Lithuania

   

Social Sustainability

#17
Key Findings
In the category of social sustainability, Lithuania falls into the sample’s middle ranks (rank 17).

The country has a high level of tertiary education attainment, but vocational training enrollment rates are low. Students score below the OECD average in reading, math and science. Funding for education has been increased consistently in recent years.

The government has committed to reducing the at-risk-of-poverty rate, increasing social support payments and expanding the list of social services provided. Health outcomes in Lithuania are comparatively poor. While almost all citizens have healthcare coverage, satisfaction with healthcare availability is low, and out-of-pocket expenses are high.

Gender equality is a strong government focus. Family policy is fragmented, and dominated by financial support for families with children. Access to kindergartens and other childcare facilities remains insufficient. Pensions do not prevent senior-citizen poverty. Integration policy has been focused on Ukrainians in recent years, with few services for other immigrants.

Sustainable Education System

#15

To what extent do policies and regulations in the education system hinder or facilitate high-quality education and training?

10
 9

Education policies are fully aligned with the goal of ensuring high-quality education and training.
 8
 7
 6


Education policies are largely aligned with the goal of ensuring high-quality education and training.
 5
 4
 3


Education policies are only somewhat aligned with the goal of ensuring high-quality education and training.
 2
 1

Education policies are not at all aligned with the goal of ensuring high-quality education and training.
Policies Targeting Quality Education
7
Education policies in Lithuania are largely aligned with the goal of ensuring high-quality education and training. The country boasts a very high and increasing level of tertiary attainment, surpassing the OECD average (46.50% of the population compared to the OECD average of 41.90% in 2022) (OECD 2023). The rate of early school leaving was 4.8% in 2022, which is significantly below the OECD average of 8.09% (OECD 2023).

However, enrollment rates in vocational education and training programs remain low. The reputation of vocational education and training in Lithuania could be improved, as could the rate of adult participation in lifelong learning programs. Additionally, Lithuania needs to enhance the quality of its education programs. According to the most recent PISA report, released in 2022, Lithuanian students continue to score below the OECD average in reading, mathematics and science. Furthermore, there has been little change in these achievements over an extended period of time (since 2006).

A 2017 OECD report on education in Lithuania stated that the country’s schools and higher-education institutions would benefit by clarifying and raising performance expectations, aligning resources to support those raised expectations, strengthening performance monitoring and quality assurance procedures, and building institutional capacity. Furthermore, the report advised addressing mismatches between graduates’ skills and labor market needs. In a staff working document, the European Commission recommended improving quality and efficiency at all levels of education and training, including adult education. Many of these points have been addressed by the country’s authorities, as discussed below.

The coalition government formed in late 2020 clearly indicated in its program that improving access to quality education was its top priority. This objective featured at the beginning of the government’s program, accompanied by a list of priority projects and success indicators to be achieved by 2024 – the end of the government’s term – and 2030.

In an effort to enhance the quality of education at all levels, the government included a series of priority projects in its program. It began by focusing on early childhood education, emphasizing teacher education, educational flexibility and the early identification of talented students. Additionally, the government introduced performance monitoring in order to address emerging problems promptly and work toward improving early education standards.

At the secondary education level, the government committed to establishing adequate quality standards in the country’s schools by restructuring the school network. This restructuring was intended to concentrate resources, thereby improving the quality of teaching.

The government’s flagship project, launched in 2022, became known as the “Millennium schools.” These schools are designed to have modern infrastructure and emphasize state-of-the-art learning approaches such as leadership and informal education. By 2025, the plan is to have 150 such schools able to set a good example for others. Private schools and schools that select students by competition are not eligible.

The National Recovery and Resilience Plan – financed by the Next Generation EU economic recovery fund – includes reform measures in education, such as digitalization and improvements in educational performance. The use of EU funding, which extends to 2026, might improve the chances of advancing these reforms and maintaining their continuity after the next parliamentary elections scheduled for 2024.

Among other initiatives aimed at increasing the quality of secondary education, the government’s program underlined the need to improve curriculum content in response to the challenges of the 21st century. It emphasized the importance of individual analytical capabilities, a focus on real-life problems during the learning process, and general competencies such as reading skills and mathematics. Additionally, the program highlighted the need for civic education, creative thinking, cultural education, social and emotional intelligence, and digital skills.

Furthermore, the program committed to developing internationally recognized educational centers of excellence, which would contribute to educating and training teachers. This includes support for joint degree master’s programs for educators and funding for research on education in cooperation with other European countries, particularly the Nordic nations.

In the area of tertiary education, the main focus of the government program is on increasing quality at all levels of university education, particularly in internationalization, student and lecturer mobility, and cooperation with businesses. It is committed to upgrading the requirements for entry into university study programs, clarifying the missions of universities and colleges, and improving vocational education and training to better meet labor market demands and contribute to the development of the country’s regions. Additionally, it contains several projects aimed at increasing the attractiveness and quality of lifelong learning in Lithuania.

Successive governments have committed to improving the attractiveness of the teaching profession, particularly by increasing teachers’ wages. By 2024, these wages were slated to equal 130% of the average wage in the country. The government also initiated a national agreement among parliamentary political parties on education policy for 2021 – 2030 to strengthen the continuity and consistency of education policy and increase its funding over the long term. This agreement was signed by the governing and opposition parties at the start of the 2021 – 2022 academic year, and included many provisions from the government’s program, along with concrete funding commitments and success indicators. For example, it set the objective of increasing salaries for school teachers and university lecturers to 130% and 150% of the national average wage, respectively, by 2024.

According to the government’s annual report on its activities in 2022, several key reforms were implemented to enhance the education system. These included consolidating secondary schools to increase class sizes and elevate quality standards, and reforming vocational training schools to better align with labor market demands. Significant resources were dedicated to educating and training teachers and providing expert advice to schools on improving quality standards.

The study curricula for early childhood, primary and secondary education were updated. A new model of vocational training was established in cooperation with municipalities, businesses and researchers. Additionally, seven science, technology, engineering, arts and math (STEAM) centers were launched, along with a new project focused on the digital transformation of education. As a supplement to base funding, performance-based funding was introduced for universities, which includes additional funding tied to the achievement of specified quality standards.

Funding was increased in 2022 – 2023, including salary increases for school teachers and university lecturers.

