Health promotion for older people in Lithuania: Between bureaucratic and financial constraints

Milena Pavlova,

Liubove Murauskiene,

Elina Miteniece,

Agnieszka Sowa,

Iwona Kowalska-Bobko,

Alicja Domagała,

Wim Groot

The health system in Lithuania has a strong focus on hospital treatment. Overall, there is a lack of sufficient funds explicitly devoted to public health. This country report draws upon several national reports focused on the Lithuanian health system and other country-specific sources in order to outline the major institutional and financing challenges for health promotion in Lithuania, specifically for older adults. As suggested in our review, the key problems in public health services in Lithuania, including health promotion for older persons, are the bureaucratic and financial constraints, a lack of intersectoral cooperation, staff shortages and capacity problems. The implementations of public health initiatives greatly depend on the political will and the government’s ability to implement policies, which are still weak in Lithuania. Moreover, the public health legislation lacks clarity and fails to provide an adequate base for local-level evidence-based interventions. Concrete action plans, as those recently developed in the area of healthy aging and health inequalities, are needed to provide guidance for health promotion among older adults.
Słowa kluczowe: public health, health promotion, older adults, health policy, Lithuania

1. Adany R., Villerusa A., Bislimovska J., Kulzhanov M., Public health education in Central and Eastern Europe, and Central Asia, “Public Health Reviews” 2011; 33: 105–133.

2. OECD, Lithuania: fostering open and inclusive policy making, OECD Publishing, Paris 2015,­sive-policy-making-9789264235762-en.htm; accessed: 19.10.2016.

3. Murauskiene L., Janoniene R., Veniute M., van Ginneken E., Karanikolos M., Lithuania: health system review, “Health Systems in Transition” 2013; 15 (2): 1–150.

4. Ministry of Health, Lithuania Country Review. JA-CHRODIS – Good Practice in the Field of Health Promotion and Primary Prevention, 2014,; accessed: 19.10.2016.

5. Tambor M., Pavlova M., Rechel B., Golinowska S., Sowada C., Groot W., The inability to pay for health services in Central and Eastern Europe: evidence from six countries, “European Journal of Public Health” 2013; 24 (3): 378–385.

6. Bouman R., Horne R., Milasi S., Prasad N., Ageing and labour market implications for Lithuania, ILO Research Department working paper no. 6, International Labour Office, Geneva 2015,; accessed: 19.10.2016.

7. Selli K., Czabanowska K., Danusevičienė L., Butkevičienė R., Jurkuvienė R., Overall J., Discrimination of elderly patients in the health care system of Lithuania, “South Eastern European Journal of Public Health” 2016, VI; doi: 10.4119/UNBI/SEEJPH-2016-124.

8. Tamosiunas A., Klumbiene J., Petkeviciene J., Radisauskas R., Vikhireva O., Luksiene D., Virviciute D., Trends in major risk factors and mortality from main non-communicable diseases in Lithuania, 1985–2013, “BMC Public Health” 2016; 16: 717.

9. Tamosiunas A., Luksiene D., Baceviciene M., Bernotiene G., Radisauskas R., Malinauskiene V., Bobak M., Health factors and risk of all-cause, cardiovascular, and coronary heart disease mortality: findings from the MONICA and HAPIEE studies in Lithuania, “PLoS ONE” 2014; 9 (12): e114283.

10. Stanojević Jerković O., Sauliūnė S., Šumskas L., Birt C., Kersnik J., Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey, “European Journal of Public Health” 2015; doi: 10.1093/eurpub/ckv097.

11. Republic of Lithuania, Law on Health Insurance (as last amended on 10 July 2014 – No XII-1001) 1996,; accessed: 19.10.2016.

12. Stepurko T., Pavlova M., Gryga I., Murauskiene L., Groot W., Informal payments for health care services: The case of Lithuania, Poland and Ukraine, “Journal of Eurasian Studies” 2015; 6 (1): 46–58.

13. Kavaliunas A., Sceponavicius A., Asokliene L., Developing public health at local level: Lithuanian example, in: Kavaliunas A. (ed.), IFEH 12th World Congress on Environmental Health: new technologies, healthy human being and environment, Medimond International Proceedings, Bologna 2012: 1–6.

14. Ministry of Social Security and Labor, Report on the follow-up to the Regional Implementation Strategy (RIS) of the Madrid International Plan of Action on Ageing 
(MIPAA) in Lithuania
, 2012,; accessed: 19.10.2016.

15. Newiger-Bogumil C., Creative age management strategies for SMEs in the Baltic Sea Region. Annex 1: Country Studies: Lithuania, 2012,; accessed: 19.10.2016.

16. HeFiLL, HeFiLL – Healthy and Fit in Later Life, 2013,; accessed: 19.10.2016.

17. i2i Project, From isolation to inclusion, 2007,; accessed: 19.10.2016.

18. Mažionienė A., Valeckienė D., Mažionytė I., Beržinytė D., Aleksandravičiutė T., Bliudžiutė D., Razmutė R., Zakarauskaitė K., Ageing in Lithuania, 2011,; accessed: 19.10.2016.

19. Nakrosis V., Vilpisauskas R., Jahn D., Sustainable governance indicators: 2015 Lithuania report, Bertelsmann Stiftung, Gütersloh 2015.

20. Momkuviene V., Independent experts positively evaluate prevention programmes’ efficiency, National Health Insurance Fund, Vilnius 2011,–07–20&item_id=1910; accessed: 19.10.2016.

21. McKee M., Mackenbach J., Conditions for successful health policies, in: Mackenbach J., McKee M. (eds), Successes and failures of health policy in Europe: four decades of divergent trends and converging challenges, Open University Press, Maidenhead 2013: 331–355.

22. Kalediene R. et al., Public health bureaus: new players in health improvement in Lithuania, “Acta Medica Lituanica” 2011; 18: 183–189.

23. National Audit Office of Lithuania. Organising public health improvement in municipalities. Public Audit Report No. VA-P-10-2-3, National Audit Office of Lithuania, Vilnius 2015.

Czasopismo ukazuje się w sposób ciągły on-line.
Pierwotną wersją czasopisma jest wersja elektroniczna publikowana w internecie.