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  Issue 62

   

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Problems during the implementation of gynecological check-ups program

The Women Organization of the municipality of Sveti Nikole, in cooperation with 17 women NGOs from Macedonia has managed to lobby a change in the Law for health protection and introduction of a program for regular women’s gynecological check-ups for early diagnosis of cervical cancer. In 2005 and 2006 the Government passed the Program for early discovery and prevention of diseases of female reproductive organs in the Republic of Macedonia. The program projects a free Pap smear for 20% of the female population at the age between 19-65 or 128.000 women per year. The check-ups should be made by their personal gynecologists who have made contracts with the Health Fund. 8.500.000 denars was provided for realization of the 2005 program, and additional 3.000.000 denars will be provided for 2006. These funds are aimed at Pap smear, printing informative materials and keeping a register for carried check-ups.

Following the check-ups in the course of 2005 and 2006, it has been noticed that the program has not been completely realized and in some towns there has not been any Pap smear made at all.

The Women Organization of the municipality of Sveti Nikole held 4 round tables in Prilep, Bitola, Kriva Palanka and Kocani in the course of June 2006, with representatives of health houses and gynecologists, where the problems during the realization of the program were discussed. The gynecologists stated that they were not well informed by the Ministry of Health about the program and the way it should be realized. Apart from their will and readiness to help in the realization of check-ups, they are facing some serious problems. They are not motivated enough to carry out checkups, as they do not get any compensation at all and the capitation for the checkups is as lowest as 18 denars per patient. They are also facing the need to previously purchase materials for the Pap smear and untimely covering the material costs by the Health Fund. Privatization of gynecology will further deepen the problems related to program implementation and most gynecologists are not even motivated to make contracts with the Health Fund. As a result, most of the women who were informed about the program could not get a gynecological checkup and Pap smear.

We witnesses that the number of women having malignant diseases is growing each year. Our organization works on increasing women’s awareness of the need for regular gynecological checkups for early diagnosis of cervical cancer. In spite of that, competent institutions do not completely realize their obligations according to the Gynecological Checkups Program. The costs for healing these women are big and it is necessary for the state to pay bigger attention to women’s health protection. The health reforms being late even more worsens the condition of women’s health protection. There is a vacuum-space where competencies and the way of further operations of certain health institutions are not known. Women’s NGOs call the Government and the Ministry of Health to take concrete steps for consistent implementation of the passed program.

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