North Macedonia | Ukraine and Impacted Countries Emergency Appeal - Final Report (MGR65002), March 2026

Countries: the Republic of North Macedonia, Ukraine Source: International Federation of Red Cross and Red Crescent Societies Please refer to the attached file. SITUATION ANALYSIS Description of the crisis As a result of the international armed conflict between Russia and Ukraine, beginning on 24 February 2022, a total of 86,4362 displaced people from Ukraine had entered North Macedonia by February 2025. More than 80 per cent of those fleeing were women, including single mothers with young children and older people above 65 years of age, groups considered among the most vulnerable due to their higher risk of unemployment, limited income sources and increased protection needs. In contrast to other migrant groups transiting through North Macedonia, displaced people from Ukraine were anticipated to remain in the country for the duration of the conflict, progressively integrating into local communities. In terms of legal and policy preparedness, North Macedonia remained the only country in the region and in Europe that had not introduced temporary protection status for displaced people from Ukraine by the end of 2022, as envisioned under the Law on International and Temporary Protection and widely implemented by other countries. Instead, displaced people from Ukraine were instructed to apply for temporary humanitarian residence permits, which did not provide full access to essential public services, including free state-funded healthcare, psychological support, medicines or emergency medical care. Accommodation was largely provided through private housing arrangements, primarily rented apartments or housing offered by Ukrainian property owners, relatives, host families and local residents extending support free of charge. Initial assessments carried out at Red Cross of the Republic of North Macedonia (RCRNM) registration points identified significant vulnerabilities among displaced people from Ukraine, triggering a swift response focused on basic assistance, protection services and psychosocial support (PSS). As the situation continued to evolve with new arrivals and escalating financial pressures affecting both displaced families and host communities, humanitarian needs became increasingly complex, further challenging access to services and the delivery of assistance. At the end of 2022, a comprehensive needs assessment3 was undertaken through a survey involving 590 displaced people from Ukraine. The results served as an evidence base for planning interventions in 2023 and 2024, shaping programme priorities and operational approaches. During 2023–2024, the RCRNM regularly assisted displaced people from Ukraine and increasingly delivered humanitarian support through cash and voucher assistance (CVA). This modality was introduced after assessment showed that many displaced people had been residing in the country for an extended period making cash-based support more appropriate to meet their needs. During this period, the RCRNM also initiated integration-focused activities, including continuous Macedonian language courses and PSS services designed to strengthen personal resilience, social skills and community inclusion. Access to healthcare emerged as one of the most pressing needs. Due to their legal status, displaced people from Ukraine were required to cover all medical expenses, significantly limiting their access to essential services. To mitigate these barriers and address urgent health needs, the RCRNM mobilized additional resources, supported by the Swiss Red Cross, to provide emergency medical care, secure chronic and urgent medications and cover critical health-related costs. In 2025, humanitarian assistance to the affected population continued, though with limited resources and decreasing involvement from other organizations in the country, such as the Swiss Red Cross and the United Nations High Commissioner for Refugees (UNHCR), reflecting the broader global policy direction toward the situation in Ukraine. Assistance remained focused on the most vulnerable groups, primarily through CVA for women’s health check-ups and the procurement of shoes, clothing and essential household items. Additional support was provided to facilitate access to medical services and medicines, implement child-focused activities and enable networking initiatives connecting employers with job seekers.
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