CHANCES OF PROMOTING HEALTH WORKERS ABILITIES DESPITE THE THREATS BROUGHT BY CHANGES IN HEALTH INSTITUTIONS ORGANIZATION IN THE REPUBLIC OF NORTH MACEDONIA

Abstract

The great changes that have been made on global level and especially in the surroundings, except for getting new opportunities, have mostly brought more problems in healthcare. Global digital connection has eased a lot of work processes and has created possibilities of using a large number of data, increasing the level of knowledge. However, the overall changes of the economic paradigm beginning in the end of the twentieth century, as well as the possibility of obligatory privatization of large number of health branches, has led to changes not only of structure, but also the culture not in interest of transferring knowledge and experience among health workers. Legal regulations exist but they are mostly declarative. The hidden mental models of health workers and the non-existent motivation from the society give the reason why problems become deeper, which have negative impact on population’s healthcare. Whether it is about formal training, prescribed by law, or informal, there has been a noticeable indifference in transferring practical abilities. Organizational learning has not been recognized nor practiced in health institutions. The aim is to find the gaps in the health system in which strategic management has been hardly used. This will enable continuous flow of information, as well as reaching the mail goal – optimization of health services in the country. The empiric research findings have been presented within the method of theoretical analysis, and a descriptive analysis of the legal regulative and culture before and after the changes has been given as well. The comparative method makes comparison between the transfer of abilities in private and public health institutions. The final results show that the transfer of abilities between coworkers in private institutions has been decreasing. Coworkers who work in the same institution do not reveal or exchange information nor experience which will increase the level of knowledge or practice to other coworkers. Even worse is the same transfer between private institutions because of the fear of competition. The abovementioned conclusions will be directed towards the government which should use strategic planning with precise goal about the way how to perform formal training of health workers in order to be successful in raising knowledge and abilities to an optimal level as well as motivation of the participants. Ministry of Health should pay attention to informing the health workers about the advantages of implementation of organizational learning in every sphere of health institutions. The result would be change of health workers’ mental model and institutions would become learning organizations. If human resources are not included, most of the recommendations mentioned here in this work will not be implemented.