Sri Lanka Health System Review

Overview

Sri Lanka has achieved strong health outcomes over and above what is commensurate with its income level. The country has made significant gains in essential health indicators, witnessed a steady increase in life expectancy among its people, and eliminated malaria, filariasis, polio and neonatal tetanus. At the same time, Sri Lanka’s health system faces challenges arising from a rapidly ageing population, and the need to address the burden of non-communicable diseases which currently contributes to nearly 75% of deaths in the country.

The majority of services in the country, including inpatient care (95%) and outpatient care (50%) is provided by the public sector. The role of the private sector in health is growing, but accessible to a fraction of the population who can afford the high costs. Studies suggest that the quality of care across public and private sectors is comparable. Curative care is provided across different levels. Preventive healthcare is provided through geographically defined areas, each served by a medical officer of health, who are given strong supportive supervision.

Government spending as a share of GDP has remained around 1.7% during the period 2013 to 2016. Household contribution to current health expenditure is significant, but catastrophic health expenditure remains low as the government remains a key provider of inpatient care. Medication and investigations are provided free of charge.

The first comprehensive national health policy based on primary health care drafted in 1992 was revised with a focus on universal health coverage (2014–2016). The current policy (2016–2025) addresses emerging health issues, quality and safety, and the expectations of the people. Recent reforms make an effort to re-organize primary care services and include the launch of a policy on health-care delivery for UHC along with other supporting policies such as the National Authority on Tobacco and Alcohol, National Policy and Strategic Framework for Prevention and Control of Chronic Non-communicable Diseases, National Policy on Health Information, and Policy on Health Service delivery for UHC.

The Sri Lanka HiT review presents comprehensive information on the country’s health system. The review also presents information on reforms towards UHC and to address emerging health needs.