In 2023, when the draft budget for 2024 was prepared, some trade unions representing teachers staged public demonstrations, demanding accelerated increases in funding, particularly in the area of salaries. They argued that due to high inflation and an inadequate methodology for calculating teachers’ salaries, the government was failing to meet its promises. Some opposition parties supported their demands, and some considered withdrawing from the national agreement on education policy (as the Lithuanian Farmers and Greens Union ultimately did). After a series of negotiations between officials from the Ministry of Education, Science and Sport and trade unions, some unions reached a common ground with the government. The government maintained that it remained committed to achieving the funding indicators set in its program and the national agreement of the parliamentary political parties.

It should be noted that the multiple crises faced by Lithuanian authorities during the term of the current government – including the COVID-19 pandemic, the geopolitical crisis, the energy crisis, the cost-of-living crisis, etc. – did not affect increases in funding for education and research. The trend of increasing funding for schools and universities, initiated by the previous administration, continued under the Šimonytė coalition government and was maintained in 2022 and 2023. The most recent increases in budgetary expenditures allocated for the wages of school teachers and university academic staff were scheduled for 2024.

Citations:
OECD. 2023. “Lithuania.” In Education at a Glance 2023: OECD Indicators, OECD Publishing, Paris.
DOI: https://doi.org/10.1787/14d8e52c-en
European Commission. 2019. “Country Report Lithuania 2019.” COMMISSION STAFF WORKING DOCUMENT. https://ec.europa.eu/info/sites/info/files/file_import/2019-european-semester-country-report-lithuania_en.pdf
OECD. 2017. “Education in Lithuania, 2017.” http://www.oecd-ilibrary.org/education/education-in-lithuania_9789264281486-en;jsessionid=8scv3cpilndh.x-oecd-live-03
The Seimas. 2020. Resolution on The Program of the Eighteenth Government of Lithuania (in Lithuanian), 11 December, No. XIV-72.
The Government Annual Report for 2022, 17 May 2023 (in Lithuanian), https://epilietis.lrv.lt/lt/naujienos/seimui-teikiama-vyriausybes-2022-metu-veiklos-ataskaita

To what extent does the current policy approach in the education system hinder or facilitate equitable access to high-quality education and training?

10
 9

Education policies are fully aligned with the goal of ensuring equitable access to high-quality education and training.
 8
 7
 6


Education policies are largely aligned with the goal of ensuring equitable access to high-quality education and training.
 5
 4
 3


Education policies are only somewhat aligned with the goal of ensuring equitable access to high-quality education and training.
 2
 1

Education policies are not at all aligned with the goal of ensuring equitable access to high-quality education and training.
Policies Targeting Equitable Access to Education
7
Education policies are largely aligned with the goal of ensuring equitable access to high-quality education. The country exhibits an urban-rural divide, and there are notable disparities in educational achievements between girls and boys. According to Eurydice, an analysis of differences in the achievements of 15-year-olds showed that pupils from families from low socioeconomic strata studying in the same schools scored 46 points below the national average, equivalent to a 1.5-year gap. When compared with children from families at higher socioeconomic strata, the gap widened to 86 points, or 2.8 years.

The coalition government formed in late 2020 committed to both improving the quality of education and enhancing equity of access to it. Regarding access, the government undertook several projects, including dedicating additional attention and resources to families requiring social assistance for early childhood education services. It also emphasized inclusive educational initiatives for children with special needs, and focused on enhancing the quality of teaching and studies in schools for national minorities.

In the area of tertiary education, the government outlined plans to increase support for students from socially disadvantaged families and students with special needs. Additional investments in IT skills and technological upgrades for the education process could also contribute to more equitable access, particularly in rural areas.

In 2022, the government adopted amendments to the Law on Education aimed at facilitating individual help for pupils who experience difficulties during the study process and who fail intermediary tests, which have also been reformed to signal earlier about such needs (The Government Annual Report for 2022, 2023). Additionally, throughout the year, financial and expert-consultation support was provided to improve equitable access to education, with 54 partnership agreements signed between municipalities, the National Education Agency and 90 schools.

Also, information and financial support were provided to refugees from Ukraine regarding educational opportunities and their practical use. According to the findings of Eurydice (2023), quoted in the government report on its 2022 activities, Lithuania is among the countries where more than half of all pupils and students who arrived from Ukraine have been integrated into local schools. In 2022, the Lithuanian government allocated €28 million to integrate refugees from Ukraine into the education system.

Citations:
Eurydice, https://eurydice.eacea.ec.europa.eu/national-education-systems/lithuania/overview
The Seimas. 2020. The Resolution on The Program of the Eighteenth Government of Lithuania (in Lithuanian), No. XIV-72.
The Government Annual Report for 2022, 17 May 2023 (in Lithuanian), https://epilietis.lrv.lt/lt/naujienos/seimui-teikiama-vyriausybes-2022-metu-veiklos-ataskaita.

Sustainable Institutions Supporting Basic Human Needs

#17

To what extent do existing institutions ensure equal access to essential services and basic income support for those in need?

10
 9

Existing essential public services and basic income support are fully aligned with the goal of ensuring equal access for those in need.
 8
 7
 6


Existing essential public services and basic income support are largely aligned with the goal of ensuring equal access for those in need.
 5
 4
 3


Existing essential public services and basic income support are only somewhat aligned with the goal of ensuring equal access for those in need.
 2
 1

Existing essential public services and basic income support are not at all aligned with the goal of ensuring equal access for those in need.
Policies Targeting Equal Access to Essential Services and Basic Income Support
7
According to a European Commission report published in 2020, Lithuania belongs to the majority of EU member states in which the term “essential services” was not used in national or subnational legislation or documents regulating service provision. The Ministry of Social Security and Labor provides information to people in need of social support and has prepared guidelines for local county officials to facilitate the provision of support for eligible low-income residents. The central authorities actively use media to inform potential recipients about the ways in which they can obtain social support, either by contacting their municipal institutions or using the Social Support for Family Information System (SPIS).

Essential services for low-income individuals are provided on a means-tested basis. Eligibility for social assistance is often used to grant access to services such as water, energy, sanitation and housing. However, there are also types of support that are universal – provided for all – such as lunch provision for children at early childhood education organizations (Baptista and Marlier 2020). Municipalities have some discretion in determining eligibility for social assistance in individual cases.

