World Health Day is celebrated worldwide, every year on April 7. This day, initiated and funded by the World Health organization, has the main intention of raising awareness on important topics in the global health, throughout the world. This year, the theme is, ‘Universal Health Coverage: everyone, everywhere’. The Health Capsule talked to two of the giants in Sri Lanka’s health system, to get more information about the celebration of world health day and about how far we have come and the challenges that we face, when it comes to healthcare in Sri Lanka.   

Sri Lanka to host World Health Day 2018
The WHO announced recently that this year’s World Health Day Celebrations would be held in Sri Lanka, saying there is no other country more suitable to celebrate the day. Dr. S. Sridharan, Deputy Director General of Health Services at the Ministry of Health, explained some of the milestones that we have achieved in terms of universal healthcare for Sri Lanka to be chosen as the host of this year’s events.   

We recently conducted a research which revealed that 35% of the risk factors for the Non Communicable Diseases in our country are Poor diet, smoking and a lack of exercise

What we have achieved so far
Sri Lanka is one of the few countries where the cost of healthcare at the point of delivery is zero in the government sector. This has gone a long way towards providing optimum healthcare for all, transcending barriers of social and economical status and gender etc., explained Dr. Sridharan.   
“Health coverage is also an important consideration when it comes to Universal healthcare. We are proud to say that Sri Lanka is the only country in the world where a citizen living anywhere in the country can reach a government health facility within a 3.6 km radius”, stated the doctor, further pointing out that Sri Lanka has employed healthcare staff including medical officers, nursing officers and paramedical staff in the remotest areas of the country, enabling all the Sri Lankans to benefit by getting treated by a qualified medical person.   

He also explained that in Sri Lanka, a patient could obtain safe and better treatment, thanks to the many protocols and guidelines that are in place in treating the diseases. “These, combined with the reduction of the price of essential drugs drastically, supplying eye lenses as well as stents free of cost to the patients and removing the ceiling of expenditure when it comes to cancer treatments, were appreciated by the World Economic Forum, which declared Sri Lanka to be the number one in health care”, he continued.   

Sri Lanka is renowned for its outstanding Maternal and Child Health facilities. The Guardian, a prominent British newspaper recently published an article, stating that newborn survival rates in the United States are only slightly better than that of Sri Lankan rates. Talking about this, Dr. Sridharan explained that we have been able to achieve these results by spending 150 dollars per person while the US has spent 7500 dollars per person in health care to achieve that status. These are just a few achievements in the field of healthcare that the country has accomplished so far, disclosed the doctor.   

Still a long way to go
While there have been many positive improvements in Sri Lankan health sector during the past 100 years, new challenges keep popping up. According to Dr. Ruwaiz Haniffa, president of the Sri Lanka Medical Association, Consultant Family Physician and Lecturer at the Faculty of Medicine, University of Colombo, the most immediate challenges that we face are the ageing population and the fast spreading of non-communicable diseases.   

Sri Lanka has the highest aging population in the world and 1.7 million persons will be added to the elderly cohort during the next 15 years (2017 to 2032), according to Dr. Haniffa. But we are still not fully prepared to face the challenges that an increased ageing population would bring, especially in the healthcare sector.   

One of the ways that we can give attention to these issues is by improving primary health care, 

With the control and sometimes eradication of communicable diseases like Malaria, dysentery, and with the lifestyle changes, Non communicable diseases are raising their head as well. Relative contribution from mortality due to Non-Communicable Disease (NCD) which is currently very high (80.7%), is projected to remain high by 2030 (81.8%). But finding solutions for these diseases in the hospital setting is impractical, explained 
Dr. Haniffa.   

“We recently conducted a research which revealed that 35% of the risk factors for the Non Communicable Diseases in our country are Poor diet, smoking and a lack of exercise”, revealed the doctor. Since none of these can be ‘treated’ in the hospital setting, the optimum method is to spread awareness at the grassroots level, which when it comes to our health system are the primary healthcare services like hospital outpatient departments and general practitioners.   
Treating patients instead of diseases.   

Sri Lanka’s celebrations of World Health Day this year, with the participation of the professional bodies related to the health field including the Health Ministry and the Sri Lanka Medical Association, are having more focus on ‘patient centered care’, that is treating the patient as a whole, instead of treating individual diseases, pronounced Dr. Haniffa.  “Looking at the number of hospital admissions per year, there are only about 6 million admissions, but, around 111 million visits per year occur  to OPD’s and other primary healthcare centres,”  he continued. A person is hospitalized only if he or she has a disease. But, people have other health issues that do not require hospital admission, yet are equally important, which comes under universal health coverage. “One of the ways that we can give attention to these issues is by improving primary health care, “stated Dr. Haniffa, stressing the need to treat individuals, rather than treating the individual disease, taking a holistic approach to all their health concerns.   

This method is also cost- effective, because advising a patient about exercise for 10 minutes in the primary healthcare setting is more cost effective than waiting until he gets the disease to treat him with a lipid lowering drug for life, as the doctor explained.   

Discussing the events that are occurring parallel to the world health day, Dr. Haniffa disclosed that SLMA, along with several other organizations including the Health Ministry and the WHO, are uniting to achieve the objective of universal health coverage and patient centred care. One of the proposed projects, funded by the World Bank, aiming on improving universal health coverage by reorganizing primary health care in Sri Lanka, is scheduled to be launched in September. In addition, a workshop for the parliamentarians, explaining the concept of universal healthcare and its importance to our country, is planned to be conducted in June at the parliament premises itself, he revealed.