Health care status and needs of Jaffna By: Dr. S. Sivansuthan
Jaffna is the worst affected area in the ethnic conflict.
Shortage of staff – JTH (1200 beds) 600 53%
48%
400 300 200
47%
46% 29%
16%
100 Ord. Lab
Atten.
Supp. Staff
Nurses
Mos
0 Consult.
No. of staff
500
2007 2006 Needed
2007 Needed
100 80 60
77%
40
0
RMP
0%
MOO
20
9%
Consult.
No. of staff
Shortage of Doctors – Jaffna(38 hospitals)
Patient care JTH
Other hospitals (38)
In Pts
72%
28%
Deliveries
70%
30%
Out Pts
74%
26%
.
Poor public awareness & knowledge
UP 1.2
129
120 100
91
80
105
68 55
60
42
37
40
27
20 2
3
11 7
54
23 22
47 50
Province
Number of cases reported
7.3
Not reported
140
30 32
13
0 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 Year of reporting
NCP
2
SGP
2.7 5.2
SP NWP
7.5
CP
7.8
N&E
8.2 58
WP 0
10
20
30
40
50
Percentage
Number of reported HIV / AIDS cases 1987 – 2006 in Srilanka
HIV / AIDS Cases by Province
60
Other challenges • Lack of lab facilities & shortage of equipments • Shortage of medicines
Short term strategies • Providing good health care service with minimum staff • Training of staff • Improving hospital facilities • Motivating the doctors & staff to stay in jaffna
Upgrading clinical laboratory services Current Situation • • • •
Substandard lab facilities Tests are largely performed manually Shortage of trained technical personnel Certain tests can not be done. Eg:- coagulation profile, hormonal assay, tumor markers, auto immune screen, troponin, lipid profile …..
What is needed?
Upgrading clinical laboratory services • What is needed?
•Fully-automated analyzers all the tests can be done with minimum staff Total Estimate - SL Rs. 13.96 million Contribution from Ministry of Health – SL Rs. 8.7 million Balance needed – SL Rs. 5.26 million = US$ 52,600/-
Estimated cost for fullyautomated analyzers • Fully Automated 5 Part Haematology Analyzer- 2 million Reagent cost per one year – 1.8 million Coulter Mixer - 40,000/= • Coagulation Analyzer (2 channel) – 450,000/= • Centrifuge & Analytical Balance - 240,000/= • Spectrophotometer - 180,000/= • Glass Distiller – 250,000/= • Osmolarity Meter – 300,000/= Total cost - SL Rs. 5.26 million = US$ 52,600/Biochemistry Analyzer and Immunology & Serology Analyzer worth of 8.7 million will be provided by Ministry of Health next year
Benefits of Upgrading the Laboratory Services • Accurate result • Avoidance of unnecessary transfers • Prevention of delay in initiating treatment • Covering up the shortage of man power and improvement/development of the Histopathology section
Telemedicine • Telepathology • Experts anywhere in the world can interpret or advice • Radiology • Neurosurgical opinion
Lease line Installation fee – 25,000 Rental - 30,000 / month 385,000 / year
= 3850 US$
Teaching activities • Weekly clinical meetings for doctors • Postgraduate classes – weekly • Intensive care training for moo • Twice a month seminars & training for nurses
Cost for Nurses education & training Stationeries & Handouts 2x12x45x25 = 27,000/Publications – 25,000/Refreshment - 2x12x45x65 = 70,200/Annual cost - Rs. 122,200/- = US$ 1222/-
Cost for Regular weekly clinical meetings & doctors education Handouts & Stationeries – 115,000 Refreshment -225,000/= Annual Cost – SL Rs 340,000/= ( 3400 US$ )
Documentaries, audio visual cds
2005
•2007 – Mosquito control
Establishment of Health Education Unit Equipment Needed & Estimated Cost • Video camera - 450,000/• Computer with capture card facilities – 250,000/• DV player - 40,000/• Digital Copier - 350,000/• Digital camera - 55,000/-
Total Cost
SL Rs. 1,145,000/- = US$ 11,450/-
CPR • No cardiac defibrillators in medical Wds • lot of critically ill patients are managed • No cardiology ward • Limited beds in ICU [ 6 beds ] • No high dependency units
.
650,000 X 8 = 5.2 million SL Rs ( 52,000 US$ )
Special fund for drugs & its distribution • Shortage of drugs • Difficulty in distribution • Inappropriate usage of drugs
1 million SL Rs = 10,000 US$ Plastic envelops for distribution of medicines to clinic patients Cost – 30,000x3x12 = SL Rs.1.08 million . . ( USS$ 10,800/-)
Cardiology high dependency unit Estimated cost • • • • • • • • • •
•
Cardiac bed Mattress Defibrillator Cardiac Monitor ECG Recorder Pulse Oxymeter Syringe pump – Sphygmomanometer Sucker -
10 x 80,000/- = 800,000/10 x 5,000/- = 50,000/1 x 650,000/- = 650,000/2 x 600,000/- = 1,200,000/1 x 150,000/- = 150,000/2 x 140,000/- = 280,000/10 x140,000/- = 1,400,000/= 4 x 7,500/- = 30,000/2 x 40,000/- = 80,000/-
Total Cost SL Rs. 4.64 million ( US$ 46,400/-)
Establishment of indoor play room for pediatric unit • Estimated cost – 75,000 SL Rs . (750 US$)