Case study: Community and health services: the Kaunas District Public Health Bureau, Lithuania
The Kaunas District Public Health Bureau is part of the Lithuanian national health system. The main aim of the Bureau is to work in partnerships at the local, national and international levels to promote health in the Kaunas District, improve the quality of life of the inhabitants of the District through a life-course approach, and organize the assessment and monitoring of public health in the District.
Located in the central part of Lithuania, the Kaunas Region is the third largest region in the country as far as area covered (8089 km2) and the second largest regarding number of inhabitants. At the beginning of 2017, the population was 569 875 (20% of the total population of Lithuania). The Kaunas Region covers eight municipalities, namely: Birstonas, Kaunas City, Kaunas District, Jonava District, Kaisiadorys District, Kedainiai District, Prienai District and Raseiniai District. The Kaunas District, which covers an area of 1496 km2 (578 mi2) to the north, west and south of Kaunas City, has 25 settlements with local communities. In 2016, the total population was 90 295, almost 16% of which were 65 years of age, or more. Population density in the District was 54/km2 (140/mi2). Among the districts in the Kaunas Region, the Kaunas District stands out as actively promoting health in its communities. Since 2013, the Kaunas District, as a part of the Kaunas Region, has participated in the WHO Regions for Health Network.
Lithuanian health statistics clearly indicate that health-related behavioural problems, such as physical inactivity and unhealthy eating habits, are widespread in the country. As a result, more than half of the population are overweight, or obese, and approximately half consider their health to be average, or lower than average; these trends tend to relate more to older rather than younger people. The prevalence of chronic diseases increases with age and, thus, the risk for cardiovascular disease in the Kaunas District is much higher than in the rest of Lithuania. Furthermore, many people in the District suffer from mental-health problems.
Thanks to its collaboration with the Lithuanian Sports University (leaders in sports and health sciences), the Kaunas District Public Health Bureau has been able to address these challenges through the development of several intersectional interventions based on the life-course approach. Currently, the Bureau, led by Laurynas Dilys, is involved in a number of public health projects related to health promotion across all age groups at the local, national and international levels.
Several examples of good practice by the Bureau in tackling health-related behavioural problems follow.
- For several years, within the framework of the project entitled, "Promoting physical activity among Kaunas District communities using information technologies", the Bureau (in collaboration with the Lithuanian Sports University) has been running interactive physical-activity programmes in the communities of the District’s 25 settlements. Residents can participate in exercise programmes held on a weekly basis in community leisure halls, schools, etc., under the online guidance of professional coaches of the University.
- For the third year in a row, the Bureau (in collaboration with Lithuanian Sports University) has conducted the evaluation and monitoring of physical fitness in primary-school children in the Kaunas Region.
- Currently, the Bureau is organizing free monthly aqua exercise activities for people of all ages living in Kaunas District.
- In 2017, more than 100 people between the ages of 18 and 80 participated in a three-day summer health campus that provided a variety of physical activities, such as Pilates workouts, kickboxing, dancing, and Nordic walking. Seminars on healthy nutrition and the benefits of physical activity were also organized during the event. Communication and collaboration among the participants facilitated a supportive social environment – a protective factor for mental health. It is planned to continue this initiative and to implement other similar projects in the future.
The participatory approach
Specialists of the Bureau work in many sectors, including that for education where they monitor and assess health and conduct research. Close attention is paid to ensuring community involvement through the organization of events, seminars and open-discussion initiatives to share expertise and experience. The Bureau also contributes to the debate on health-policy decisions related to the Lithuanian health-care system in various governmental institutions and collaborates with the Lithuanian Ministry of Education and Science on the implementation and improvement of health-enhancing practices and policies in primary and secondary schools.
Since November 2017, the Kaunas District Public Health Bureau has been implementing the new, challenging European Union ERASMUS+ project, “Communities of practice for healthy lifestyle”, which relates to Key Action 2 (KA2), “Cooperation and Innovation for Good Practices” coordinated by Hanzehogeschool Groningen Stichting, (Hanze University of Applied Sciences), Netherlands. The aim is to develop and sustain communities of practice to stimulate innovation and socioeconomic development in healthy ageing.
In addition, an application has been submitted to the European Social Fund Agency (established by the Ministry of Social Security and Labour and the Ministry of Education and Science) for the renewal of the three-year project, "Promoting physical activity among Kaunas District communities", and for its continued funding. The aim of the project is to provide access to twice-weekly exercise sessions, both online and live, for all communities of the 25 settlements of the Kaunas District.
About the WHO Regions for Health Network
The WHO Regions for Health Network was established in 1993 with the aim of:
- creating synergy between regions and stakeholders in the field of health (mutual learning);
- strengthening cooperation/collaboration between regional and local actors and the international health institutions;
- promoting the contributions of the regions and local authorities, particularly the health authorities, to the international policy-making process; and
- increasing understanding of regional and local health systems (exchange of experiences).