Association ESE


   Association for Emancipation, Solidarity and Equality of Women.


WHAT happens to the money from the Dutch grant for maternal and child health?

Since 2009, the Association ESE has been continuously working in the field of promotion of health care for mothers and children and accordingly, so far it has submitted several proposals for measures to increase the coverage of Roma children with immunization and preventive health services. ESE has been implementing the activities in this field together with three Roma civil society organizations.

Taking into consideration the subject of our interest and the objective of the project “Set-up of an integrated system for health care for mothers and children to improve the health outcome in R. Macedonia“, which is implemented by the Ministry of Health, we prepared an analysis regarding the program and financial implementation of the project. The analysis was made in order to assess the impact from this project with regard to the improvement of health care for mothers and children.

More specifically, this project is financed through the grant provided by the Kingdom of Netherlands (grant ORIO) and aims to overcome the following areas of concern, which are determinate by the Ministry of Health:

– the average coverage with vaccination in R.Macedonia accounts for about 95%, which is considered low compared to the European average, which accounts for 100%. The biggest problems related to vaccination in R. Macedonia occur in the poor, Roma and rural areas, where the vaccination coverage is below 80%.

– Macedonia ranks second highest in Europe in terms of the birth rate; However, the perinatal and infant mortality rates are the highest in Europe.

–  the level of health care in the immunization departments is below the standards.

– in R. Macedonia, one patronage nurse is assigned for 5.000 people.    Furthermore, insufficient importance is given to the patronage nurses in the health system and they face a shortage of equipment and vehicles. 

When we initiated the analysis of the program and financial implementation of the project, we found out that in R. Macedonia there are no publicly available data with regard to this grant, nor the competent institutions share the information once a request for  access to public information is submitted. The low level of proactive transparency and accountability of the public institutions with regard to the information about donations, grants and loans is characteristic for the public institutions in R. Macedonia.

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