Hospital Practice 1. Health Services in Sri Lanka

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  • Hospital Practice1. Health Services in Sri Lanka

  • Organization of health ServiceHealth care is provided by bothPublic Sector (for nearly 60% of population) &Private Sector

  • Public sector health careThe Department of Health Services and the Provincial Health Sector encompass the entire range ofPreventiveCurativeRehabilitative health care provision

  • Private Sector Health careThe private sector provides mainly curative careNearly 50% of the outpatient care of the populationLargely concentrated in the urban and suburban areas ?

  • Inpatient care95% of inpatient care is provided by the public sectorServices are provided byDepartment of Health ServicesProvincial councilsLocal Authorities & Service provisions especially forArmed forcesPolice personnelEstate population

  • Systems of MedicineWesternAyurvedicUnaniSiddhaHomeopathy The public sector comprises Western & Ayurvedic systems. Western medicine is the main sector catering to the needs of the people.

  • AccessibilitySri Lanka possesses an extensive network of health care institutionsThe majority of the population has easy access to a reasonable level of healthcare facilitiesAny health care unit can be found not further than 1.4 km from any homeFree government western type health care services are available within 4.8 km from home

  • National Health PolicyThe broad aim of the heath policy is toIncrease the life expectancyImprove the quality of lifeThis is to be achieved by Controlling preventable diseasesHealth promotion activities

  • Concern of the GovernmentTo address health problems likeInequities in health service provisionCare of elderly and disabledNon-communicable diseasesAccidents and suicidesSubstance abuse and malnutrition

  • Thrust areas for implementationImprove hospitals to reduce inequitiesExpand the services to areas of special needs (e.g. the elderly, disabled, victims of war and conflict, occupational health problems, mental health, estate health services)Develop health promotional programmesReforms of organizational structure to improve efficiency and effectivenessResource mobilization and managementThe government has taken efforts To maximize the financial allocations on health development

  • Health AdministrationThe health services function under a Cabinet Minister.With the implementation of the provincial councils act the services were devolved toMinistry of Health at the national level (Central)Provincial Ministries of Health at the eight provinces (now nine)

  • Central Government Ministry of HealthMH /DGHS is primarily Responsible for the protection and promotion of peoples health.Its Key functions areSetting policy guidelinesMedical and paramedical educationManagement of teaching and specialized medical institutionsBulk purchase of medical requisites

  • Provincial Ministries of HealthPMHS /PDHS are responsible for management and effective implementation of health services in the respective provincesTo manage the Provincial, Base and District Hospitals, Peripheral Units, Rural Hospitals, Maternity Homes and outpatient facilities such as central dispensaries and Visiting Stations


  • Ministry of Health & the Department of Health ServicesIn 1999, the Ministry of Health was restructured resulting the separation of the Department of Health Services from the Ministry of Health.The Director General of Health Services heads the Department and has the immediate support from Deputy Directors general, each in-charge of a special programme area. They have a number of Directors responsible for different programmes and organizations

  • Department of Health Services

  • Health FacilitiesConsists of a Network of curative care institutionsPrimary care InstitutionsCentral Dispensaries, Maternity Homes, Rural Hospitals, Peripheral Units, District HospitalsSecondary care InstitutionsBase Hospitals, Provincial HospitalsTertiary care institutionsTeaching Hospitals, Special Hospitals

  • Number of hospitals & beds15 teaching hospitals 14,695 beds in 2000Total beds in all hospitals 57,027 in 2000Ratio of beds per patients 2.9 per 1000 patients

  • The National Hospital of Sri LankaIn 2000 2,881 patient bedsProvides for number of specialties including subspecialties like neurology, cardio-thoracic surgery but excluding paediatrics, obstetrics, opthalmology and dental surgery.Has a well equipped accident service and several intensive care unitsThe specialties not found in NHSL are provided by the two maternity hospitals, childrens hospital , eye hospital and the dental institute.

  • Provincial hospitals and Base HospitalsIn 2000 There were 6 Provincial hospitals 36 Base hospitals with 9,865 patient bedsThe provincial hospitals at Kalutara, Ratnapura, Matara and Badulla and Base hospitals at Kegalle and Gampola are under the Department of Health ServicesOnly in few base hospitals have basic specialties

  • Specialties at provincial hospitals General medicineSurgeryObstetricsGyneacalogyOpthalmologyENT PaediatricsRadiology Pathological laboratories & other auxiliary services

  • District Hospitals, Peripheral Units and Rural HospitalsThe distinction between DH, PU,and RH is made on their size and the range of facilities provided. DHs are the largestThe total care available in DHs and Pus is superior to RHs because the availability of nursing personnelIn 2000 were 156 DHs, 93 Pus (4,586 beds), 167 RHs (4,382 beds)

  • Preventive Services252 Health Units (MOH offices) headed by Medical Officers of Health, carry out preventive services.The staff include PHIs, PHNs & Midwifves

  • Health ManpowerMedical officers 7,963 Persons per doctor 2431Number of Nurses per 100,000 population 76There was a shortage of Radiographers, Physiotherapists, Medical Laboratory Technicians, Pharmacists and ECG Recordists

  • Health Manpower TrainingBasic TrainingUniversitiesNIHS -KalutaraTraining SchoolsPost Basic TrainingPGIMAbroad - FellowshipsPBS- NursingIn-service Training Programmes

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