Lithuanian-Swiss Cooperation Programme:
financial support for the health sector

Programme objective - improved quality of health care in perinatal and neonatal health care services in Lithuania. Programme results will ensure contribution to the reduction of economic and social disparities between Lithuania and the more advanced countries of the enlarged EU and contribution within Lithuania to the reduction of economic and social disparities between the dynamic urban centres and the structurally weak peripheral regions. The support also contributes directly to the Lithuanian Governmental Programme's objectives: to improve perinatal and neonatal health care services in Lithuania and to introduce energy efficient technologies into Lithuanian hospitals that provide perinatal and neonatal health care services.

A feasibility study has been carried out in order to identify the needs of hospitals that provide perinatal and neonatal health care services. The programmes prepared on the basis of the feasibility study define the selection criteria for the beneficiary hospitals, the list of the beneficiaries, the funded activities, the order and procedure of public procurement, and allocate the support funds. The Swiss Government approved the programmes in April 2011, the support agreements approving the final project proposals were signed on 20 December 2011, and the agreements with the beneficiaries are to were signed in June 2012. The Cooperation Programme will run until 13 December 2016 (projects will run until 31 August 2016).

The Swiss support is assigned to two health sector programmes:

1. Improvement of perinatal and neonatal care services in Lithuania - CHF 31.294 mln.*
(CHF 26.600 mln. is the Swiss support funds and CHF 4.694 is the co-financing of the Republic of Lithuania)

Results after programme implementation:

• 27 hospitals supplied with modern medical equipment necessary for providing quality services
• 3 vehicles with special equipment for safe transportation of neonates purchased
• Premises of 9 healthcare establishments repaired
• More than 4,000 participants improved their professional mqualifications and modern technology usage skills
• 72 diagnostics and treatment guidelines in obstetrics and neonatology developed
• Computer database on the health of pregnant and delivering women and neonates developed and prepared for usage

2. Introduction of energy efficient technologies into the Lithuanian hospitals providing perinatal and neonatal health care services - CHF 22.353 mln.*
(CHF 19.000 mln. is the Swiss support funds and CHF 3.353 is the co-financing of the Republic of Lithuania)

Results after programme implementation:

• Thermal insulation of hospital buildings improved (roofs and exterior walls renovated and insulated, windows and doors replace
• Heating stations and internal heating systems modernised
• Alternative energy sources such as solar cells, heating pumps and photovoltaic power stations systems installed
• Ventilation and air conditioning systems modernised / installed
• Electricity supply systems (with LED lighting) modernised / installed
• Medical gas (oxygen, vacuum, compressed air) supply systems installed
• Ambient air pollution reduced, and microclimate and energy efficiency improved

Programme Administration

National Coordination Unit (NCU). The Ministry of Finance of the Republic of Lithuania will implement the functions of the national coordination unit set forth in the Framework Agreement.

Part of the functions of the national coordination unit has been delegated to the Central Project Management Agency (CPMA).

Intermediate Body. The Ministry of Health of the Republic of Lithuania (MoH) has been assigned the function of the Intermediate Body. Acting as the Intermediate Body, MoH performs the following functions:

• prepares the final project proposals and submits them to the CPMA;
• submits the VAT eligibility declaration of each Executing Agency together with the final project proposal to the CPMA;
• signs the Programme and Project Implementation Agreements;
• organises work of the Joint Health Sector Programmes Steering Committee;
• checks compliance of payment claims and the respective supporting documents received from the Executing Agencies in accordance with the requirements of the Framework Agreement, the Project Agreement, the Programme and Project Implementation Agreements and submits them together with the approved Project implementation reports provided by the Executing Agencies to the CPMA;
• upon receipt from the CPMA of conclusions on the eligibility of costs, prepares payment applications to the State Treasury and submits them to the NCU;
• supervises the implementation of the Programme and performs the required control;
• if necessary, performs on-the-spot checks at the Programme implementation locations;
• checks for any irregularities and reports on them to the NCU and the CPMA;
• prepares reports on the Programme implementation and submits them to the CPMA.

In the preparation and administration of the Programmes, the functions of the Ministry as the Intermediate Body are performed by the International Project Management Division.

Joint Health Sector Programmes Steering Committee

To coordinate the activities of the programme, the Joint Health Sector Steering Committee is established for the programmes funded under the Lithuanian–Swiss Cooperation Programme aimed at reducing economic and social disparities within the enlarged European Union.
The Chairman of the Committee is the Viceminister of Health. The Committee consists of representatives of the Ministry of Health, the Ministry of Finance, the CPMA, the Lithuanian Neonatology Association, the Lithuanian Association of Obstetricians and Gynaecologists, the Lithuanian Nursing Specialists Organisation, Lithuanian Obstetricians Union, the State Patients’ Fund under the MoH and the public establishment Centre of Registers.
The Swiss representatives are invited to the meetings of the Committee as observers. Switzerland has the right to express an objection to decisions on the implementation of the activities.

The Programme Steering Committee performs the following functions:

• makes recommendations on the Final Project Proposals for the health sector to the Ministry of Health;
• makes recommendations on the list of the beneficiaries, activities and their scope and budget suggested by the Ministry of Health;
• evaluates the information provided by the Management and Monitoring Group of the Lithuanian–Swiss Cooperation Programme on the progress in implementing the projects within the health sector programme framework;
• upon proposal from the Management and Monitoring Groups, approves the final reports on the performance of the project implementation agreements;
• discusses and approves the health sector programme implementation reports prepared by the secretariat of the Committee;
• monitors the overall progress of implementation of the health sector programmes;
• takes other necessary measures to fully achieve the objectives of the health sector programmes.