The coalition government formed in 2020 committed to reducing the share of people at risk of poverty from 20.6% to 17% by 2024 and further to 14% by 2030 (Seimas 2020). It emphasized the use of individually tailored social support, increased access to services, increased delegation of service provision to municipalities and NGOs, and direct funding of service access through new technologies. In 2022, the government raised the value of social support payments and expanded the list of social services provided.

During the energy crisis of 2022, some rules for means-tested social support and access to essential services were relaxed (The Government Report for 2022, 2023). Additionally, the government decided to provide universal support to the population to compensate for the increases in electricity and gas (heating) prices – a decision based on the argument that targeting the support would have been too time-consuming, and would put too much pressure on the administrative capacities of the institutions responsible. Importantly, the government stated that it learned from this crisis management experience and would aim in the future to revise the existing system of social support and access to essential services. It said this revision would draw on the state open data governance platform, with technical solutions to be implemented that would allow the individual needs and financial situations of people at risk to be rapidly identified, and which would inform them about available support offerings and provide access to services without excessive administrative burden.

Citations:
Ministry of Social Security and Labor. “Social support to Low-Income people.” https://socmin.lrv.lt/lt/veiklos-sritys/seima-ir-vaikai/socialine-parama-seimoms-ir-vaikams/pinigine-socialine-parama-nepasiturintiems-gyventojams-socialine-pasalpa-busto-sildymo-geriamojo-ir-karsto-vandens-islaidu-kompensacijos (accessed 15.01.2024)
Baptista, I., and E. Marlier. 2020. Access to Essential Services for People on Low Incomes in Europe.
An analysis of policies in 35 countries. European Social Policy Network (ESPN). Brussels: European Commission.
The Seimas, the Resolution on The Program of the Eighteenth Government of Lithuania. 2020. No. XIV-72.
The Government Annual Report for 2022, 17 May 2023 (in Lithuanian), https://epilietis.lrv.lt/lt/naujienos/seimui-teikiama-vyriausybes-2022-metu-veiklos-ataskaita.

To what extent do existing institutions and policies ensure high-quality services and basic income support?

10
 9

Existing essential public services and basic income support are fully aligned with the goal of satisfying basic human needs.
 8
 7
 6


Existing essential public services and basic income support are largely aligned with the goal of satisfying basic human needs.
 5
 4
 3


Existing essential public services and basic income support are only somewhat aligned with the goal of satisfying basic human needs.
 2
 1

Existing essential public services and basic income support are not at all aligned with the goal of satisfying basic human needs.
Policies Targeting Quality of Essential Services and Basic Income Support
6
Existing essential public services and basic income support programs are largely aligned with the goal of satisfying basic human needs. State and municipal institutions provide social support, usually in a targeted and means-tested way, to enable people to access housing, water, sanitation and energy. The digital infrastructure is well developed in the country, with strong competition in the telecommunications services sector allowing consumers to benefit from relatively low prices and broad coverage. The public transport infrastructure is also well developed, although more investment is needed to maintain its quality. Increasingly, more municipalities have been experimenting with the provision of free services, covered from their municipal budgets. However, the relatively high rate of poverty and the relatively low level of adequacy of the guaranteed minimum income benefits suggest that the level of support could still be improved.

Citations:
Ministry of Social Security and Labor. “Social support to Low-Income people (in Lithuanian).” https://socmin.lrv.lt/lt/veiklos-sritys/seima-ir-vaikai/socialine-parama-seimoms-ir-vaikams/pinigine-socialine-parama-nepasiturintiems-gyventojams-socialine-pasalpa-busto-sildymo-geriamojo-ir-karsto-vandens-islaidu-kompensacijos
Baptista, I., and E. Marlier. 2020. Access to Essential Services for People on Low Incomes in Europe.
An analysis of policies in 35 countries. Brussels: European Commission.

Sustainable Health System

#25

To what extent does current health policy hinder or facilitate health system resilience?

10
 9

Health policies are fully aligned with the goal of achieving a resilient health system.
 8
 7
 6


Health policies are largely aligned with the goal of achieving a resilient health system.
 5
 4
 3


Health policies are only somewhat aligned with the goal of achieving a resilient health system.
 2
 1

Health policies are not at all aligned with the goal of achieving a resilient health system.
Policies Targeting Health System Resilience
6
Health outcomes in Lithuania are among the poorest in the EU. Lithuania has one of the lowest expected healthy life expectancies at birth and one of the lowest overall life expectancies. According to the OECD country report 2023, life expectancy in Lithuania was 74.2 years – 6.1 years below the OECD average. The preventable mortality in Lithuania was 326 deaths per 100,000 – much higher than the OECD average of 158 – with the treatable mortality at 155 per 100,000, also higher than the OECD average of 79. Additionally, government spending on health services as a percentage of GDP remains one of the lowest such figures among OECD countries.

According to OECD data, excess mortality during the COVID-19 pandemic (2020 – 2021) in Lithuania was close to the OECD average. However, the number of COVID-19-related deaths in Lithuania during this period was significantly higher, reaching 2,645 per million compared to the OECD average of 1,634 per million. The number of hospital discharges and the waiting times for surgery in Lithuania in 2020 increased significantly more than the OECD average.

In terms of resilience, one of the key lessons learned by policymakers during this crisis was the need not only to maintain sufficient reserves of protective medical equipment but also to have timely access to data on key crisis management indicators, such as the number of infected individuals and their distribution, available hospital facilities, and vaccination dynamics. Having the capacity for data analysis was also seen to be critical.

The coalition government formed in late 2020 has been straightforward about these issues, stating them upfront in its program. In addition to poor health outcomes, it also identified a relatively fast-aging society as a challenge complicating efforts to improve health indicators. Among its goals in the healthcare sector, the program highlighted the need to strengthen the resilience of the healthcare system with regard to future threats and crises.

Placing a high priority on increasing resilience, as well as on being able to adapt to the fast-changing environment and manage those changes effectively, it outlined the following initiatives. First, it aims to enhance readiness for threats and crises such as future pandemics or accidents at the nuclear power station in nearby Belarus. The plan highlights the need to establish sufficient reserves of civilian protection instruments, educate society and train healthcare workers in relevant competencies.

