Health Scenario in Sri Lanka

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Health Scenario in Sri Lanka

• Dr.Sarath Samaraga
• Deputy Director General (Planning)

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Sri Lanka
Total Population 20.064 m
(2004)
GDP per capita 947 USD (2003)
GDP per capita (PPP US) 4,300
Human Development Index (HDI) 0.751 (2005)
Sri Lanka is ranked 93rd in the 2005 Human
Development Report, with an HDI value of 0.751.
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Sri Lanka

• Life expectancy at birth (years) 73
• Adult literacy rate 92.3
• Infant Mortality Rate 14.35 / 1000
  LB
• Hospital beds 3.6 per 1,000
  persons
• Doctors 2,300 persons per
  doctor
• Nurses 826 persons per
  staff nurse

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Problems

• Malnutrition
• rapid increase in noncommunicable diseases
• violence and injuries (intentional and
  unintentional)
• malaria, TB, dengue and filariasis
• the above-mentioned problems are compounded for
  the poor population, with an estimated 25 of the
  population below the national poverty line and
  7 on less than one dollar/day.

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Health Sector as an organic system
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SECTORS
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Human Resources
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(No Transcript)
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Doctors and Nurses in the Health Sector over the
years.
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Health Financing
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Public Resource Mobilization and Resource
AllocationIssues Facing the Health Sector in
Sri Lanka
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MINIMUM FINANCING NEED 30-40 PER PERSON PER
YEAR TO COVER ESSENTIAL INTERVENTIONS Sri Lanka
currently spending about 29 per capita 50 by
the state 50 Private Only 1 Private Health
Insurance
Per capita health expenditure 3.2 of GDP
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Who Pays?
Source Annual Health Accounts, Ministry of
Health 2002
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IS SRI LANKA INVESTING ENOUGH IN HEALTH?

• NOT BY INTERNATIONAL STANDARDS
• NHE/GDP NHE/GDP
• Sri Lanka 3.2 UK 6.8
• Philippines 3.6 Canada 9.2
• Thailand 3.7 Australia 8.3
• Bangladesh 3.9 Japan 7.5
• Myanmar ?

Source IPS-NHA 2002
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Sri Lanka MOH Health Expenditure Share of GDP,
1939 to 2003
Figure 01
MOH Health Expenditure combines Recurrent
Capital Expenditures , 2003 is based on Estimates
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Trends in Sri Lanka Public Expenditure Shares of
GDP for Health, Education and Defence, 1972-2003
Figure 02
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Estimated Growth of Health Expenditure by
Government of Sri Lanka 2001-2015
Source Health sector master plan study 2003
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Age Pyramid 1981 and 2001
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Planning Issues Challenges
Required Policy Framework and Guiding Principles

• 1 Responding to Epidemiology (Service and
  System)
• In order to meet the epidemiological
  changes, reorientation of the health care
  services and their delivery system is a must.
  This can be derived from the following three
  principles
• Principle 1 Prioritisation and Characterisation
  of Disease (Communicable/Non Communicable)
• Principle 2 Exploration and Development of New
  Strategy
• Principle 3 Linking and Integrating Services and
  Systems

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Planning Issues Challenges
Required Policy Framework and Guiding Principles
2 Responding to Patients Expectation (Culture
and Care) Not only through the global awakening
of patients right and equity, but also by
looking at the characteristics of the disease
itself, patient participation and satisfaction
bears greater importance in the success of
treatment. Greater efforts are needed in
educating patients as well as health service
providers to make better choices. This calls for
reorientation of peoples cultural norm on the
health care in association with the following
principles Principle 1 Improvement of Quality
and Safety Principle 2 Securing of Patient
Right Principle 3 Enhancement of Client
Satisfaction
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Planning Issues Challenges
Required Policy Framework and Guiding Principles
3 Responding to Efficacy of the System (Mission
and Management) Reorientation of the health
sector organisation, management and information
systems is required to respond to efficacy of the
system. In the changing situation, it must
reframe the entire management system to
Principle 1 Be Accountable
Principle 2 Be Flexible Principle 3
Be Efficient
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thank you!