This year’s focus on universal health care is a timely reminder that
Many of these measures were designed to address what were then considered the key challenges of previous centuries, such as high maternal and child mortality rates and infectious diseases that claimed the health and lives of thousands.
Sri Lanka’s healthcare faces new challenges
However, we can no longer afford to rest on our laurels. Our policies and systems must now evolve to address the country’s urgent concerns.
The island must also now contend with a worrying rise in non-communicable diseases such as cardiovascular diseases (CVD), ischemic heart disease and stroke, cancers, diabetes, and respiratory conditions such as asthma.
and this is taking place while the country is aspiring to become an upper middle-income country.
With such a rapidly aging population in Sri Lanka, it is imperative for policymakers to ensure that social and economic institutions in the country are ready to face the health challenges and social consequences ahead.
In response, Sri Lanka is undertaking an ambitious agenda that will strengthen and expand primary healthcare services from the ground up. Documented in “Re-Organizing Primary Healthcare in Sri Lanka, preserving our progress preparing our future” this approach is backed by strong evidence.
Facilitated by the Ministry of Health, Nutrition and Indigenous Medicine, and supported by the World Bank, the report makes a case for why, and how, Sri Lanka must re-imagine its primary healthcare systems in order to attain the goals of universal healthcare.
Why focus on primary healthcare?
Yet, in practice, gaps in the quality of investigative services, a shortage of qualified personnel and some medications mean that people pass by such primary health care institutions and seek help at larger, tertiary care institutions instead.
This is not ideal – in fact, as the Director General of Health Services, Dr. Anil Jasinghe notes, 70‐80% of all care should be delivered at the primary care level, with 10‐15% of care provided at the secondary level and only the most advanced cases treated at the tertiary level.
This is of particular concern when it comes to treating non-communicable disease (NCDs) – in an aging population, NCDs can impede new progress and even reverse the gains made.
Ways to improve Sri Lanka's healthcare
We have identified three general areas for action: re-organizing primary health care to meet Sri Lanka’s future needs; using data and information to improve people-centered service provision and strengthening the health sector.
Tackling these challenges will require a complex and ambitious plan, with many moving parts. For instance, we could integrate prevention and treatment of service delivery for NCDs, including developing Healthy Life Centres and locating community-based NCD screening in Primary Medical Care Institutions (PMCIs).
Another focus should be on improving the efficiency and reliability of supply chain management systems for pharmaceuticals and medical supplies.
We will also have to continue to invest in and expand the country’s capacity of human resources for health, ensuring all providers have the skills, time and supplies necessary to provide quality, people-centered primary health care to Sri Lankans throughout their lives.
These are only some of the measures that are being discussed, but they all hold the potential to save lives and improve the experiences of Sri Lankans in the moments when they are most vulnerable and in need of help.
On January 23, 2019, the Government of Sri Lanka and the World Bank signed a $200 million loan agreement to help increase the use and quality of Sri Lanka’s primary healthcare services.