Second, the plan emphasizes the need for the healthcare system to be prepared for future challenges such as climate change, an aging society, antibiotic resistance and growing volumes of disinformation. To address these challenges, it commits to making the healthcare system open to future changes and innovations, while also developing the use of information technologies and artificial intelligence; strengthening cooperation with NGOs, media and various stakeholders; developing good practices; and improving the prestige of the medical profession. However, it does not set indicators of success explicitly linked to increasing the resilience of the country’s healthcare system.

In July 2021, the government allocated €268 million as a part of the New Generation Lithuania plan, funded by the EU Recovery and Resilience Facility, for a component described as “a resilient and future-proof health system.” Under this component, the government plans a series of reforms and investments aimed at: 1) improving the quality and accessibility of healthcare services and promoting innovation, 2) enhancing long-term care services, and 3) strengthening the resilience of the healthcare system to handle emergencies.

Regarding reforms, the focus is on shifting further to outpatient care, reorganizing the hospital network, digitalizing healthcare, improving the working conditions of health professionals, addressing healthcare staff shortages and skills, introducing measures to enhance the quality of healthcare, scaling up prevention measures, improving access to long-term care, and reforming healthcare financing to reduce dependence on employment-related contributions.

In terms of investments, the plan includes targeted measures to create a center for advanced therapies, establish a health professionals’ competence platform, digitalize the health system, develop an integrated healthcare quality assessment model, and set up long-term care day centers and mobile teams. To ensure the efficient delivery of health services during emergencies and to strengthen the resilience of the health system, investments are proposed to modernize the infrastructure of healthcare facilities to ensure their effective functioning in emergency and crisis situations.

Among the main achievements listed in its annual report for 2022, the government highlighted the consolidation of public healthcare organizations to improve coordination of their activities, as well as the adoption of by-laws on the repeated use of health data accumulated in information registers for the purposes of scientific research, innovations, knowledge management and healthcare policy changes.

Citations:
OECD. 2023. “Health at a Glance 2023 Country Note: Lithuania.” https://www.oecd.org/health/health-at-a-glance/
OECD. 2023. Ready for the Next Crisis? Investing in Health System Resilience. Paris: OECD Publishing. https://doi.org/10.1787/1e53cf80-en
The Seimas, the Resolution on The Program of the Eighteenth Government of Lithuania (in Lithuanian). 11 December 2020. No. XIV-72.
Ministry of Finance. “Materials on New Generation Lithuania Plan.” https://finmin.lrv.lt/en/eu-and-international-cooperation/new-generation-lithuania/
Council of the European Union. 2023. Annex to the Council Implementing Decision Amending Implementing Decision of 20 July 2021 on the Approval of the Assessment of the Recovery and Resilience Plan for Lithuania, Interinstitutional File: 2023/0387 (NLE), Brussels, 27 October 2023.
Seimui teikiama Vyriausybės 2022 metų veiklos ataskaita. 2023. “The Government Annual Report for 2022, 17 May 2023 (in Lithuanian).” https://epilietis.lrv.lt/lt/naujienos/seimui-teikiama-vyriausybes-2022-metu-veik-los-ataskaita

To what extent does current health policy hinder or facilitate achieving high-quality healthcare?

10
 9

Health policies are fully aligned with the goal of achieving high-quality healthcare.
 8
 7
 6


Health policies are largely aligned with the goal of achieving high-quality healthcare.
 5
 4
 3


Health policies are only somewhat aligned with the goal of achieving high-quality healthcare.
 2
 1

Health policies are not at all aligned with the goal of achieving high-quality healthcare.
Policies Targeting High-Quality Healthcare
6
Health policies are largely aligned with the goal of achieving high-quality healthcare, although their implementation often faces obstacles. According to the OECD (2023), Lithuania performed better than the OECD average on 58% of quality-of-care indicators. However, it scored poorly on acute care, with a 30-day mortality rate after stroke of 15.4%, compared to the OECD average of 7.8%. In primary care, Lithuania had 554 avoidable admissions per 100,000 population, in contrast to the OECD average of 463. For preventive care, 46% of women were screened for breast cancer, below the OECD average of 55%. Additionally, the rate of unmet need for medical care is among the highest among OECD countries.

The 2020 coalition government prioritized strengthening public health, emphasizing disease prevention and cultivating a healthy lifestyle through proper nutrition, physical activity, balanced working, studying and leisure regimes, sex education, and the prevention of substances affecting stress and psychology (Seimas 2020). It also committed to further improving the quality of individual healthcare services by enhancing focus on their safety. This would be based on a quality management system that uses data and evidence for the purposes of monitoring and diagnosing, with the support of new technologies, best practices and expert recommendations, and quality assessment based on patient feedback.

The government also stressed the importance of increasing healthcare effectiveness through individually tailored services. These services are based on the application of the most recent prevention, diagnosis, treatment and care techniques. Funding for services would be linked to the quality and effectiveness of their provision, irrespective of the ownership or subordination of particular healthcare institutions.

The program defined several indicators of success. By 2024, goals are to increase average life expectancy to 77 years (from 76), reduce the difference in life expectancy between men and women to eight years (from 9.8), increase average healthy life expectancy to 60.5 years (from 58.1), and have the share of adults who assess their state of health as good or very good reach 64% (up from 58%). More ambitious indicators regarding life expectancy and health self-assessments were set for 2030.

In 2022, the government allocated additional resources for activities aimed at strengthening public healthcare, particularly psychological health, healthy lifestyles, more effective management of infectious diseases, and expansions to the network of schools that practice health-strengthening activities (The Government Annual Report for 2022, 2023). It also began implementing a project to establish a model for providing long-term care services, which aims to deliver all types of care services in a sustainable “single point of contact” manner.

Although the annual report on government activities in 2022 noted a slight decrease in the life expectancy gap between men and women (from 9.6 to 9.3 years), it acknowledged that this gap remained the EU’s largest (The Government Annual Report for 2022, 2023). It also noted that, contrary to plans, average healthy life expectancy had decreased compared to 2019. This negative trend was explained with reference to the restricted accessibility of healthcare services due to the management of the COVID-19 pandemic, as well as to the pandemic itself.

