The NMQAL tests samples of medicinal drugs for quality control before they are registered by the NMRA and also has a role in post-marketing surveillance of these medicinal drugs through random assessments.
5.7.3 Blood and blood products The National Blood Transfusion Service (NBTS) is a fully state-owned special campaign for maintaining blood transfusion services across the country. The NBTS has a service history spanning more than 55 years. There are 99 functioning blood banks within the state hospitals at the level of BHs and above, and two stand-alone blood centres (the National Blood Centre and the Southern Regional Blood Centre) affiliated to 19 cluster centres, based on the geographical distribution. Each cluster centre is headed by a consultant transfusion physician who provides clinical and technical guidance. The service provides quality-assured blood and blood components and relevant laboratory testing for the entire state sector hospitals and for most of the private sector hospitals. Sri Lanka collects 100% of the blood from voluntary donors. All donated blood is tested for HIV, hepatitis B and C, and syphilis (National Blood Transfusion Services, 2016). The human leukocyte antigen (HLA) laboratory of the NBTS is the only place in Sri Lanka where cross-matching for organ transplantation is carried out. Other functions of the NBTS include manufacturing laboratory reagents and reagent red cells, promoting appropriate clinical use of blood and blood components through hospital transfusion committees, conducting training programmes for postgraduate trainees on transfusion medicine and haematology, and promoting transfusion medical research.
5.8 Rehabilitation Although the true extent of disability in Sri Lanka is unknown, WHO estimates that 15% of the population has some form of disability. Currently, both inpatient and outpatient rehabilitation care are available in secondary- and tertiary-care institutions in the government sector and in the larger private hospitals. In addition, special rehabilitation hospitals at Ragama, Digana and Laliambe provide dedicated rehabilitative care to around 4500 patients every year (Ministry of Health, Nutrition and Indigenous Medicine, 2016b). These services are under consultant rheumatologists and their supportive technical teams comprise general physiotherapists, speech therapists and occupational therapists. Lack of knowledge among the general population about what can be achieved through rehabilitation has led to a degree of acceptance of disability. This, together with insufficient services, both institutional and community based, problems of accessibility and cost remain as barriers to rehabilitation.
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