is no understanding what is a reform, which are ideological grounds, which are goals and objectives of reforms in countries that have structural adjustments and what kind of obstacles a reform may have on its way of implementation.

This book is far from comprehensive presentation of situations within health sector of Republic of Macedonia; neither I dare to expose myself as an expert of medical aspects of those situations. Main challenges placed in front of me were to give notional framework in order to make an easier normative debate regarding reforms in Macedonia;

To establish an ideological context and background of the reforms; to speak about doubtfulness of health reforms, or more precisely about the problems rising during its implementation. 

Because I am certain that the health reform is a political issue, or more precisely issue of governance and governance reform, equally as it is issue of management and organization, I tried to reach those aspects of reform that are exposed through most modern political and social conceptions of governance.

Download the Book Public Health and Health Reform- Prof. Branislav Sarkanjac