SEATTLE — Sri Lanka, an island nation often known as “India’s Teardrop,” impressively upgraded its health care system on a number of levels to address its medical challenges. Health care and disease in Sri Lanka are being focused on through the Primary Health Care System Strengthening Project, which emphasizes detection and management of non-communicable diseases in high-risk population groups in selected areas of the country.
Sri Lanka has achieved extraordinary progress in universal coverage in maternal and child health while addressing communicable diseases. Between 2005 and 2015, the rate of under-five mortality decreased from 14.3 to 9.6 per 100,000 live births, and the rate of maternal mortality decreased from 43 to 30 per 100,000 live births. With a life expectancy of 75.3 years, these results exceed other South Asian countries. At the same time, malnutrition among adults and children has not adequately improved, with 16.8 percent of babies delivered with a low birth-weight.
Access to health care has accelerated the demographic and pattern of disease development changes as the Sri Lankan population ages. With the population over 60 expected to double in the next 25 years, this will have an impact on Sri Lanka’s health profile especially considering that out-of-pocket expenses stand at 38 percent — creating a significant burden for the poor.
Disease in Sri Lanka
There is an increasing prevalence of non-communicable diseases, both chronic – such as diabetes, cancer, mental health – and acute ailments such as injuries. Noncommunicable diseases (NCD) cause more than 75 percent of all deaths and nearly one in five people die prematurely from NCDs thanks to an unhealthy diet, use of alcohol and physical inactivity. However, it is communicable diseases, such as dengue, influenza and tuberculosis that top the health issues affecting the country in the poorest of the population.
From January to July 2017, the Sri Lankan Ministry of Health (MoH) reported 185,000 dengue fever cases, including 215 deaths. This is 4.3 percent higher than the average number of cases for the same period between 2010 and 2016. Flooding due to heavier rainfall intensified the outbreak.
However, the country has effectively tackled another mosquito-born disease: Malaria. Sri Lanka reported the last case of Malaria in 2012 and the World Health Organization (WHO) declared the country Malaria-free in 2016. The Maldives and Singapore are the only other two nations in the region declared to be free of the disease. At the end of 2018, reports surfaced that two new cases of Malaria existed in Sri Lanka and the conclusion was that one of the individuals traveled outside of the country and, therefore, infected the other person. About 400,000 Malaria-related deaths take place worldwide each year.
National Health Development Plan
The World Bank supports the implementation of Sri Lanka’s National Health Development Plan, which aims to continually upgrade the standards of the public health system in order to address health care and diseases in Sri Lanka that affects the population countrywide.
The objectives of the Plan are to:
- Advance the quality of maternal and child health care
- Provide better emergency care for everyone
- Upgrade medical facilities and health staff
- Address challenges of malnutrition
- Prevent and manage non-communicable diseases with innovative technology in the health sector
The Second Health Sector Development Project implemented in mid-2013 ended in September 2018 after helping with the push forward to tackling health care and disease in Sri Lanka that needed additional attention. To date, this project has:
- Increased the availability of standard emergency and trauma serves to nearly half of the centrally-managed hospitals and several provincial hospitals
- Opened at least two Healthy Lifestyle Centers and three health and community support groups
- Succeeded in ensuring there are functioning quality management units in 100 percent of centrally managed hospitals and nearly all provincial hospitals
- Increased the percentage of locally managed hospitals reporting their mortality and morbidity data electronically
An Investment in Health Care
In 2018, Microsoft Corporation Founder Bill Gates commended the Sri Lankan health care system as being high quality and well staffed with a number of female health care professionals as a model that other countries may follow. Gates suggested that as the world improves, investment in health, education and economic opportunity will pave the way for future, rapid improvement in these areas.
With the help of The Gates Foundation, World Bank and other global entities, the focus towards quality improvement not only within the hospitals and clinics in Sri Lanka but with how the general public receives vital information about disease prevention, gives the population an opportunity to take care of themselves and their loved ones.
– Colette Sherrington