Citations:
OECD. 2023. “Health at a Glance 2023 Country Note: Lithuania.” https://www.oecd.org/health/health-at-a-glance/
The Seimas, the Resolution on The Program of the Eighteenth Government of Lithuania (in Lithuanian), 11 December 2020, No. XIV-72;
The Government Annual Report for 2022, 17 May 2023 (in Lithuanian), https://epilietis.lrv.lt/lt/naujienos/seimui-teikiama-vyriausybes-2022-metu-veik los-ataskaita.

To what extent does current health policy hinder or facilitate equitable access to high-quality healthcare?

10
 9

Health policies are fully aligned with the goal of achieving equitable access to high-quality healthcare.
 8
 7
 6


Health policies are largely aligned with the goal of achieving equitable access to high-quality healthcare.
 5
 4
 3


Health policies are only somewhat aligned with the goal of achieving equitable access to high-quality healthcare.
 2
 1

Health policies are not at all aligned with the goal of achieving equitable access to high-quality healthcare.
Policies Targeting Equitable Access to Healthcare
6
Health policies are largely aligned with the goal of achieving equitable access to high-quality healthcare, although actual access varies depending on particular location and institution. Although almost all of the population is covered for a core set of services, according to the OECD (2023), only 51% of people in Lithuania were satisfied with the availability of quality healthcare – a share considerably lower than the OECD average of 67%. The 69% of patients covered by mandatory prepayment plans was lower than the OECD average of 76%. Out-of-pocket spending, which accounted for 30% of healthcare expenditure, was higher than the OECD average of 18%. Lithuania spent $3,587 per capita on health, less than the OECD average of $4,986 (in purchasing power parity terms), which was equal to 7.5% of GDP compared to the OECD average of 9.2%.

The number of practicing doctors – 4.5 per 1,000 population – is higher than the OECD (2023) average of 3.7, but the number of practicing nurses – 7.9 per 1,000 population – is lower than the OECD average of 9.2. Lithuania had 6.1 hospital beds per 1,000 population, more than the OECD average of 4.3.

The 2020 government coalition committed to reducing the large differences in terms of healthcare that result from poverty or economic, social or regional divergences (Seimas 2020). It also indicated the intention to improve the accessibility of healthcare services irrespective of geography, organization or patient economic situation by reducing bureaucratic constraints and excessive administrative burdens, improving the access and quality of primary care, expanding the services provided by family doctors, expanding emergency services, and expanding access to and choice of compensated medicines, as well as by offering patients the best available innovative and effective methods of treatment. It also pointed to the importance of ensuring that members of the medical profession are well paid, qualified and motivated.

In 2022, the government adopted changes to the Law on Healthcare Institutions and the Law on the Healthcare System, establishing a model for the provision of individual healthcare services based on regional cooperative networks. It also amended the Law on Pharmacies, seeking to expand patients’ access to compensated medicines, while additionally expanding the list of such medicines. It also allocated new funding in order to increase salaries within the medical profession.

Citations:
OECD. 2023. “Health at a Glance 2023 Country Note: Lithuania.” https://www.oecd.org/health/health-at-a-glance/
The Seimas. 2020. “Resolution on The Program of the Eighteenth Government of Lithuania” (in Lithuanian). 11 December, No. XIV-72
The Government of Lithuania. 2023. “The Government Annual Report for 2022.” 17 May (in Lithuanian). https://epilietis.lrv.lt/lt/naujienos/seimui-teikiama-vyriausybes-2022-metu-veik los-ataskaita

Gender Equality

#13

How committed is the government to ensuring gender equality in all respects?

10
 9

The government is clearly committed to the goal of ensuring gender equality.
 8
 7
 6


The government is largely committed to the goal of ensuring gender equality.
 5
 4
 3


The government is only somewhat committed to the goal of ensuring gender equality.
 2
 1

The government is not at all committed to the goal of ensuring gender equality.
Policy Efforts and Commitment to Achieving Gender Equality
8
The government is clearly committed to ensuring gender equality. Equal opportunity and equal treatment are mandated by Article 28 of the Lithuanian Constitution. According to the European Institute for Gender Equality, the process of accession to the European Union “played a crucial role in fostering gender equality and gender mainstreaming in Lithuania’s national policy and body of legislation.”

Lithuania has two key laws that ensure the consistent and systematic implementation of programs, measures and projects to promote gender equality: the Law on Equal Opportunities for Women and Men (1998) and the Law on Equal Treatment (adopted in 2003 and entered into force in 2005). These laws cover discrimination based on 14 grounds, including gender.

The Law on Equal Opportunities for Women and Men forbids any discrimination – whether direct or indirect – on the ground of sex, including sexual harassment. The Law on Equal Treatment has been reformed several times and, according to the European Institute for Gender Equality, is now fully in line with the EU acquis and other international instruments.

In addition to these legislative norms, Lithuania has compiled several key strategic documents since 2012. The National Program on Equal Opportunities for Women and Men – the first version of which was in place from 2010 to 2014, and the second from 2015 through 2021 – aimed to ensure a consistent, sophisticated and systematic approach to gender equality issues in all fields. The National Program pursued four main priorities: equal opportunities for women and men in the labor market; gender balance in decision-making; gender mainstreaming, especially in culture, education and science, national defense, and international obligations; and increased management effectiveness.

Gender equality activities have been implemented in the priority areas of employment, science and education, healthcare, environmental protection, national defense, decision-making, EU and international cooperation, and the development of mechanisms and methods to implement equal opportunities for women and men. Every year, progress on the implementation of the National Program is reported to the government, while an independent external comparative assessment of the overall impact of the National Program is carried out every five years.

Lithuania has also implemented an accompanying action plan for the National Program (the first version was in place from 2015 – 2017 and the second from 2018 – 2021). The action plan outlines concrete actions, implementation deadlines, responsible institutions and state budget allocations needed for each step, and additionally specifies evaluation criteria. It also sets out 20 specific targets, including reducing the pay gap between women and men; encouraging girls and boys to choose “nontraditional professions or studies for women and men”; guaranteeing access to services and information for the prevention of cervical, breast and prostate cancer; and encouraging women’s activity in the field of environmental protection.

Among the most recently adopted documents, the National Progress Plan (an institutional plan that provides policy direction for the future) includes equal opportunities for all as a horizontal principle. This principle covers the commitment to respect human rights regardless of any identity factors such as gender, age or race. It also underscores the necessity of ensuring equal access to services, and of implementing strategic programs that consider the specific needs of women and men, different age groups, ethnic minorities, and other groups vulnerable to discrimination. At the ministerial level, each ministry has committed to implementing gender equality as a horizontal principle. However, no gender mainstreaming measures have been officially adopted.

