4. Physical and human resources
Chapter summary The state curative facilities in the allopathic system are organized into a tiered structure, each providing a defined level of care. They range from the National Hospital of Sri Lanka and teaching hospitals with super specialties; provincial, district, general and base hospitals with selected specialties; to divisional hospitals (outpatient care and inward care) manned by nonspecialist doctors and primary medical care units offering only outpatient care. Some 628 hospitals provide inpatient care facilities and have a combined total bed strength of 83 275 with an average of 3.9 beds per 1000 population. The public health services are mostly provided by the state sector through a network of some 354 MOH units, which run 3825 branch clinics spread across the country. Sri Lanka completed a Service Availability and Readiness Assessment (SARA) survey in 2017 among a sample of 755 facilities, including curative and preventive service delivery points, the relevant findings from which have been summarized in this chapter. Investment proposals are identified through the respective national and provincial budgets. Institutions that come under the line ministry are seen to get a major share of funding for physical resources. In the private sector, investment for ambulatory care clinics (general practitioner [GP] practices) is borne by the practitioners themselves. Investment for the establishment of private hospitals is done mostly through Board of Investment (BOI)-approved projects by entrepreneurs. The past decade has witnessed the development and deployment of many institution-based electronic HISs in Sri Lanka. There are successful and scaled-up models (i.e. electronic Indoor Morbidity and Mortality Reporting [e-IMMR], Health Information Management System [HIMS], Hospital Health Information Management System [HHIMS], Reproductive Health Management Information System [RHIMS] and District Nutrition Management System [DNMS]), which have been implemented with varying levels of maturity, while the rest are limited to pilot implementation and have failed to scale up to the national level. Major concerns identified are lack of clear policies guiding
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