Sri Lanka Health System Review

Page 145

The strategic area of health promotion and risk reduction specifies the plans for the following: reduction of tobacco and alcohol use; promotion of a healthy diet high in fruit and vegetables and low in saturated fat and transfat, sugar and salt; promotion of physical activity and healthy behaviour; and reducing household air pollution (Ministry of Health, Nutrition and Indigenous Medicine, 2016c). Cost-effective strategies adopted include NCD screening programmes at the community level and empowering communities to adopt healthy lifestyles. The NCD screening strategy consists of screening people above 35 years of age at healthy lifestyle centres (HLCs), workplace screening and mobile screening. HLCs will address risk reduction through early identification of both behavioural and intermediate risk factors. Currently, there are some 896 HLCs established throughout the country. Reorganization of primary health care has commenced. It will provide continuing care for NCDs closer to people’s homes. The Ministry has piloted a Package of Essential NCD Interventions (PEN) and adopted an Essential Services Package for Sri Lanka. Both these packages highlight the need for instituting opportunistic screening at primary health-care settings and these proposed changes would need extra HR with a better skill mix. This warrants a rescaling and retooling of existing staff to meet these demands.

5.1.6 Disease-specific campaigns In addition to the above programmes, specific diseases of public health importance are addressed through specialized vertical campaigns, administered centrally. Tuberculosis (TB), sexually transmitted infections (STIs) and leprosy are some such campaigns. The elimination of malaria and filariasis were led by two such vertical programmes. These programmes undertake preventive, curative and rehabilitative activities in disease-specific areas relevant to their mandate. The preventive and promotive components of these services as well as some curative functions reach the community through the MOH system.

5.2 Curative care services In the government sector, curative services are provided through an extensive hierarchical network of institutions ranging from primary medical care units (PMCUs), divisional hospitals (DHs), base hospitals (BHs), district general hospitals (DGHs), provincial general hospitals (PGHs), special hospitals and teaching hospitals (THs).13 13 Refer to Chapter 4, Table 4.1.

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9. Appendices ................................................................................................ 206 9.1 References

21min
pages 230-247

9.3 About the authors

4min
pages 250-254

7.6 Transparency and accountability

18min
pages 220-229

9.2 HiT methodology and production process

2min
pages 248-249

7.4 Health outcomes, health service outcomes and quality of care

5min
pages 203-205

7.3 User experience and equity of access to health care

14min
pages 195-202

7.1 Objectives of the health system

4min
pages 182-183

7. Assessment of the health system .......................................................... 157 Chapter summary

1min
page 181

6.3 Future developments

10min
pages 174-180

developments in Sri Lanka

1min
page 164

6.2 Analysis of recent major reforms

17min
pages 165-173

6. Principal health reforms ......................................................................... 139 Chapter summary

1min
page 163

medicine

2min
page 162

5.11 Mental health care

5min
pages 157-159

5.13 Health services for specific populations

1min
page 161

5.8 Rehabilitation

3min
pages 153-154

5.7 Pharmaceutical care

3min
pages 151-152

5.6 Emergency care

2min
page 150

5.2 Curative care services

3min
pages 145-146

5.4 Inpatient care

3min
pages 148-149

4.2 Human resources

6min
pages 117-120

5. Provision of services ................................................................................ 113 Chapter summary

1min
page 137

4.1 Physical resources

1min
page 104

4. Physical and human resources ................................................................ 78 Chapter summary

3min
pages 102-103

3.7 Payment mechanisms

1min
pages 100-101

3.6 Other financing

1min
page 99

Figure 3.8 OOP spending on health by expenditure deciles, 2016

11min
pages 86-92

3.5 Voluntary private health insurance

3min
pages 97-98

3.2 Sources of revenue and financial flows

2min
pages 81-82

3.3 Overview of the public financing schemes

2min
page 85

Figure 3.6 Financing system related to health-care provision

0
page 83

3. Health financing ......................................................................................... 48 Chapter summary

1min
page 72

2.9 Patient empowerment

7min
pages 68-71

2.8 Regulation

8min
pages 64-67

2.7 Health information management

5min
pages 61-63

2.6 Intersectorality

3min
pages 59-60

2.4 Decentralization and centralization

3min
pages 56-57

2.2 Overview of the health system

1min
page 52

2.1 Historical background

2min
page 51

2.3 Organization

1min
page 53

2. Organization and governance ................................................................... 26 Chapter summary

1min
page 50

1. Introduction .................................................................................................. 1 Chapter summary

1min
page 25

1.4 Health status

11min
pages 37-43

1.3 Political context

2min
page 36

1.5 Human-induced and natural disasters

3min
pages 48-49

Figure 1.1 Map of Sri Lanka

1min
pages 27-28

1.1 Geography and sociodemography

1min
page 26

1.2 Economic context

2min
page 35

1 Analysis of the significant health reforms that affected health

2min
page 30
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