7.1 General context
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The health of young people in Lithuania is lagging behind other EU countries. The most recent information on youth health can be found at Statistical Portrait of the Youth published by Statistics Lithuania. General statistical information (including youth health) is provided by The Institute of Hygiene as well as Statistics Lithuania section on Youth in Lithuania. The national health monitoring and surveillance system for physical activity was established in 2011 under the leadership of the Department of Physical Education and Sports. Data on physical activity includes frequency, duration and intensity of physical activity and can be disaggregated according to age group and socioeconomic indicators. Areas that require particular attention are the high suicide rate, as well as related psychological and behavioural issues, and high levels of smoking and alcohol consumption among young people as well as the need to increase physical activity and access to health and sex education information. Considerable inequalities in youth health depending on urban or rural residence and the level of education prevail. The large educational and urban / rural and educational inequalities are indicative of a greater social and psychological stress experienced by the rural and low-educated youth because of unhealthy lifestyles and lack of accessibility of health care and preventive measures.
The main concepts related the health conditions of young people include psychological assistance which is provided at secondary schools by psychologists of pedagogical psychological services and healthcare in schools (see Law on Education Articles 19 and 22). Healthcare in schools services are aimed to protect and improve health of learners, by actively cooperating with their parents (guardians, curators). Healthcare in schools comprises public healthcare activities carried out by specialists of municipal public healthcare institutions or healthcare specialists (see also Order of the Minister of health on the the qualification requirements for healthcare specialists working at schools). Schools may implement only learners’ health promotion programmes which are approved by the Ministry of Education and Science, other ministries or municipal institutions. Personal healthcare in schools is designated for learners with special educational needs in accordance with the procedure laid down by legal acts. Schools can develop and implement health improvement programmes. Such programmes may be supported with funds of state and/or municipal target programmes on public health support, and other funds. Article 6 of the Law on Public Health Care of the Republic of Lithuania (Lietuvos Respublikos visuomenės sveikatos priežiūros įstatymas) states that public health care functions at pre-school, pre-primary, primary, basic and secondary education programs in pre-school, general education schools and vocational education institutions in the territory of the municipality, public health strengthening, public health monitoring are designated to municipalities. The municipalities carry out independent public health care functions such as: 1) implemening public health measures provided for in the strategic development plans of the municipality and (or) municipal strategic plans approved by the municipal council, taking into account the prevailing public health problems in the municipality; 2) participate in the implementation of state public health programs, interinstitutional activities plans; 3) carry out the health care of children and young people, except for public health care provided by pre-school, pre-primary, primary, basic and secondary education programs in pre-school, general education schools and vocational education institutions located in the municipality's territory; 4) includes social partners in public health promotion activities. Municipal Public Health Bureaus (Visuomenes sveikatos biurai) are established in each municipality that act as municipal public health care institutions. The functions of the Municipal Public Health Bureaus are established by the Ministry of Health, which among other programmes include municipal public health support programmes for youth. Public health care provided by municipalities is financed from the state budget, the municipal budget, the municipal public health support program, the Compulsory Health Insurance Fund and other funds. In accordance with the procedure established by the Government, the municipalities report annually to the Ministry of Health.