The Ministry of Social Security and Labor is responsible for gender equality policy and gender mainstreaming, as well as for implementing, monitoring and following up on central strategies and measures. In 2021, the ministry became responsible for coordinating the implementation of gender equality as a horizontal principle in the work of the central government. The Office of the Equal Opportunities Ombudsperson is the independent gender equality body in Lithuania.

Citations:
The Parliament of Lithuania, the Law on Equal Opportunities for Women and Men. 1 December 1997. No. VIII-947. https://e-seimas.lrs.lt/portal/legalAct/lt/TAD/TAIS.69453/asr
The Parliament of Lithuania, the Law on Equal Treatment (in Lithuanian). 18 November 2003. No. IX-1826. https://e-seimas.lrs.lt/portal/legalAct/lt/TAD/TAIS.222522/asr
European Institute for Gender Equality. “Country Information: Lithuania.” https://eige.europa.eu/gender-mainstreaming/countries/lithuania
Lithuanian Ministry of Social Security and Labor. “Gender Equality.” https://socmin.lrv.lt/en/activities/gender-equality

Strong Families

#17

To what extent does the current family policy approach support or hinder unpaid family care work?

10
 9

Family policies are fully aligned with the goal of creating the conditions for strong families.
 8
 7
 6


Family policies are largely aligned with the goal of creating the conditions for strong families.
 5
 4
 3


Family policies are only somewhat aligned with the goal of creating the conditions for strong families.
 2
 1

Family policies are not at all aligned with the goal of creating family-friendly conditions.
Family Policies
7
Family policies are largely aligned with the goal of creating strong families. Lithuanian family policy is based on both passive (financial support for families) and active (social services and infrastructure) measures. The government provides support for women seeking to combine parenting and employment, including family and social-welfare legislation (e.g., special conditions for various types of flexible work arrangements in the Labor Code applicable to families), financial assistance to families raising children (child benefits and partial housing subsidies), and social services targeted at both children and parents (including preschool education and psychiatric help for parents or children).

According to OECD data for 2022, the length of paid maternity, parental and home care leave for women in Lithuania was 62 weeks, exceeding the OECD average of 56 weeks. The length of paid father-specific leave was four weeks, which is below the OECD average of 10 weeks. Information from the Social Insurance Fund Board (SODRA) indicates that in 2022, mothers accounted for 75.6% of all users of parental leave benefits, while fathers accounted for 24.4%. Additionally, 100% of employed women in Lithuania take their full entitlement to maternity leave (Braziene and Vysniauskiene 2023).

Access to kindergartens and other childcare facilities remains insufficient. Overall, family policy is fragmented and focused on supporting families facing particular social risks, primarily through financial support for families with children. More attention should be paid to developing universal family services with NGO engagement. The previous government (2016 – 2020) placed substantial emphasis on family policy, including proposals to help parents balance child-raising and work, as well as increases in financial benefits for families with children. The current Šimonytė government has continued to increase financial benefits, raised salaries for specialists in the field, and introduced some new services.

Starting in 2022, new preventive social services were introduced (The Government Annual Report for 2022, 2023). Additionally, 250 individual care specialists began providing care services for families.

Beginning in 2023, two nontransferable months of leave were implemented. This means the father or mother, adoptive parents, or guardians must take at least two months (60 calendar days) of parental leave. The remaining leave can be shared according to the family’s needs. Nontransferable months of parental leave can be taken all at once or in blocks, alternating with the other parent. Parental benefits for nontransferable months are higher, amounting to 100% of previous earnings. Nontransferable leave (or portions of the leave) for the same child cannot be taken by both parents simultaneously.

Parental leave benefits have changed as follows: parents receive 77.34% of previous net earnings until the child turns 18 months of age, or 58% of net earnings until the child turns 12 months of age, and then 38.67% of net earnings until the child turns 24 months of age.

Citations:
OECD. “Dataset: Employment – Length of maternity, parental and home care leave, and paid father-specific leave.” https://stats.oecd.org/Index.aspx?DataSetCode=GENDER_EMP
Braziene, R., and S. Vysniauskiene. 2023. “International Network on Leave Policies and Research, Country Report: Lithuania.” https://www.leavenetwork.org/annual-review-reports/country-reports
The Government Annual Report for 2022, 17 May 2023 (in Lithuanian), https://epilietis.lrv.lt/lt/naujienos/seimui-teikiama-vyriausybes-2022-metu-veiklos-ataskaita

Sustainable Pension System

#24

To what extent does the current pension policy approach prevent poverty among senior citizens?

10
 9

Pension policies are fully aligned with the goal of preventing old-age poverty.
 8
 7
 6


Pension policies are largely aligned with the goal of preventing old-age poverty.
 5
 4
 3


Pension policies are only somewhat aligned with the goal of preventing old-age poverty.
 2
 1

Pension policies are not at all aligned with the goal of preventing old-age poverty.
Policies Aimed at Old-Age Poverty Prevention
6
Pension policies are largely aligned with the goal of preventing old-age poverty. According to the OECD, Lithuania’s senior citizen poverty rate has been among the OECD countries’ highest. Both previous and current governments have increased funding for old-age pensions and made some modifications to the three-pillar pension system, which mixes public and private programs.

The 2020 – 2024 coalition government increased pensions substantially – they grew by 17% on average in 2022 (an increase of 12% in January and another 5% in June). The average old-age pension, which stood at €255 in 2016, rose to €413 in 2021, to €482 in June 2022 and to €542 in 2023.

The government indexed old-age pensions in both 2022 and 2023. In Lithuania, pension indexation rules link pension increases to average increases in the wage fund. However, according to the OECD, these increases were not enough to compensate for high inflation rates, and in real terms, pensions were around 4% lower in January 2023 than in January 2022 (except for targeted benefits, which increased by almost 4% due to the importance of food prices in indexing targeted benefits). According to projections offered by the Ministry of Social Security and Labor, old-age average pensions are expected to increase faster than prices in 2024, and will reach €605.

