Lithuanian – Swiss Cooperation Programme ( health sector )

1. Lithuanian – SwissCooperation Programme (healthsector) 2014Vilnius

2. Programme of the Government of the Republic of Lithuania (2012 – 2016) includes: “We will ensure that within three to four years effective working maternity and children’s departments at the hospitals will be renovated and equipped with the necessary modern medical equipment to provide safer and higher quality health care services for pregnant, delivering women and newborn babies.” Therefore, it is valuable that the Lithuanian and Swiss Cooperation Programme contributes to the implementation of such an important Lithuanian Government’s priority.

3. Previous, relevant experience In 1994-1996 the Swiss Government granted 4.6 m CHF to the project “Neonatology”. These funds were used for procurement of modern medical equipment and staff training activities at the 8 largest hospitals of the country providing perinatal and neonatal health care services.

4. Previous, relevant experience In 1997-1999 the Swiss Government granted 4 m CHF to the project “Pediatric Intensive Care and Pediatric Anesthesia”. These funds were used for supplying 5 Pediatric Reanimation and Intensive Care Units and 2 Pediatric Anesthesia Units at Vilnius, Kaunas and Klaipėda University Hospitals and Klaipėda, Panevėžys and Šiauliai Regional Hospitals with: • modern medical equipment; • staff training and education activities; • support for establishing the transport system.

5. Neonatalmortalility 1997 - 2012

6. Births per 1000 inhabitants

7. Infantmortality per 1 000 livebirths

8. Agreements • Programmes implementation agreements were signed on 9th February, 2012 and will be implemented by 13th of June, 2017. • Projects implementation agreements with 17 hospitalswere signed on 12th June, 2012and will be implemented by31st of November, 2016. • 5 new Projects implementation agreements were signed on December, 2013 and will be implemented by31st of November, 2016.

9. Thegoalof the LithuanianandSwiss Cooperation Programme • To reduce economic and social disparities between Lithuania and more advanced European Union member states, as well as between Lithuania’s urban centres and peripheral regions. • The purpose of this support is to improve the quality and accessibility of perinatal and neonatal services and reduce the disparities between regional and urban hospitals.  

10. Hospitals participating in theProgramme Alytus Regional S. Kudirkos Hospital Children`s Hospital (Affiliate of Vilnius University Hospital Santariškės Clinics) Christian Maternity Home Hospital Hospitalof Lithuanian University of Health Sciences Kaunas Clinics Kaunas Clinical Hospital Kėdainiai Hospital Klaipėda University Hospital Marijampolė Hospital Mažeikiai Hospital P. Mažylis Maternity Home Hospital (Affiliateof Kaunas ClinicalHospital) Panevėžys Republican Hospital Pasvalys Hospital Raseiniai Hospital Šiauliai Republican Hospital Tauragė Hospital Telšiai Hospital Trakai Hospital Ukmergė Hospital Utena Hospital Vilnius Clinical Hospital Vilnius Maternity Home Hospital Vilnius University Hospital Santariškės Clinics Vilkaviškis Hospital Visaginas Hospital

11. Programme “Improvement of perinatal and neonatal care services in Lithuania” 31,294 m CHF (~87,600 m LTL, rate applied: 1 CHF = 2,8 LTL) 26,600 m CHF – Swisssupportfunds 4,694 m CHF – co-financingoftheRepublicofLithuania

12. Programme Goals • To improve the quality of health care services to pregnant, delivering women and neonates. • To improve collection of statistic data on the health of pregnant, delivering women and neonates and to expand the possibilities of sharing and analysing the collected data.

13. Expected Results (outputs) • 24 hospitals will be equipped with the necessary modern medical equipment for providing high quality perinatal and neonatal health care services. • Vehicles with special equipment for safe transportation of neonates will be provided to 3 health care institutionsproviding medical care to premature neonates and the services of neonatal reanimation and intensive treatment. • Premises of 10 health care institutions will be repaired. • 70 guidelines and protocols of diagnostics and treatment in obstetrics and neonatology will be developed. • Professional competence and modern technology usage skills of not less than 1300 health care specialists engaged in the provision of obstetric and neonatal services will be improved. • Computer database of pregnant, delivering women and newborn babies health data will be developed and prepared for usage in health careinstitutions, improving the collection of statistical data on perinatal and neonatal health and expanding the possibilities of data analysis through the inclusion of data on premature and unhealthy neonates required for the remote monitoring of such neonates.

