Background and Aim. Contemporary health systems require stronger intersectoral cooperation. Public health should be understood both as a distinct profession and as a shared competence area for physicians, nurses, midwives, and other health professionals. Unclear national role definitions may hinder the harmonization of competency standards and cross-border mobility of public health professionals within Europe. This study assessed the relationship between the competency framework of the Association of Schools of Public Health in the European Region (ASPHER), public health education, and the positioning of public health specialists within the Lithuanian health system, and identified gaps between global and local levels.

Materials and Methods. A legal framework and policy analysis were conducted, including a review of national legislation, regulatory documents, and public health study programs. A survey of 200 public health specialists and 54 managers assessed competencies, gaps, and workforce needs was implemented.

Results. Educational programs are generally aligned with european framework competencies, but professional functions are fragmented across numerous legal acts, creating ambiguity. Only 56.6% of competencies were reported as fully held, with the largest gaps in crisis communication (32.2%) and One Health approaches (30.5%). Managers reported an 82% vs. 51% gap between competencies needed and held. Leadership and intersectoral competencies are not systematically included in workforce development, and an unclear distinction between public health as a profession and a shared activity may hinder interprofessional collaboration.

Conclusions. Formal alignment with international competency frameworks does not automatically ensure coherent national implementation. The Lithuanian case highlights the importance for competency evaluation instruments in postgraduate training and continuous professional education. A clearer national concept of the public health profession is needed, alongside recognition of public health as a shared competence area for the broader health workforce, to support harmonization with European frameworks, professional mobility, and collaboration with clinical medicine and other professions.