Lithuania is a country with an approximate area of 65 000 km2. Its population is 3.422 million, and the gender ratio (expressed as men per 100 women) is 87. The proportion of the population under the age of 15 years is 18%, and the proportion above the age of 60 years is 20%. The literacy rate is 99.6% for both men and women. The country is in the higher middle-income group (by World Bank 2004 criteria).

The health budget represents 6% of the country's gross domestic product. The per capita total expenditure on health is $478 (international $) and the per capita government expenditure on health is $337. Life expectancy at birth is 66.2 years for males and 77.6 years for females. Healthy life expectancy at birth is 59 years for males and 68 years for females (World Health Organization, 2005).

Cultural context

Lithuania has undergone a marked transition in its economic, social and cultural life. After economic decline in the 1990s, the economy started to grow significantly after 2000. Similar trends can be observed in the dynamics of public health indicators: they reached their worst in 1994; after that a gradual improvement in the indicators of mortality and general morbidity was observed. However, high levels of social pathology remain (including violence, suicides, alcohol misuse and other self-destructive behaviours); this is combined with a stigmatising approach by the general population towards people with a mental disturbance and other vulnerable groups. Lithuania is among the countries with the highest rates of suicide in Europe, and indeed the world (42–44 per 100 000 per year during the last 10 years), with middle-aged rural males the group at highest risk (among whom the rates of suicide exceed 100 per 100 000). According to a World Health Organization (2002) report, youth homicide rates in Lithuania (5.4 cases per 100 000 of the population aged 10–29 years) and other Baltic countries are several times higher than those in ‘old’ member states of the European Union (EU) and Central European countries, but none the less are three times lower than those in Russia. Recently the problem of bullying in schools has been recognised as a serious issue (it appears that more than half of all schoolchildren in Lithuania are involved in bullying).