Lincoln university

Bachelor of Biomedical Science (Hons)

COURSE CODE -BMC4713
Principles of Health Management

Name: - S.A.T. Tharangana

Student ID:LU202304070005
Name of the Lecturer: Dr. Chamendra Sirimanna
Dead line of the assignment:12.05.2024
Submission date of the assignment:12.05.2024
 Table of Contents

Introduction....................................................................................................................................3
Sri Lanka health care system and services...................................................................................4
Comparison on Sri Lankan Health care system from other countries...........................................6
Advantages and Disadvantages of Sri Lankan Health care system..............................................8
Ideas on improving Sri Lankan Health care system....................................................................11
Conclusion...................................................................................................................................14
Reference....................................................................................................................................15

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 Introduction

Sri Lanka's Healthcare System

Sri Lanka boasts a unique healthcare system, interwoven with threads of
tradition and modern advancements. This system, a source of national pride, has yielded
impressive results in terms of life expectancy and disease control. Let's delve deeper into its rich
history, structure, and current challenges. Sri Lanka's healthcare story predates recorded history.
Ayurveda, a traditional system of medicine originating in India, found a strong foothold in Sri
Lanka. This holistic approach emphasizes preventative care, herbal remedies, and lifestyle
modifications. Alongside Ayurveda, other indigenous practices like Siddha medicine also
flourished, showcasing Sri Lanka's deep-rooted understanding of health and wellness. Following
independence in 1948, Sri Lanka prioritized healthcare as a cornerstone of national development.
The government embarked on an ambitious project to establish a free, universal healthcare
system accessible to all citizens. This commitment resulted in a vast network of public hospitals,
dispensaries, and maternal and child health clinics spread across the country.
 Sri Lanka health care system and services
Sri Lanka, the resplendent island nation nestled in the Indian Ocean, boasts a rich tapestry of
history and tradition. This legacy extends to its healthcare system, one of the earliest documented
in the world. Today, Sri Lanka stands tall with a unique model that prioritizes accessibility and
prevention, offering a compelling case study in global healthcare.

This comprehensive system is built on three pillars:

● Primary Care: Forming the bedrock of the system, primary care is readily available at
geographically dispersed hospitals, clinics, and dispensaries. Staffed by general
practitioners, these facilities cater to basic medical needs, preventive measures, and early
diagnosis. Think of them as the first point of contact for most healthcare needs.

● Secondary Care: For cases requiring more specialized attention, patients are referred to
secondary level hospitals. These provincial facilities boast a wider range of specialists,
along with diagnostic equipment like X-ray and ultrasound machines. They handle a
broader spectrum of illnesses and offer in-patient care for more complex conditions.

● Tertiary Care: The apex of the system lies in tertiary care hospitals, typically teaching
hospitals located in major cities. These advanced centers house highly qualified
specialists, cutting-edge technology (MRI, CT scans), and cater to the most intricate
medical needs, including surgeries and specialized treatments.

A Spectrum of Services: From Prevention to Cure

Sri Lanka's healthcare system goes beyond just treating illnesses. It actively promotes preventive
measures through:

● Immunization Programs: Extensive childhood immunization programs ensure

protection against a multitude of diseases, leading to improved child health outcomes.
● Maternal and Child Health Care: Dedicated services cater to prenatal care, safe
childbirth practices, and well-being of mothers and children. Think regular checkups,
nutritional guidance, and access to essential services during pregnancy and infancy.
● Public Health Campaigns: The government spearheads campaigns to raise awareness
about healthy lifestyles, hygiene practices, and the importance of early disease detection

Curative Services: Addressing Medical Needs

Beyond prevention, the system tackles a wide range of medical conditions, including:
 ● Communicable Diseases: Sri Lanka has successfully tackled diseases like malaria and
filariasis through targeted interventions.
● Non-Communicable Diseases: The system addresses the growing burden of chronic
illnesses like diabetes and heart disease through specialized care and management
programs.
● Accidents and Injuries: Hospitals are equipped to handle emergencies and provide
trauma care.

Accessibility: A Core Principle

One of the most remarkable aspects of the Sri Lankan healthcare system is its commitment to
universal access. Here's what this means for citizens:

● Free Healthcare: The government finances the majority of healthcare costs, meaning
citizens can access consultations, diagnostics, and even hospitalization without upfront
payments. This significantly reduces financial burdens on individuals and families.
● Geographic Reach: The extensive network of primary healthcare facilities ensures
geographically dispersed populations have access to basic medical services.
● Subsidized Medication: Essential medications are heavily subsidized by the
government, making them more affordable for citizens.

Additional Considerations: The Private Sector and Traditional Medicine

While the public sector forms the backbone of the system, a private sector also exists offering
specialized services and advanced treatments. However, these services come at a cost, which
may not be accessible to all.

