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| Geographic origin of residents in all social care institutions in Macedonia |
For the reasons of deinstitutionalisation,
the geographic origin of residents is very important, since, in principle,
residents should return to their home environment.[1]
In the tables below we illustrate this dimension of residents’ profile on the
level of statistical regions and on the level of territories covered by centres
for social work.
|
No. Reg.
|
Regions/ residents per 10.000
inhabitants
|
adult
|
children
|
old age
|
all institution
|
|
1
|
East
|
2,6
|
9,5
|
16,4
|
6,8
|
|
2
|
Northeast
|
0,4
|
5,4
|
35,1
|
5,8
|
|
3
|
Pelagonia
|
1,3
|
10,3
|
50,5
|
11,3
|
|
4
|
Polog
|
0,3
|
1,5
|
1,0
|
0,7
|
|
5
|
Skopje
|
0,9
|
3,9
|
10,5
|
3,2
|
|
6
|
Southeast
|
1,8
|
4,4
|
6,3
|
3,5
|
|
7
|
Southwest
|
0,8
|
2,2
|
6,3
|
2,0
|
|
8
|
Vardar
|
2,0
|
6,2
|
15,3
|
5,4
|
|
0
|
R. Macedonia
|
1,1
|
4,7
|
17,0
|
4,3
|
|
|
Test of Homogeneity of Variances
|
0,334
|
0,167
|
*0,024
|
*0,028
|
|
|
ANOVA
|
0,142
|
0,221
|
*0,017
|
*0,033
|
Source: Annual reports, questionnaire and Statistical Office
data
Legend: red – considerably above average; green –
considerably below average.
There is quite a variability in the
distribution of the geographic origin of the residents. The Polog region has
consistently much lower rate than other regions and Pelagonia has usually
double the national rate (expect for special institutions for adults). Eastern
region has higher rates for children and adults, Vardar region higher for
adults (maybe because Demir Kapija attracts). Northeast region has considerably
lower rate for adult or special institutions, while considerably higher for old
age institution. We can speculate that the differences can be attributed to a)
vicinity of the institutions (e.g. Pelagonia has institutions for children and
for old age, but has not an institution for adults; Northeast has a big old age
home but no other institutions); or b) by regional cultural differences
regarding institutionalisation (like strong traditional family ties and clan
organisation of extended families, shame and fear of stigmatisation) or maybe c)
by some other structural moments (East region has high rate of
institutionalisation for children and adult institutions but there are no such
institutions and has a high emigration rate). Polog and partially Southwest
region have consistently low rates that are probably to be attributed to both
migration and strong family traditions and extended families.
However, significant differences (*) of
institutionalisation rate are only between the old age home rates and rate of
all institutions. However, the picture is slightly different if we look at the differences
between the geographic areas covered by centres for social work.
Table 8: Institutionalisation rate
per 10.000 inhabitants by territory covered by centres
for social work
|
No. Reg.
|
Region
|
No. CSW
|
CSW territory
|
adult
|
children
|
old age
|
all institution
|
|
1
|
East
|
19
|
Probištip
|
1,3
|
12,7
|
0,0
|
3,3
|
|
1
|
East
|
1
|
Berovo
|
1,7
|
28,0
|
9,9
|
7,9
|
|
1
|
East
|
10
|
Kočani
|
2,5
|
4,9
|
21,1
|
6,7
|
|
1
|
East
|
4
|
Delčevo
|
2,5
|
7,7
|
19,6
|
6,8
|
|
1
|
East
|
22
|
Štip
|
2,7
|
6,0
|
13,2
|
5,7
|
|
1
|
East
|
30
|
Vinica
|
4,6
|
15,0
|
30,3
|
11,3
|
|
2
|
Northeast
|
11
|
Kratovo
|
0,0
|
14,0
|
43,9
|
9,6
|
|
2
|
Northeast
|
14
|
Kumanovo
|
0,4
|
4,7
|
31,4
|
5,1
|
|
2
|
Northeast
|
12
|
Kriva Palanka
|
0,4
|
7,2
|
48,8
|
8,9
|
|
3
|
Pelagonia
|
21
|
Resen
|
0,6
|
21,0
|
27,5
|
8,6
|
|
3
|
Pelagonia
|
13
|
Kruševo
|
1,1
|
0,0
|
19,6
|
4,2
|
|
3
|
Pelagonia
|
2
|
Bitola
|
1,1
|
13,9
|
75,6
|
15,6
|
|
3
|
Pelagonia
|
18
|
Prilep
|
1,6
|
6,8
|
29,0
|
7,4
|
|
3
|
Pelagonia
|
5
|
Demir Hisar
|
3,7
|
8,2
|
61,5
|
18,3
|
|
4
|
Polog
|
27
|
Tetovo
|
0,0
|
0,7
|
0,6
|
0,2
|
|
4
|
Polog
|
7
|
Gostivar
|
0,7
|
3,1
|
1,8
|
1,4
|
|
5
|
Skopje
|
23
|
Skopje
|
0,9
|
3,9
|
10,5
|
3,2
|
|
6
|
Southeast
|
28
|
Valandovo
|
0,8
|
4,7
|
17,6
|
4,2
|
|
6
|
Southeast
|
6
|
Gevgelija
|
1,5
|
13,8
|
3,7
|
4,4
|
|
6
|
Southeast
|
25
|
Strumica
|
1,9
|
2,1
|
6,4
|
3,2
|
|
6
|
Southeast
|
20
|
Radoviš
|
2,1
|
2,9
|
4,9
|
3,4
|
|
7
|
Southwest
|
3
|
Debar
|
0,0
|
3,3
|
0,0
|
0,7
|
|
7
|
Southwest
|
24
|
Struga
|
0,3
|
2,2
|
1,5
|
0,9
|
|
7
|
Southwest
|
17
|
Ohrid
|
0,4
|
1,9
|
4,6
|
1,4
|
|
7
|
Southwest
|
9
|
Kičevo
|
1,6
|
2,2
|
7,5
|
2,8
|
|
7
|
Southwest
|
15
|
Makedonski Brod
