Public Health Initiatives

Programme Summary

Why was the programme needed? Public health is “the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society” (Acheson, 1988; WHO). In the medical field, clinicians treat diseases and injuries but in public health, specialists – prevent them. That is why public health and its improvement is already a challenge. Public health interventions are complex and their success relies heavily on partnerships with other sectors, also, the effect of interventions is often longer-term and indirect and “invisible” to the public. As young people are the future of our society we need to work together by paying a high attention to children and youth health. According to various research data (2007), situation in Lithuania was not satisfying: 20% of children aged 15–16 had tried drugs and 95,9% of them had tried alcohol at least once, 71,6% of the Lithuanian population aged 15–34 had smoked at least once in their life, also, the life-style habits of youth and reproductive health indicators were unfavourable for health. Significant disparities between men and women, rural and urban population, people with different education and income status were observed in Lithuania. Also, Lithuania stood out from the other countries in having huge health inequalities in terms of age, gender, access to health care, etc. Therefore, all the public health initiatives of the programme were very important and all of them were directed to improve public health, to strengthen health care services for children and young people and to reduce health inequalities in Lithuania.What did the programme achieve? During the reporting period all 24 projects were successfully implemented and all programme outcomes’ indicators were reached. First of all, the goal to develop a national Child health monitoring information system intended for the analysis of preventive medical check-up data and health-related factors by ensuring access to health data to a broader circle of specialists at the national and municipal levels was reached. As a result the development of the information system contributed to the outcome (No. 1) of the programme area – “national health registers and health information systems, data management and use improved“. Upgrade of the health promotion infrastructure (592 health offices were equipped/renovated) in schools and pre-school education institutions contributed to the outcome (No. 2) of the programme area – “improved access to and quality of health services including reproductive and preventive child health care”. Furthermore, the programme provided for paying more attention to youth health, prevention and reduction of life-style related diseases by increasing the availability of youth-friendly health care services and providing high-quality and friendly health care services designed to meet the needs of the youth, thus contributing to the outcome (No. 3) – “life-style related diseases prevented or reduced“. The creation of the model for the strengthening of the capacities to identify and reduce health inequalities and enhancement of administrative capacities in the area of identification and reduction of health inequalities contributed to the achievement of outcome (No. 4) – “reduced inequalities between user groups“. Furthermore, significant progress in achieving target output indicators was reached: all target indicators were fully achieved (target values of 5 indicators were exceeded). During all programme implementation period the programme focus area remained among the priorities on political agenda and is very much in line with the government programme, Public Health Strategy for 2016–2023, as well as with MoH policy priorities placing focus to health inequalities, public health promotion and disease prevention. The programme contributed to tackling economic and social disparities as one of the objectives of the 2009–2014 Norwegian Financial Mechanism by supporting child and youth health care initiatives, providing assistance in capacity building for identification and reduction of health inequalities through inter-sectoral approach and promoting exchange of skills and knowledge with Norwegian counterparts. Programme projects contributed to the cohesion objective with particular attention devoted to problematic areas and regions (as projects include 13 problematic areas / regional centers of Lithuania). The developed national Child health monitoring information system enables systematic analysis of preventive medical check-up data and health-related factors and provides possibilities for purposeful health policy making on national and municipal levels (pre-defined project 1). The developed unified system for monitoring health inequalities enables systematic assessment of inequalities in population health on different levels (national, regional, municipality, sub-districts of municipality), this alongside with practical guidelines and strengthened administrative capacities creates prerequisites for improved planning and implementation of inter-sectoral actions for addressing disparities in population health (pre-defined project 2). Modernization of student health offices in schools and pre-schools improved quality and accessibility of health care services provision in more than one third of Lithuanian schools and pre-school educational institutions. In long-term period, this will result in added-value, i.e. creating and fostering healthy environment in schools / pre-schools and respective municipalities, improving physical and mental health of children and youth (Measure 1). The programme, also, contributed to the prevention and reduction of life-style related diseases of youth as it increased the accessibility and quality of youth-friendly healthcare services by implementing the created model for such services in 12 municipalities (Measure 2 and Small grant scheme). Upon implementation of the model for the provision of youth-friendly health care services, approximately 230 000 young people in urban and rural areas (about 37% of total Lithuanian youth population) can benefit from improved access and quality of health care services. This, also, contributes to the improvement of youth quality of life, reduction of inequalities in youth health, thus, improvement of social and economic well-being in Lithuania.How were bilateral relations strengthened? Strengthening bilateral relations between Lithuania and Norway was, also, a very important objective of the programme. During the programme implementation the bilateral element was very visible and implemented initiatives laid foundations for bilateral partnerships and further common activities. It should be noted that Norway has valuable experience in programme fields and willingly shares it. During the programme implementation period projects having four official Norwegian partners were successfully implemented, best practices were shared, 12 applications under the measure B of the Bilateral Fund were received, approved and implemented, as well as initiatives organized by PO were implemented. Successful implementation of new and continued bilateral cooperation activities and high interest in developing bilateral relations expressed from both sides should be pointed out as a positive trend. Although the programme had no official donor partner on the programme level, use of the Bilateral Fund was one of the highest among other programmes in Lithuania, funded from Norway Grants.What will be the impact of the programme? One of the opportunities and an effective tool for experience exchange proved to be complementary activities providing possibility for networking with colleagues implementing similar programmes in other countries and learning from external experience. During the programme implementation period, Complementary Action funding was used to attract high quality input and expertise from Norway, Austria, Poland, Slovenia and other countries. Participation in international events provided not only with latest public health innovations, knowledge and inspirational experience but, also, with useful contacts and new insights, which were used by implementation of the programme measures and for the future international events to be organized within the programme. Various information and publicity activities were carried out by PO, project promoters and partners during the programme implementation period. These activities have raised public awareness about the programme, its projects, results and their significance as well as bilateral dimension and increased visibility of the Grants and the programme not only on local, national, but, also, on international levels. During the reporting period there were more than 340 organized events which gathered in total over 90 900 participants. These events were very useful, also, in terms of exchanging professional knowledge and experience, discussing relevant issues and possible solutions in relevant fields. Looking forward the main challenge is to ensure the sustainability and monitoring of the projects’ results, further use of the results developed, guidelines / methodologies prepared, to stimulate intersectoral partnerships and to ensure further development of bilateral dimension of the programme. However, as external experts evaluated the activities implemented and the results achieved under the programme will have long term positive effect to public health sector in Lithuania for at least 10 years or even longer.