While Macedonians generally have access to safe drinking water and sanitation, inequities still exist. Roma communities, especially in Skopje, have much less access - only 16% have toilets and bathrooms and 26% access to water. Educational and health facilities also lack adequate facilities for maintaining menstrual hygiene. Addressing these inequities requires standards for menstrual hygiene management, public toilets, and services for vulnerable groups like the homeless and those in informal settlements. Challenges include geographical disparities, lack of funding, and proper operation and maintenance of water and sanitation systems.