Transforming Health Service Competencies in Remote Regions: Lessons from Lithuania’s Public Health Reform

Abstract

In Lithuania, the year 2024 has been identified as a pivotal moment for healthcare reform, which encompasses two primary objectives: implementing a proactive public health policy and enhancing the accessibility, quality, and efficiency of healthcare through the restructuring of the service delivery network. This reform is essential for remote regions, where demographic shifts have modified service requirements. Certain services, such as midwifery, have diminished, while others, including elderly nursing care, require reestablishment. Adapting to these reforms has disrupted competencies, underscoring their importance as a critical area for regional development, particularly in enhancing new resources. By analysing the public health reform in Lithuania through the lens of remote regions, it becomes possible to identify specific strategies and practices that can be applied both nationally and internationally. The study aims to highlight shifts in the emerging needs of healthcare personnel's competencies in remote regional areas, particularly during the national healthcare system's structural transformations, and their capacity to achieve the reform goal of delivering top-quality health services based on transformative competencies. The study uses qualitative interviews to identify the competencies health professionals lack following the establishment of new Primary Health Care Centres. The study revealed that while clinical and professional competencies related to legal and clinical responsibilities are easier to adopt from a technical standpoint, competencies like leadership, collaboration, and patient involvement pose greater challenges, leading to community stress. The acquisition of these competencies requires long-term investment in staff development, emotional support, and clear change management. Moreover, the new structure of health centers and newly introduced work processes may increase employees’ emotional exhaustion, stress, or even the risk of burnout if adequate support or training is not provided.