It's important to note that Sri Lanka also has a rich tradition of traditional medicine, which plays
a complementary role. Ayurveda, Siddha, and Unani medicine systems are practiced alongside
modern medicine, offering patients a wider range of options for managing their health.

Comparison on Sri Lankan Health care system from

other countries.
Sri Lanka's healthcare system, with its focus on universal access and preventive care, stands out
in the global landscape. Here's a comparative analysis with healthcare models from developed
and developing countries:

Developed Nations: High-Income, High-Tech Systems

● Model Examples: Countries like the United States, Germany, and Japan exemplify high-
income healthcare systems. These models are characterized by:
○ Advanced Technology: Hospitals boast cutting-edge equipment for diagnosis
and treatment, offering a wider range of specialized options.
○ Medical Specialists: A higher concentration of specialists allows for more in-
depth care for complex medical conditions.
○ Pharmaceutical Innovation: These countries are at the forefront of medical
research and development, providing access to the latest medications and
treatments.

Comparison with Sri Lanka:

● Strengths of Developed Models: Sri Lanka can benefit from:

○ Technology Transfer: Collaboration and knowledge sharing can improve

diagnostic capabilities and treatment options within the Sri Lankan system.
○ Specialist Training: Exchange programs and partnerships can enhance the
availability of specialists in Sri Lanka.
○ Pharmaceutical Access: Negotiations and strategic partnerships can ensure
access to essential and innovative drugs in Sri Lanka at affordable prices.

● Weaknesses of Developed Models:

○ High Costs: These systems are often marked by high healthcare costs, with a
significant portion borne by individuals through insurance premiums and co-pays.
This can create financial barriers to accessing care.
○ Inequalities: Despite advancements, disparities in access and quality of care can
exist based on socioeconomic status and location.

Developing Countries: Varied Approaches with Challenges

● Model Examples: Developing countries present a diverse landscape. Some, like Brazil
and Cuba, have established universal healthcare systems, while others rely more heavily
on private healthcare or a mix of both. These systems often face challenges such as:
 ○ Resource Constraints: Limited financial resources can restrict infrastructure
development, equipment availability, and access to medications.
○ Workforce Shortages: A lack of trained medical professionals can hinder service
delivery and limit access to specialized care, especially in rural areas.
○ Communicable Diseases: Developing countries may face a higher burden of
infectious diseases, requiring a strong focus on public health interventions.

Comparison with Sri Lanka:

● Strengths of Sri Lanka: Sri Lanka offers valuable lessons for other developing nations:

○ Universal Coverage: Sri Lanka's commitment to providing free healthcare at the

point of service is a model for ensuring equitable access.
○ Focus on Prevention: The emphasis on preventive care through immunization
programs and public health campaigns is crucial for reducing the burden of
disease in developing countries.
○ Resourceful System: Despite limitations, Sri Lanka effectively utilizes its
resources to provide basic healthcare services to a large population.
● Challenges for Sri Lanka: Sri Lanka can learn from others:

○ Public-Private Partnerships: Strategic collaborations with the private sector can

help expand service offerings and address resource constraints.
○ Addressing Non-Communicable Diseases: As Sri Lanka faces a rise in chronic
illnesses, adopting best practices from other countries can improve management
programs.

Beyond the Binary: Hybrid Models and the Future

The world of healthcare is not a one-size-fits-all proposition. Many countries are

adopting hybrid models, incorporating elements of both public and private healthcare systems.
Sri Lanka can explore such models to leverage the strengths of both sectors while mitigating
their drawbacks.

Looking ahead, advancements in technology, telemedicine, and data-driven healthcare

hold immense potential for all healthcare systems, including Sri Lanka's. Embracing these
advancements will be crucial in ensuring efficient service delivery, improved quality of care, and
continued success for Sri Lanka's enduring legacy in healthcare.
 Advantages and Disadvantages of Sri Lankan Health
care system

Sri Lanka's healthcare system stands out for its commitment to universal access and
preventive care. However, like any system, it has its strengths and weaknesses. Here's a
comprehensive analysis of the advantages and disadvantages of Sri Lanka's healthcare system:

Advantages: A Foundation for Good Health

● Universal Access: Sri Lanka's most significant advantage is its commitment to providing
free healthcare at the point of service. This eliminates financial barriers and ensures
everyone receives basic medical care, regardless of socioeconomic background. This
fosters a healthier citizenry and reduces social inequalities in health outcomes.

● Focus on Prevention: Sri Lanka prioritizes preventative measures through extensive

immunization programs, maternal and child health services, and public health campaigns.
This proactive approach helps reduce the burden of infectious diseases, promotes healthy
lifestyles, and contributes to better overall health.

● Qualified Professionals: Sri Lanka boasts a well-trained medical workforce. Doctors,

nurses, and other healthcare professionals are adept at providing basic and essential care.
This ensures a strong foundation for the healthcare system.

