PDHS Sabaragamuwa

Provincial Health system

Sabaragamuwa

Provincial Director of Health Services Office

Rathnapura
Objectives

• To describe the provincial health system

• To discuss the strengths and gaps in the system

• To discuss the opportunities for the development and reorientation

Introduction PDHS Sabaragamuwa

Land area 4,968 km2 (7.5%)

Population 1,928,655 (9.5%)

% of population by sector of Rural 86.5%

residence Urban 5.5%
Estate 8.0%

Number of health divisions (29) Ratnapura 18

Kegalle 11

Literacy Rate 94.8%

Health indicators
Indicator Provincial value National (Reference)

Maternal mortality ratio 41.7 33.7 (FHB,2015)

(per 100,000 LB)
Infant mortality rate 9.8 8.4 (FHB,2016)
(per 1000 LB)
% of Low birth weight 10.8 11.2 (FHB,2016)

% of pregnant mothers with low BMI 21.2 18.8 (FHB,2016)

on or before 12 weeks of gestation
Everybody’s Business. Strengthening Health Systems to Improve Health Outcomes. WHO’s Frame Work for Action. WHO, 2007
 Health care service delivery
PDHS Sabaragamuwa

Health Care Service

Curative Services Preventive and Promotive Services

PGH MOH
01. Anti Malaria
02. Anti Leprosy
DGH SP: Campaign 03. PHVS
04. Anti Filariasis
05. NPTCCD
BH 06. NSACP

DH

Technical Support by Ministry of

PMCU Health and its Focal Points Eg:
FHB, HEB, Epidemiology Unit
etc.
 Health administrative Structure
PDHS Sabaragamuwa

Provincial Health Minister

Provincial Health Secretary

Provincial Director of
Health Servicers

Regional Director of Health

Service

Curative Preventive

MS MOH/AMOH

MOIC

OIC/RMSD
Primary health care cervices provided by different institutions
Services PMCU DH - C DH - B DH -A

Emergency care and ✔ ✔ ✔ ✔

treatment
Basic treatment for diseases ✔ ✔ ✔ ✔
including antibiotics
MCH clinic ✔ ✔ ✔ ✔
services(ANC/FP/WWC/Imm
unization)
Medical clinics ✔ ✔ ✔ ✔

HLC ✔ ✔ ✔ ✔

Oral health care ✔ ✔ ✔ ✔

In-ward patient care ✕ ✔ ✔ ✔

Laboratory facilities for basic ✕ ✕ ✕ ✔

investigations
Access to health care institutions
Access to health care institutions
Disease prevention and promotion of health
Strengths

• Well established Public health system

• Political commitment

• Improved accessibility to health care

• Technically competent health care workforce

• Continuous development in infrastructure

PDHS Sabaragamuwa Photographs related to DLI 02
ETU
PDHS Sabaragamuwa Photographs related to DLI 05
PDHS Sabaragamuwa Photographs related to DLI 06
Areas to be improved
• e-Medical record keeping

• CPD/CME

• Reduction of out of pocket expenditure(>40%)

• Waste management

• Human resource

• Research
Challenges

• Mental health (intermediate care centres)

• Prevention of injuries and NCD

• Malnutrition

• Elderly care and palliative care

• Prevention of alcohol and tobacco addiction

• Occupational and environmental health

Way forward
• Electronic patient medical record management system with
legislations

• Health insurance systems for financial risk protection

• Revision of carder and recruitment of health staff

• Continuous medical education and performance appraisal system

• Close monitoring and evaluation for efficiency and effectiveness of

interventions
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