Sri Lanka Health Profile 2012

HEALTH & DEVELOPMENT
The general health status of the population is good. Health is a long-standing Government priority and the United Nations (UN) Millennium Development Goals (MDGs) have been attained nationwide although there are still regional disparities. Demographic and epidemiological transition is taking place, bringing changes in health priorities and challenges for the health system. The Health Ministry (now Ministry of Healthcare and Nutrition, MHN) redefined its strategic direction in a National Health Policy document in 1996, which formed the basis for the Health Sector Master Plan in 2002 and the Strategic Framework for Health Development in Sri Lanka in 2003.
Sri Lanka has an extensive network of public health clinics and hospitals. Most people live within 5 km of a health facility. However, decentralization is incomplete, with excessive reliance on tertiary and secondary level hospitals and under-utilization of primary care facilities which often lack staff and service quality. Information systems and laboratory services are poorly developed and quality control for pharmaceuticals remains to be addressed. There is a shortage of nurses and paramedical personnel and concentration of medical staff in urban centres. Health care is provided free of charge: this is becoming difficult to sustain.
Communicable diseases are still important causes of morbidity and mortality, notably malaria, tuberculosis, dengue, Japanese encephalitis, diarrhoeal diseases and acute respiratory infections. Tuberculosis has a high incidence in and around Colombo and malaria is still prevalent in a few districts in North Central and Eastern provinces. The incidence of vaccine-preventable and vector-borne diseases has been greatly reduced but regional variations persist. Sri Lanka is a low prevalence country for HIV/AIDS.
Noncommunicable diseases have increased, particularly cardiovascular and cerebrovascular diseases, cancers, diabetes, and tobacco, alcohol and substance abuse; pesticide poisoning is a long term problem. Mental health disorders are common and Sri Lanka has a particularly high suicide rate (around 6000 per year). Injuries, including traffic accidents, are a major cause of hospital admissions. Malnutrition is prevalent in children in disadvantaged population groups.
The tsunami in December 2004 caused more than 31 000 deaths, destroyed 92 health facilities and displaced about 850 000 people. Infrastructure is now being reconstructed in the affected areas.

OPPORTUNITIES

• Government's strong commitment to health; Strategic Framework for Health Development in Sri Lanka 2003 addresses changing needs, priority activities and reduction of inequalities
• Poverty Reduction Strategy Paper developed in 2002
• MDGs have been achieved at national level
• Nationwide network of health facilities; healthcare provided free of charge.

CHALLENGES
• Strengthening the stewardship role of the MHN
• Meeting the rising costs of healthcare
• Reduction of regional disparities in disease burden and access to health care; improving skill-mix of medical personnel
• Improving use of primary care facilities
• Strengthening of information systems, laboratory services, mental health services
• Addressing environmental factors with important public health impact
• Coordination of public and private healthcare providers.