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Creating Environment and Health Information System in Lithuania :

Creating Environment and Health Information System in Lithuania :. First steps. Ingrida Zurlyte , Aida Laukaitien e State Public Health Centre, Vilnius, Lithuania. The Central and Eastern European Chapter/ISEE Meeting 4 – 6 September, 2003, Balatonfoldvar. National Framework.

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Creating Environment and Health Information System in Lithuania :

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  1. Creating Environment and Health Information System in Lithuania: First steps Ingrida Zurlyte, Aida Laukaitiene State Public Health Centre, Vilnius, Lithuania The Central and Eastern European Chapter/ISEE Meeting 4 – 6 September, 2003, Balatonfoldvar

  2. National Framework • National Public Health Strategy, 2001 • Law on Public Health Care, 2002 • Law on Public Health Monitoring, 2002 (by-law acts, 2003) • National Environmental Health Action Programme (2003 – 2006) • National Public Health Monitoring Programme (draft) • Strategic Planning for Health Sector

  3. National Framewok • Long – Term State Development Strategy, 2002 • National Sustainable Development Strategy and Implementation Plan, 2003 • Information Society Programme

  4. Environmental Health Information System - environmental health data collection, transmission, processing and delivery to end-user in the most efficient way in order to possess everyday tool for environmental health management (NEHAP of Lithuania, 2003) • The purpose is to: • collect and process environmental health information on geographical principle and with national coverage; • assess environmental health situation; • ensure fast and effective use of environmental health data and information for identification of “hot spots”; • provide input for environmental health impact assessment; • use in forecasting and policy decision – making process.

  5. Input from international projects • WHO/DEPA Project on Implementation of National Environmental Health Action Plans in Czech Republic, Estonia, Lithuania, Poland and Slovakia, 2000 – 2001 • WHO mission to review EH monitoring and information system in Lithuania, 2001 • Analysis and strategic recommendations for integrated EH information system, 2001

  6. Input from international projects • WHO project: Environment and Health Indicators: developing methodology for the WHO European Region • Planning, set of EH indicators • Feasibility study for core set of EH indicators • Pilot study (data collection, EuroIndy, meta data information, fact – sheets for reporting)

  7. Feasibility study • Issues addressed: • Availability and quality of necessary data; • Accessibility and exchange mechanisms; • Use and usefulness of proposed indicators in (sub)national context; • Capacity for multi – agency working on the information.

  8. Results of Feasibility Study • From the WHO core set of indicators (55): - most were feasible (24) - 17 partly feasible - 14 not feasible (exposure related indicators; noise related effect indicators (annoyance, sleep disturbance; exceedance of WHO drinking water guidelines) • Only 3 indicators not useful (consumption of leaded gasoline; blood lead level in children; standardized mortality ration by occupation)

  9. Positive experience – feasibility study • Renewed contacts and new contacts established. • More clear and generalized view on existing EH information, assessment of gaps. • Created understanding, awareness in health and other sectors; • Standardized forms for information collection and evaluation. • Cooperation with WHO and EEA.

  10. Problems • Problems with identifying data-holders (additional administrative capacities and time); • Data is spread in different institutions (27), 10 of them from health sector. • Lack of institutional co-operation and data exchange, lack of dataor data duplication; • Financial and timing problems – motivation, reluctance from some institutions and experts; • Transitional period (changes in methods, new and old data are hardly comparable and new data are not complete);

  11. Problems • Reorganization of public health institutions: moving responsibilities • Each institutions/expert are very specialized difficult to generalize. • Incompatibility of environment and health data collection and presentation formats • Poor EH reporting

  12. National List of Environmental Health Indicators, adopted by the Order of the Minister of Health, August 30, 2002 • Based on WHO core set of EH indicators, feasibility study results and new proposals • Discussed with public health, environmental institutions and Statistical Department • Procedure for data collection, analysis and reporting, end of 2003.

  13. Example from the national list

  14. Some other differences • Children statistics: 0-2; 3-6; 0-14; 0-15 years old • Mortality due to external causes in children under 6 years old • Acute communicable intestinal diseases morbidity in children under 6 years of age • Different formulation of food safety indicators • Number of outbreaks of communicable disease transmitted by food per year • Incidence rate of acute intestinal communicable disease and bacterial food toxic infections

  15. Rate of road traffic causalties (injury+death)

  16. Useful floor area per person in Lithuania during the year 1996-2001 Notes:Data of useful floor area are collected in Lithuania. Lithuanian Statistical Department defines Useful floor area as: the floor space of dwellings measured inside the outer walls; excluding cellars, uninhabitable attics and, in multi-dwelling houses, common area.

  17. Problems encountered • Interpretation in environmental health terms • Lack of data: for drinking water quality; food action indicators only from the year 2000; sites containing large amount of chemicals – approximate only • Action indicators: broad; very approx estimation (subjective judgment) • Food borne illness or water born illness – different from WHO indicators • Regulatory requirements for land use around areas with large quantities of chemicals – who is responsible?

  18. Application on local level • Interest from local level exist • Differences between counties and localities • Need for additional training and guidance from national level • Should be clear for local authorities what data, where to get etc.

  19. Expectations • Environmental health assessments • Environmental Health (Public Health) reporting and communication • Contribute to monitoring of environment and health actions • Incorporate children EH indicators

  20. Tasks • Ensure continuity of work done • Build partnership with stakeholders • Managers and politicians should take ownership of the environmental health information system • Complete legal basis for EHIS functioning. • Create financial – economic basis for EH information system functioning. • Solve issues of EHIS holder(s) management and subordination.

  21. Thank you for your attention!

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