14. Completedworks (I) Medicalequipment 23Lithuanian hospitals equipped with 34 differentnamesofnecessary modern medical equipment ofmorethan31 m LTL: • Alytus Regional S. Kudirkos Hospital • Children`s Hospital (Affiliate of Vilnius University Hospital Santariškės Clinics) • Christian Maternity Home Hospital • Hospitalof Lithuanian University of Health Sciences Kaunas Clinics • Kaunas Clinical Hospital • Kėdainiai Hospital • Klaipėda University Hospital • Marijampolė Hospital • Mažeikiai Hospital • P. Mažylis Maternity Home Hospital (Affiliateof Kaunas ClinicalHospital) • Panevėžys Republican Hospital • Pasvalys Hospital • Raseiniai Hospital • Tauragė Hospital • Telšiai Hospital • Trakai Hospital • Ukmergė Hospital • Utena Hospital • Vilnius Clinical Hospital • Vilnius Maternity Home Hospital • Vilnius University Hospital Santariškės Clinics • Vilkaviškis Hospital • Visaginas Hospital Monitors for essessment of the state of the newborns, incubators, anaesthesia apparatuses, equipment for foetus condition examination and for surgery and reanimation of newborns, ultrasound equipment, warmed newborn reanimation tables, universal delivery beds and ect.

15. Completed works (II) • 20 units of otoacoustic emission accumulating devices for the neonates hearing screening were bought. • Otoacoustic emission accumulating devices for the neonates hearing screening are necessary by implementing newborn hearing screening.

16. KaunasClinicsUkmergė Hospital Utena Hospital

17. Visaginas Hospital Pasvalys Hospital Kėdainiai Hospital

18. Mažeikiai Hospital Vilnius MaternityHome Telšiai Hospital

19. Completed works (III) Repair works • Contracts of technical projects and technical projects supervision services and repair works were signed by 4 of 10 hospitals. • 1 hospital completed repair works. Professional competence improvement and guidelines and protocols of diagnostics and treatment • Thecontractofhealth care specialists’ professional competence improvement and development of diagnostics and treatment guidelines and protocols in obstetrics and neonatology was signed on 27 June, 2013. • 23 (of 70) the most important guidelines and protocols of diagnostics and treatment in obstetrics and neonatology were developed. Computer database • The contract of technical supervision services related to development and installation of computer database of pregnant, delivering women and newborn babies health records planned to be signed in 2014.

20. Programme “Introduction of energy efficient technologies into the Lithuanian hospitals providing perinatal and neonatal health care services” 22,353 m CHF (~62,600 m LTL, rate applied: 1 CHF = 2,8 LTL) 19,000 m CHF – Swisssupportfunds 3,353 m CHF – co-financingoftheRepublicofLithuania

21. Expected Results (outputs) 1. Thermal insulation installed: • renovated and insulated roofs; • insulated exterior walls; • replaced windows and exterior doors; • sealed seams between the board panels of exterior walls. 2. Energy efficient engineering systems installed and operational: • upgraded heating stations; • upgraded external/internal hot water supply systems ; • upgraded internal heating systems; • upgraded electricity supply systems (including installation of lighting with LED lights). 3. Microclimate improvement engineering systems installed and operational: • upgraded/installed ventilation/air conditioning systems. 4. Rehabilitated and modernized vacuum and oxygen supply systems installed and operational

22. Completed works (I) • 5 new hospitals included into the Programme and Projects implementation agreements were signed. • 12 agreements to the Projects implementation agreements were signed. • 3 hospitals completed repair works (2 hospitals will carry out procurements of installation of lighting with LED lights). • Repair works are in process in 2 hospitals. • 5 hospitals are preparing to announce repair works procurements. • 9 hospitals prepared technical projects expertise's. • 6 hospitals completed public procurements.

23. Completed works (II) The next activities are being implemented: • replaced windows – 1 hospital; • upgraded internal heating system – 1 hospital; • upgraded external hot water supply systems – 1 hospital; • upgraded/installed ventilation/air conditioning systems – 2 hospitals; • upgraded electricity supply systems – 1 hospital; • upgraded vacuum supply systems – 1 hospital; • upgraded oxygen supply systems – 1 hospital. The achievement of the other indicators is in the process.

24. Tauragė Hospital (repair works completed) Before After

25. More information: Ms Virginija Ambrazevičienė Head of International Projects Management Division Ministry of Health of the Republic of Lithuania Tel. +370 5 260 4719 El. p. virginija.ambrazeviciene@sam.lt Also: http://www.sam.lt/go.php/lit/Lietuvos_ir_Sveicarijos_bendradarbiavimo/1195 http://www.facebook.com/LietuvosIrSveicarijosBendradarbiavimoPrograma

26. We hope that together we will be able to create a Europe where our children will be safe and healthy