● Geographic Reach: The extensive network of primary healthcare facilities ensures

geographically dispersed populations have access to basic medical services. This reduces
travel burdens and facilitates early intervention for health concerns.

● Subsidized Medication: The government heavily subsidizes essential medications,

making them more affordable for citizens. This ensures access to life-saving drugs and
promotes adherence to treatment plans.

● Integration of Traditional Medicine: Sri Lanka's rich tradition of Ayurveda, Siddha,

and Unani medicine offers patients a wider range of options for managing their health.
This complementary approach can be beneficial for certain conditions.

Disadvantages: Areas for Improvement

 ● Resource Constraints: Limited financial resources can be a significant hurdle. This can
lead to:

○ Outdated Equipment: Hospitals may lack access to the latest diagnostic and
treatment technologies, potentially impacting the quality of care for complex
cases.
○ Infrastructure Strain: Aging infrastructure and a growing population can put a
strain on the system's capacity, leading to longer wait times and overcrowding in
facilities.
○ Limited Specialist Availability: The concentration of specialists may be higher
in urban areas, leaving rural areas with limited access to specialized care.
● Workforce Challenges: While Sri Lanka has a well-trained workforce, there can be
challenges with:

○ Staff Shortages: A shortage of medical professionals, particularly in certain

specialties and rural areas, can hinder service delivery and timely access to care.
○ Brain Drain: Migration of skilled medical professionals to countries with higher
salaries can create workforce gaps within the system.

● Dependency on Foreign Aid: The system relies to some extent on foreign aid, making it
susceptible to fluctuations in international funding. This can impact the system's ability to
maintain and improve services.

● Focus on Primary Care: While a strong foundation, the emphasis on primary care can
sometimes lead to delays in accessing specialized care for complex conditions. A more
streamlined referral system could improve efficiency.

● Private Sector Costs: Although public care is free, some medications and treatments,
especially in the private sector, may require out-of-pocket expenses. This can be a burden
for some families.

Moving Forward: Building on a Strong Foundation

Despite these challenges, Sri Lanka's healthcare system has demonstrably improved the nation's
health. Here are some ways to address the disadvantages and ensure continued success:

● Increased Funding: Increased investment in healthcare infrastructure, equipment, and

personnel can significantly improve service delivery, reduce wait times, and enhance
access to advanced care.
 ● Public-Private Partnerships: Strategic collaborations between the public and private
sectors can expand service offerings, provide access to advanced technologies, and
potentially reduce the burden on the public system.

● Focus on Non-Communicable Diseases: As Sri Lanka faces a rise in chronic illnesses

like diabetes and heart disease, implementing targeted programs for prevention, early
detection, and management is crucial.

● Investing in Workforce Development: Programs to retain existing medical personnel,

incentivize specialists to work in rural areas, and provide opportunities for continuous
education can strengthen the healthcare workforce.

● Embracing Technology: Telemedicine and digital health solutions can improve access
to care in remote areas, enhance communication between healthcare providers and
patients, and streamline data management.

● Focus on Sustainability: Exploring alternative funding mechanisms and diversifying

revenue streams can lessen the reliance on foreign aid and ensure the system's long-term
sustainability.

A System in Evolution

Sri Lanka's healthcare system is a work in progress, continuously striving to improve the
health and well-being of its citizens. By acknowledging its strengths and weaknesses, and
actively working towards solutions, Sri Lanka can ensure its enduring legacy in healthcare
continues to flourish.

Ideas on improving Sri Lankan Health care system.

Sri Lanka's healthcare system boasts a strong foundation built on universal access and preventive
care. However, like any system, it faces challenges. Here, we explore some innovative ideas to
enhance Sri Lanka's healthcare system, ensuring it continues to deliver quality care for its
citizens:

Optimizing Resource Allocation:

● Investing in Infrastructure and Equipment: Increased government funding or public-

private partnerships can help modernize healthcare facilities. This includes acquiring
advanced diagnostic equipment (MRI, CT scans) and upgrading existing infrastructure to
improve service delivery and patient comfort.
 ● Prioritizing Preventative Measures: Investing in stronger public health campaigns,
expanding immunization programs, and promoting healthy lifestyles can significantly
reduce the burden of treatable diseases and free up resources for more complex cases.

● Data-Driven Decision Making: Implementing robust data collection and analysis

systems can provide valuable insights into resource allocation, service utilization, and
disease patterns. This data can then be used to optimize resource allocation, prioritize
interventions, and improve overall system efficiency.

Enhancing Workforce Capacity:

● Retention Strategies: Attractive salary packages, career development opportunities, and

improved working conditions can incentivize medical professionals to remain in Sri
Lanka and reduce brain drain.