The new government has introduced changes to the pension system. In particular, persons who have not accumulated the necessary work years will now receive a base pension rate. This change aims to prevent old-age poverty among individuals who have been in nonstandard employment or had interrupted employment histories. However, some analysts have expressed concerns about the increasing politicization of the issue and potential disincentive effects.

Citations:
OECD. 2023. Pensions at a Glance 2023: OECD and G20 Indicators. Paris: OECD Publishing.
https://doi.org/10.1787/678055dd-en
Lithuanian Ministry of Social Security and Labor. “How shall we live in 2024.” https://socmin.lrv.lt/lt/naujienos/2024-metais-dides-dirbanciuju-pajamos-senjorai-sulauks-didesniu-pensiju-ugtels-ir-kitos-ismokos

To what extent does the current pension policy approach hinder or promote intergenerational equity?

10
 9

Pension policies are fully aligned with the goal of achieving intergenerational equity.
 8
 7
 6


Pension policies are largely aligned with the goal of achieving intergenerational equity.
 5
 4
 3


Pension policies are only somewhat aligned with the goal of achieving intergenerational equity.
 2
 1

Pension policies are not at all aligned with the goal of achieving intergenerational equity.
Policies Targeting Intergenerational Equity
6
Pension policies aim to achieve intergenerational equity. Lithuania’s three-pillar pension system, which combines public and private pension programs, seeks to ensure equity among old-age pensioners, the active labor force and the younger generation. Since 2004, there have been two privately funded pillars: a statutory pillar that receives a portion of mandatory state social insurance contributions, and a voluntary pillar funded through private contributions. These complement the pay-as-you-go (PAYG) state insurance fund.

However, this system as a whole suffered from instability and uncertainty, particularly during the global financial crisis in 2009, when most budgetary expenditures were cut in an attempt to manage public finances. In recent years, governments have avoided cutting pensions during the COVID-19 pandemic and the cost-of-living crisis, instead indexing benefit amounts to compensate for inflation. However, the governments have continued introducing modifications to the three-pillar pension system that might negatively affect participants’ confidence in the sustainability of the privately funded pension system.

In terms of fiscal stability, Lithuania’s pension system faces unfavorable demographic changes ahead (Bank of Lithuania, 2023). The old-age dependency ratio is projected to more than double by 2060 as the working-age population shrinks by a projected 35.8%. The parliament approved a gradual increase in the age of pension eligibility to 65 years by 2026 and changed the pension system’s second pillar to allow for a possible gradual increase in the share of social contributions received by private funds. According to the Bank of Lithuania, in the first half of 2023, 1.4 million people had savings in the second pillar worth a total of €6.5 billion. Additionally, 105,000 had savings in the third pillar worth a total of €256 million. However, due to demographic changes, the PAYG pillar continues to pose a risk to the sustainability of public finances overall.

Citations:
Lithuanian Ministry of Social Security and Labor. “System of savings for pensions” (in Lithuanian). https://socmin.lrv.lt/lt/veiklos-sritys/socialinis-draudimas/pensiju-kaupimo-sistema?lang=lt
Bank of Lithuania. 2023. “The Results of the Pension Funds in the First Half of 2023 (in Lithuanian).” https://www.lb.lt/lt/naujienos/pensiju-fondu-pusmecio-rezultatai-gera-zinia-kaupiantiesiems-senatvei

Sustainable Inclusion of Migrants

#1

To what extent does the current policy approach hinder or facilitate the inclusion of migrants into society and the labor market?

10
 9

Integration policies are fully aligned with achieving the sustainable inclusion of migrants in society.
 8
 7
 6


Integration policies are largely aligned with achieving the sustainable inclusion of migrants in society.
 5
 4
 3


Integration policies are only somewhat aligned with achieving the sustainable inclusion of migrants in society.
 2
 1

Integration policies are not at all aligned with achieving the sustainable inclusion of migrants in society.
Integration Policy
7
Integration policies are largely aimed at achieving the sustainable inclusion of migrants in society, though immigrants from neighboring European countries find it easier to integrate than do those from other regions of the world. Lithuania remains a relatively homogeneous society.

In 2022 – 2023, immigration numbers increased significantly, mostly due to an influx of refugees from Ukraine. For example, in 2022, the number of foreign-born residents increased by 89% (Department of Migration, 2023). According to the Department of Migration, as of 1 Sept 2023, there were 203,157 foreign-born residents living in the country. This constituted about 7% of the country’s population. Also, as of 1 September 2023, a total of 49,870 foreigners were benefiting from the EU’s Temporary Protection Mechanism, which is granted to Ukrainian refugees fleeing their country due to Russian aggression.

Ukrainians continue to be the largest foreign community in Lithuania, with the population numbering 85,579 people (Department of Migration 2023). The majority of Ukrainian citizens came to Lithuania after Russia launched its large-scale invasion of their home country in February 2022. The second-largest foreign-born community is made up of citizens of Belarus, totaling more than 60,000 people. Most of these individuals have fled to Lithuania since 2020, following the repression of opposition figures and the broader society in Belarus, which occurred after presidential elections deemed neither fair nor free by the West. This influx led to political debates regarding the simplification of employment procedures and education opportunities for migrants from Belarus. Since 2022, the focus has shifted to providing services to refugees from Ukraine and facilitating their integration into the labor market and society.

Lithuanian authorities have been actively providing information on social services and available job opportunities to immigrants from Ukraine. For example, the Ministry of Social Security and Labor created a dedicated site for this in both Lithuanian and Ukrainian. Information is also provided by the Department of Migration under the Ministry of Interior, which is the main institution working in this area. Lithuanian language courses are offered, as well as various education and training opportunities.

An analysis of the integration of residents from Ukraine into Lithuanian society, conducted by the Eastern Europe Studies Center (2023), showed that around 90% of them have been studying the Lithuanian language, 65% had stable incomes in Lithuania and 64% were considering applying for Lithuanian citizenship. The survey also revealed that insufficient availability of language courses, long waiting times at healthcare institutions and a feeling of social isolation were the main problems faced by immigrants from Ukraine.

The integration of legal migrants from neighboring countries and other EU member states into Lithuanian society has not been very difficult, with most taking up jobs in sectors experiencing labor shortages. Almost 50% of all foreign-born residents in Lithuania have found jobs in sectors such as long-distance freight and passenger transportation, construction, or other industrial services. According to the Department of Migration, as of 1 September 2023, a total of 97,925 foreigners held temporary residence permits in Lithuania for low-skill work, while 6,258 foreigners worked in high-skill jobs.

