1. 2014 Vilnius

2. “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. 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. 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. 1997199819992000200120022003200420052006200720082009201020112012 Number of life births 37812370193641534149311852954129977297692951029606300203153632165306763026830459 Infant deaths under 1 years 391343315294250238206240209213190172181153144118 For 1 000 life births 10,39,28,68,58,08,16,98,17,17,26,35,5 5,04,83,9 Early neonatal mortality (0 - 6 days newborns) 1651331281178998791047991796971536445 For 1 000 life births 4,33,63,53,42,93,32,63,52,73,12,62,2 1,72,11,5 Late neonatal mortality (7 - 27 days newborns) 60474447423234424531283034302629 For 1 000 life births 1,61,31,21,41,31,1 1,41,51,00,91,01,11,00,91,0 Postneonatal mortality 16616314313011910896948591837376705444 For 1 000 life births 4,4 3,93,8 3,73,13,22,93,12,82,32,42,31,81,4 Stillbirths 248240207221167193168150152137161164151147148117 For 1 000 births 6,56,45,76,45,36,55,65,05,14,65,35,24,74,84,93,8 Perinatal mortality 413373335338256291247254231228240233222200212162 For 1 000 births 10,910,09,29,88,29,88,28,57,87,78,07,46,96,57,05,3 Pregnant and delivering women mortality 6653461540230221 For 1 00 000 births 23,818,913,811,812,820,33,316,813,606,79,506,56,63,3

8.  Programmes implementation agreements were signed on 9th February, 2012 and will be implemented by 13th of June, 2017.  Projects implementation agreements with 17 hospitals were signed on 12th June, 2012 and will be implemented by 31st of November, 2016.  5 new Projects implementation agreements were signed on December, 2013 and will be implemented by 31st of November, 2016.

9.  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. Alytus Regional S. Kudirkos Hospital Children`s Hospital (Affiliate of Vilnius University Hospital Santariškės Clinics) Christian Maternity Home Hospital Hospital of Lithuanian University of Health Sciences Kaunas Clinics Kaunas Clinical Hospital Kėdainiai Hospital Klaipėda University Hospital Marijampolė Hospital Mažeikiai Hospital P. Mažylis Maternity Home Hospital (Affiliate of Kaunas Clinical Hospital) 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. 31,294 m CHF (~87,600 m LTL, rate applied: 1 CHF = 2,8 LTL) 26,600 m CHF – Swiss support funds 4,694 m CHF – co-financing of the Republic of Lithuania

12.  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.  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 institutions providing 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 care institutions, 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. Medical equipment 23 Lithuanian hospitals equipped with 34 different names of necessary modern medical equipment of more than 31 m LTL: 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 Alytus Regional S. Kudirkos Hospital Children`s Hospital (Affiliate of Vilnius University Hospital Santariškės Clinics) Christian Maternity Home Hospital Hospital of Lithuanian University of Health Sciences Kaunas Clinics Kaunas Clinical Hospital Kėdainiai Hospital Klaipėda University Hospital Marijampolė Hospital Mažeikiai Hospital P. Mažylis Maternity Home Hospital (Affiliate of Kaunas Clinical Hospital) Panevėžys Republican 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.  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.

19. 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  The contract of health 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. 22,353 m CHF (~62,600 m LTL, rate applied: 1 CHF = 2,8 LTL) 19,000 m CHF – Swiss support funds 3,353 m CHF – co-financing of the Republic of Lithuania

21. 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.  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. 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. Before After

25. 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.ltvirginija.ambrazeviciene@sam.lt Also: http://www.sam.lt/go.php/lit/Lietuvos_ir_Sveicarijos_bendradarbia vimo/1195 http://www.facebook.com/LietuvosIrSveicarijosBendradarbiavimoPr ograma