Sri Lanka Health System Review

Page 68

modest (around 17%) but it is envisaged that in the next 5 years it will be able to produce a significant proportion of the medicines needed by the country, especially for the state sector. Public–private partnerships too have been incorporated and have helped to expand the production capacities and range of medicines subject to regulation by the NMRA.

2.8.4 Health technology assessment There is no specific unit undertaking health technology assessment (HTA) as its primary function. Despite the non-availability of a dedicated unit for HTA, the basic principles are taken into consideration when developing the Essential Drugs List for the country and also in the functions of the Medical Supplies Department for procurement of medicines and vaccines for the country. The MoH and National Authority on Tobacco and Alcohol (NATA) undertook an HTA to make recommendations for increasing the taxes imposed on cigarettes in 2016–2017. There have been a number of proposals to establish an HTA unit under the MoH, but this has not been realized as yet.

2.8.5 Regulation of capital investment There is no formal mechanism for the regulation of capital investments in the state sector. Health development projects are prioritized according to set criteria, though political considerations can also influence these decisions. The resources for capital investments are made available within the annual or longer-term budgetary allocations for the MoH. For private sector investments from sources within the country, there is no formal approval required, while for investments from outside Sri Lanka, the approval of the Board of Investment of Sri Lanka is mandatory.

2.9 Patient empowerment Patient empowerment has emerged as a relatively new paradigm that can help to improve patient health outcomes while lowering the costs of care. The concept seems particularly promising for the management of chronic diseases, because empowering patients can be instrumental in achieving success in managing these conditions. At a time when much medical information can be accessed via the Internet and easily communicated to health-care providers, patients and other experts, empowering patients would enable them to make use of the information and knowledge to achieve better outcomes.

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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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