However, labor market services are not sufficiently developed in this regard, and foreign residents’ access to relevant education and training programs remains limited. Moreover, new integration facilities and services are necessary to support the inflow of foreign-born nationals. The majority of recently arrived asylum-seekers, who have arrived either via the EU scheme of resettling migrants who originally arrived in Southern European countries or through Belarus, who have typically come from countries such as Iraq, the Republic of Congo, Syria, Cameroon or Afghanistan, have presented Lithuanian authorities with more complex integration challenges. The majority of them have sought to leave Lithuania for destinations such as Germany or Sweden.

There is also a lack of targeted policies extending beyond refugees from Ukraine that actively aim for the inclusion of migrants and monitor progress based on concrete indicators. Migrants’ political participation and access to citizenship have been assessed as unfavorable by Migrant Integration Policy index authors (dating back to 2019).

Citations:
Official Statistics Portal of Lithuania. 2023. “The Population of Lithuania (Edition 2023). International Migration.” https://osp.stat.gov.lt/lietuvos-gyventojai-2023/gyventoju-migracija/tarptautine-migracija
Lrt.lt. 2023. “Number of Foreigners Living in Lithuania Surpasses 200,000.” https://www.lrt.lt/en/news-in-english/19/2083025/number-of-foreigners-living-in-lithuania-surpasses-200-000
Department of Migration, Statistics (in Lithuanian). “https://migracija.lrv.lt/lt/statistika/”
Lithuanian Ministry of Social Security and Labor. “Lithuania for Ukraine (in Lithuanian).” https://socmin.lrv.lt/lt/veiklos-sritys/socialine-integracija/lietuva-ukrainai
Eastern Europe Studies Center. 2023. “Adaptation and Integration of Ukrainian Migrants in Lithuania.” https://www.eesc.lt/en/publication/adaptation-and-integration-of-ukrainian-migrants-in-lithuania/
Migrant Integration Policy Index, Lithuania. https://www.mipex.eu/lithuania

Effective Capacity-Building for Global Poverty Reduction

#13

How committed is the government to helping build the capacity to reduce poverty and provide social protection in low- and middle-income countries?

10
 9

The government’s development cooperation strategy is fully aligned with the goal of improving capacity-building for poverty reduction in low- and middle-income countries.
 8
 7
 6


The government’s development cooperation strategy is largely aligned with the goal of improving capacity-building for poverty reduction in low- and middle-income countries.
 5
 4
 3


The government’s development cooperation strategy is only somewhat aligned with the goal of improving capacity-building in poverty reduction in low- and middle-income countries.
 2
 1

The government’s development cooperation strategy is not all aligned with the goal of improving capacity-building for poverty reduction in low- and middle-income countries.
Management of Development Cooperation by Partner Country
8
The Lithuanian government’s development cooperation strategy is largely aligned with the goal of improving capacity-building and poverty reduction in low- and middle-income countries. According to the Lithuanian Ministry of Foreign Affairs, Lithuania’s development cooperation efforts focus on Eastern Europe and countries of origin and transit for migration. Bilateral assistance has primarily and consistently gone to the EU Eastern Partnership states of Ukraine, Georgia and Moldova.

The government participates in international efforts to promote socioeconomic opportunities in developing countries through its development aid policy. Lithuania has provided development aid to Ukraine, Belarus, Moldova and Georgia through its own development aid and democracy-support program. It additionally provided aid to Afghanistan, where it was involved in the civilian-military mission, until mid-2021. Additionally, Lithuania contributes to the European Development Fund. In 2022, the portion of Lithuania’s contribution to the EU budget accounted for as official development assistance (ODA) amounted to €86.89 million. In 2011, Lithuania joined the World Bank’s International Development Association, which provides loans and grants for anti-poverty programs.

Lithuania has committed to allocating 0.33% of its gross national income (GNI) to development aid as part of its contribution to the UN Millennium Development Goals. According to the country’s authorities, in 2022 the actual level of government ODA reached €231.6 million, or 0.36% of GNI. This amount has more than tripled compared to 2021, when ODA amounted to €73.05 million, or 0.14% of GNI. An increase of about 20 times in bilateral aid to Ukraine accounted for most of this growth. Assistance to Ukraine is also strongly supported by the Lithuanian population.

In 2022, bilateral assistance made up €133.75 million or 58% of all ODA, with €45.8 million directed to Ukraine. Lithuania provided 37 bilateral projects (22 administered by embassies and 15 by the Central Project Management Agency) aimed at sharing Lithuanian expertise in the areas of good governance, European integration, resilience to disinformation, strengthening education, environmental protection, business development, women’s empowerment and digitalization. It also donated COVID-19 vaccines – 144,000 doses to the Democratic Republic of Congo and 81,600 doses to Tanzania. Multilateral ODA amounted to €97.56 million, or 42% of all ODA.

The country’s development cooperation strategic guidelines for 2022 – 2025 were adopted at the end of 2021 and focused on the following strategic areas: democracy promotion, good governance, resilience against disinformation, women’s empowerment, digitalization, education and environmental protection. These general points were complemented with development cooperation guidelines for particular regions of the world – Africa and the Middle East – as well as specific countries, namely Armenia, Moldova, Georgia, Ukraine and Uzbekistan.

However, the most commonly used indicators are the amounts of financial assistance provided and the flagship projects implemented. It would be useful to have a more elaborate system for measuring outcomes with regard to capacity-building and contributions to the achievement of other development-policy goals in recipient countries. It should also be noted that, according to the OECD, Lithuania’s ODA in 2022 amounted to 0.29% of GNI, not 0.36% of GNI as indicated by the Lithuanian authorities, which also raises the issue of accounting methodology.

Citations:
Lithuanian Ministry of Foreign Affairs. “Lithuanian Development Cooperation Policy.” https://ltaid.urm.lt/en/lithuanian-development-cooperation/lithuanian-development-cooperation-policy/115
OECD. 2023. “Development cooperation profiles: Lithuania.” https://www.oecd-ilibrary.org/sites/3eb7f948-en/index.html?itemId=/content/component/3eb7f948-en
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