● Rural Deployment Programs: Scholarships, loan forgiveness programs, and hardship

allowances can encourage specialists to practice in underserved rural areas, ensuring
equitable access to healthcare across the nation.

● Upskilling and Specialization: Investing in continuous education programs can equip

existing healthcare workers with the latest knowledge and skills, allowing them to
provide better care and potentially manage a wider range of conditions within primary
care settings.

● Telemedicine and Remote Consultation: Telemedicine platforms can connect patients

in remote areas with specialists in urban centers, reducing travel burdens and improving
access to specialized care. This can also be used for follow-up consultations, medication
management, and mental health services.

Enhancing Service Delivery and Accessibility:

● Standardized Referral Systems: Implementing clear and efficient referral pathways can
streamline the process of accessing specialized care for complex cases, reducing wait
times and improving patient outcomes.

● Community Health Outreach Programs: Programs that provide mobile healthcare

services, health education workshops, and disease screenings in underserved
communities can improve early detection and access to care for those with limited
mobility or resources.
 ● Mental Health Awareness and Support: Integrating mental health services into the
existing healthcare system and addressing the stigma surrounding mental illness can
create a more comprehensive approach to healthcare, allowing individuals to receive the
support they need.

● Digital Health Solutions: Investing in mobile health apps and online platforms can
empower patients to manage their health information, track medication adherence,
schedule appointments, and access educational resources. This can improve patient
engagement and self-care practices.

Promoting Sustainability and Innovation:

● Public-Private Partnerships: Strategic collaborations with the private sector can

leverage private investment and expertise to expand service offerings, introduce new
technologies, and reduce the burden on public finances.

● Exploring Alternative Funding Mechanisms: Investigating innovative funding models,

such as health insurance schemes or social impact bonds, can diversify revenue streams
and promote long-term sustainability of the healthcare system.

● Research and Development: Encouraging and supporting medical research within Sri
Lanka can foster innovation in areas like telemedicine, disease prevention, and
development of affordable drugs and treatments tailored to the specific needs of the Sri
Lankan population.

● Focus on Efficiency and Transparency: Implementing cost-saving measures, reducing

administrative burdens, and promoting transparency in resource allocation can ensure that
available funds are used effectively.

A Collaborative Effort for a Healthier Future

 Strengthening Sri Lanka's healthcare system requires a collaborative effort. By
implementing these ideas, Sri Lanka can ensure its citizens have access to quality, affordable
healthcare, regardless of location or socioeconomic background. Investing in infrastructure,
technology, and its workforce, while fostering innovation and promoting sustainability, will pave
the way for a brighter future for Sri Lanka's healthcare system.

Conclusion
Sri Lanka's healthcare system stands as a testament to the nation's commitment to the
well-being of its citizens. This unique model, built on the pillars of universal access and
preventive care, has demonstrably improved public health outcomes. However, like any system,
it faces challenges that require innovative solutions. Sri Lanka's healthcare system boasts a rich
history, with a well-established network of primary, secondary, and tertiary care facilities. The
emphasis on prevention through childhood immunization programs, maternal and child health
services, and public health campaigns has played a crucial role in reducing the burden of
infectious diseases. Furthermore, the dedication to universal access ensures that everyone
receives basic healthcare services, regardless of financial limitations.

Compared to high-income nations, Sri Lanka may lack access to the latest technologies
and a wider range of specialists. However, Sri Lanka's focus on prevention and its success in
addressing communicable diseases offer valuable lessons for developing countries. Learning
from others, particularly in areas like public-private partnerships and managing non-
communicable diseases, can further strengthen Sri Lanka's system. While Sri Lanka's
commitment to universal access is commendable, resource constraints limit the system's
capacity. Increased funding, strategic partnerships, and data-driven decision making can
optimize resource allocation and enhance service delivery. Investing in the healthcare workforce
through retention strategies, upskilling programs, and rural deployment initiatives can ensure a
skilled and dedicated workforce across the nation. Embracing technology like telemedicine and
digital health solutions can revolutionize access to care, particularly in remote areas.
Furthermore, promoting sustainability through innovative funding mechanisms and research
focused on Sri Lanka's specific needs will ensure the system's long-term viability.

Building a robust healthcare system hinge on collaboration. The government, private

sector, healthcare professionals, and the public all have a role to play. By working together and
embracing continuous improvement, Sri Lanka can ensure its healthcare system continues to
flourish, delivering quality care for generations to come.

In conclusion, Sri Lanka's healthcare system presents a compelling case study,

demonstrating the power of prioritizing accessibility and prevention. While challenges exist, Sri
Lanka's enduring legacy of ensuring the health of its citizens paves the way for a brighter future
filled with innovation, collaboration, and a commitment to continuous improvement.

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Sri Lanka : What Can the Private Health Sector Offer ? HNP Discuss. Pap. 1–66 (2014).

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