Although midwifery in Serbia has a long tradition, in the last decades, and especially in the last years since the Republic of Serbia is in the process of joining the European Union, this profession faces numerous challenges both in the context of formal education and the role that in the 21st century midwife has in practice. The midwife profession is faced with numerous challenges related to demographic trends and demands and expectations of a contemporary woman. The aim of the paper was to examine the difference in standards in the education of midwives in Serbia, and the neighbouring countries and Europe. Professional publications related to education and practice of midwives, published in Serbia, the neighbouring countries and Europe have been used. According to the presentation of standards and competencies of midwives in Serbia and education standards under Directive 2005/36/EZ and 2013/55/EU as well as the role and tasks midwives have in our country and European countries, there is a need for harmonization of standards in the education of midwife nurses and accreditation of joint study programs of professional master studies for nurses and midwives within the educational system of Serbia, all in the context of new paradigm of health care, which implies a holistic approach to women's health, a personalized approach and a self-protection concept. It is necessary to reform the education system of midwives in Serbia in accordance with the requirements of Directive2005/36/EZ, 2013/55/EU.

Health care is the most important activity and human kind is dealing with its organization for centuries. Public health policies and functional health care systems have as their primary objectives the preservation and improvement of public health. Problems of intensive aging of the population, continuous growth of health spending, ensuring sustainable financing of health systems and efficient use of resources are present in all world health systems. Health care system reforms have become a global phenomenon for the last twenty years of the last century. The goal of this review paper is to point out the importance and need for timely modifications of the strategy of the health care optimization plan in Serbia by 2035, so that the health care system of Serbia would be ready to respond to potential global health crises in the future. The Plan for optimizing the health care institutions network by 2035 as a key document of the Master Plan will be briefly presented with an analysis of key parameters of health care effectiveness and above all improvement of the implementation of basic principles of health care - uniformity and availability of health services on the territory of Republic of Serbia. In order to present future key changes in the health system, it is necessary to take into account the current situation, as well as the potential consequences of the global pandemic of COVID-19 virus on health systems. Databases were used for analysis: WHO, OECD, World Bank Reports. The tendency of increasing the share of health care costs in GDP, with the problems of efficient use of health care resources, is becoming the most important reason for reforming health insurance and health care in almost all countries in the world. Numerous researches of eminent experts in the field of economy and finance indicate that the introduction of compulsory health insurance with a clearly defined package of health conditions is the most rational choice in the implementation of the World Health Organization project: "Health for all in the 21st century". A health system could be said to be effective if it provides health care of maximum quality in terms of medical outcome, with minimal costs in relation to the allocated funds. Health care systems around the world today face very similar problems, and the COVID-19 pandemic has shown how "vulnerable" it is not only the health system but all of humanity when faced with such challenges.

Many of the challenges that health organizations face today are different in their work and depend on the regulations of changes in business, competition, but also the insufficient amount of all resources. The main goal of health organizations is to achieve a high quality of service. Today, the health sector is facing competition that leads to the need to gather information about current and potential users of adequate medical services. The efficiency and quality of the services provided by health institutions is largely determined by the qualification of the staff and the quality of the work team. This should be set in the conditions of increased need for better and more accurate diagnosis of various diseases and better treatment of patients. Therefore, the leaders of the organization of the health institution have a difficult task regarding the application of strategic management in order to best organize good working conditions in the team and create success in the treatment of patients. The success that the health institution will achieve depends on the education of employees, but also the application of new technologies, but also the procurement and provision of modern and adequate equipment. All this together can lead to significant and notable results in treating patients and achieving success and progress. An appropriate strategy is needed that will be implemented, but also overcome the challenges of today. That is why human resource management is one of the important tasks for an organization to survive in a changing environment and achieve success. There are three important goals in this. First of all, it is necessary to solve the problem and define the concepts related to the process of human resource planning. The second part is the one related to achieving competitiveness and specificity of the health institution. The third part included continuous training of health workers through scientific research, education and training and adaptation of innovations in health. Based on all the achieved results, it is necessary to draw conclusions and provide guidelines for further work, which indicates the need for continuous monitoring and constant creation of plans for the future.