Faustas Stepukonis, Rūta Butkevičienė, Aušra Beržanskytė, Marija Jakubauskienė, Ramunė Kalėdienė, Jurgita Vladičkienė, Mindaugas Stankūnas
Abstract
Health inequalities in Lithuania are exceptionally high according to gender, age, education, income, residence, access to health care. The Plan of actions for reduction of health inequalities 2014-2023 indicates the appropriate monitoring and assessment of inequalitiesas the main prerequisite for their decrease. Different functions are delegated to various specialists in national and municipality institutions in health and related areas. In order to have the evidence based approach to identify and reduce health inequalities, administrative capacities on a national and municipal levels were assessed applying qualitative and quantitative methods. The results from qualitative study are presented in this article. The data were collected from focus group discussions giving open questions to informants. Heterogenic groups were arranged – from six municipalities (cities – Vilnius, Kaunas, Klaipeda, districts – Utena, Vilkaviškis, Klaipėda). The number of participants in total was 58 from public health, health care, education, social and other sectors. More participants were in administrative positions (38 persons). The results revealed (1) the lack of consistant understanding of health inequalities, as well as absence of unified system / methods to ensure monitoring of health inequalities in municipality; (2) reduction of health inequalities is not a health policy priority on municipality level, although many activities most likely contribute to the reduction of population health inequalities; (3) real intersectorial collaboration on health inequalties is lacking, as well as good managerial practice tackling health issues together with other sectors; (4) there is a lack of evidence based effective interventions to reduce health inequalities and methods for their implementation on municipality level.
Keyword(s): administrative capacities; health inequalities; assessment.
DOI: 10.5200/sm-hs.2017.030
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