|
4,5
|
0,0
|
48,7
|
9,9
|
|
8
|
Vardar
|
29
|
Veles
|
1,5
|
3,7
|
0,0
|
2,3
|
|
8
|
Vardar
|
8
|
Kavadarci
|
1,6
|
10,0
|
28,6
|
7,7
|
|
8
|
Vardar
|
16
|
Negotino
|
3,0
|
0,0
|
14,7
|
5,1
|
|
8
|
Vardar
|
26
|
Sveti Nikole
|
3,5
|
14,3
|
34,5
|
11,4
|
|
10
|
R. Macedonia
|
10
|
R. Macedonia
|
1,1
|
4,7
|
17,0
|
4,3
|
|
|
|
|
T-test
|
*0,035
|
*0,043
|
0,330
|
*0,035
|
Source: Annual reports, questionnaire and Statistical
Office data
Legend: red – considerably above average; green –
considerably below average.
The differences shown in the table above
are significant for the institutionalisation rates regarding the geographic
origin in case of special institutions for adults and children, they are not
significant regarding the old age homes, but are for all institutions. This is
quite the opposite to the significance in the differences of the regions. The
reason is probably in the fewer extreme values and smaller variance inside
regions for the institutionalisation rate to the old age home.
The table above adds to our speculation
about the reasons for differentiation. Even more clearly is seen the effect of
the vicinity of an institution, which are marked in Demir Hisar, Bitola and
Negotino. Low rate in Polog region can be again explained by cultural attitude
of sending someone away from home. But in this table we can see that there is a
difference between the two centres for social work covered regions and that
Tetovo has almost none institutionalisation, while rates for Gostivar are near
the national average.
 |
| Geographic origin of residents in childrensocial care institutions in Macedonia |
We can also see that a bigger part of
Southwest region has quite homogenously low institutionalisation rate, while
the rates in Makedonski Brod exceed the regional profile and are well above
average, except in respect of children institutions . The case of Makedonski
Brod, which has no children residing in institutions but there is an extremely
high rate of adult institutionalisation, could be explained by the fact that
there are many foster families in Makedonski Brod, but maybe not so available for
adults and that so the centre for social work may be inclined to refer those to
institutional care. This can be partially confirmed or seconded by the case of
Kriva Palanka, where centre for social work has taken out the residents of
adult and children institutions and provided them with day care and fostering,
while the institutionalisation rate for the old age homes is among the highest.
 |
| Geographic origin of residents in old age homes in Macedonia |
The Northeast region remains the riddle,
most probably to be solved by cultural or structural social moments and their
intraregional variations. In this region, the institutionalisation rate is
consistently above average for children and adult special institutions, but
relatively lower for the old age homes – mostly around average, but also at a
zero value in Probištip. It looks like region is oriented to care for old
people at home by the family means, but is fast at moving adults and children
to the institutions. This may be attributed to high rate of emigration, where
emigrant can provide for their parents but cannot leave the children and
sibling to their burden. Consistently high rate in Vinica may have also some
background in a micro culture, maybe in the way that centre for social work
operates. The discrepancy of the old age rate and substantially high rate for
children in Probištip may also be attributed to that.
 |
| Geographic origin of residents in adult social care institutions in Macedonia |
Claimer: This blog is intended as a part of
Situation Analysis and Assessment/ Evaluation Report of Implementation of
National Strategy on Deinstitutionalisation 2008–2018 which will be soon
presented to the public within the EU framework project Technical assistance
support for the deinstitutionalization process in social sector. For this blog Vlado
Krstovski, Andreja Rafaelič and Kalia Popovska are considered to be co-authors.
[1] This principle was not observed in previous wave of
deinstitutionalisation. See the chapter bellow.
[2] The IR is calculated on basis of population in the age group. E.g., the
high IR for the old age in Pelagonia means that there are 50,5 residents in all old age homes across Macedonia per
10.000 inhabitants of Pelagonia region that are over 65 years old.
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