Health Care in Sri Lanka : What Can the Private Health Sector Offer?
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World Bank, Washington, DC
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This review represents an attempt to
bridge the significant knowledge gaps on the private health
sector in Sri Lanka, and foster a dialogue on opportunities
for collaboration between the government and the private
sector. It accomplishes this through a systematic collection
and analysis of primary and secondary data on the provision,
financing, and regulation of health care services. On health
service delivery, the review finds that the private sector:
includes a range of providers; focuses primarily on curative
and outpatient services rather than preventive services; is
heavily dependent on the public sector for its supply of
human resources; and is concentrated in urban areas. The
quality of health care services in Sri Lanka in both the
private and public sectors, while better than in most
developing countries, still lags behind those in more
advanced countries. There is also little systematic dialogue
and collaboration between the public and private sectors. On
financing, the review finds that private health expenditure
is more than half of total health expenditure, mostly in the
form of out-of-pocket payments by households, with clear
implications for Sri Lanka's progression toward
universal health coverage. On stewardship and regulation,
there is a clear and urgent need to bridge the existing gaps
in the legal and regulatory framework, and in the
enforcement of health regulations applicable to the private
sector, as well as to create an enabling environment for
more effective private sector participation in the health
sector. The review demonstrates that the private health
sector in Sri Lanka is a growing force, due both to greater
investment from private players as well as greater demand
from the population. The review highlights areas where a
more effective engagement with the private sector could
ensure that Sri Lanka is able to offer its citizens
universal access to good quality health service while also
stimulating economic growth.
Palabras clave
ACCESS TO HEALTH SERVICES, ACCOUNTABILITY, ACCOUNTING, AGE STRUCTURE, AGING, AMBULATORY CARE, ANCILLARY SERVICES, ANTENATAL CARE, AVAILABILITY OF DRUGS, BLOOD BANK, BLOOD PRESSURE, BREASTFEEDING, BURDEN OF DISEASE, CATASTROPHIC EXPENDITURE, CATASTROPHIC EXPENDITURES, CHILD HEALTH, CHILDBIRTH, CHILDHOOD VACCINATION, CLEANLINESS, CLINICS, COMMUNICABLE DISEASES, COST OF CARE, COST OF HEALTH CARE, DEATHS, DECISION MAKING, DELIVERY OF SERVICES, DELIVERY SYSTEM, DENTAL SURGERY, DIAGNOSIS, DIAGNOSTIC SERVICES, DIAGNOSTIC TESTS, DISPENSARIES, DOCTORS, ECONOMIC GROWTH, EMBRYO TRANSFER, EMPLOYMENT, EPIDEMIOLOGICAL TRANSITION, ETHICAL ISSUES, FAMILY PLANNING, FINANCIAL INFORMATION, GENERAL PRACTITIONERS, GROSS DOMESTIC PRODUCT, GYNECOLOGY, HEALTH AUTHORITIES, HEALTH CARE, HEALTH CARE ACCESS, HEALTH CARE FACILITY, HEALTH CARE FINANCING, HEALTH CARE INSTITUTIONS, HEALTH CARE POLICY, HEALTH CARE PROVIDER, HEALTH CARE PROVIDERS, HEALTH CARE PROVISION, HEALTH CARE SERVICES, HEALTH CARE SYSTEM, HEALTH CLINIC, HEALTH COVERAGE, HEALTH DATA, HEALTH DATABASE, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH FINANCING, HEALTH INDICATORS, HEALTH INFORMATION, HEALTH INSTITUTIONS, HEALTH INSURANCE, HEALTH INSURANCE COVER, HEALTH INSURANCE COVERAGE, HEALTH INSURANCE POLICIES, HEALTH POLICY, HEALTH PROMOTION, HEALTH PROVIDERS, HEALTH REGULATIONS, HEALTH RESEARCH, HEALTH SCREENING, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE DELIVERY, HEALTH SERVICE PROVISION, HEALTH SERVICES, HEALTH SERVICEDELIVERY, HEALTH SPECIALIST, HEALTH STATUS, HEALTH SYSTEM, HEALTH UNIT, HEALTH UNITS, HEALTHCARE, HEALTHCARE SERVICES, HOMEOPATHY, HOSPITAL BEDS, HOSPITAL CARE, HOSPITALS, HOUSEHOLD BUDGETS, HOUSEHOLD EXPENDITURE, HOUSEHOLD INCOME, HUMAN DEVELOPMENT, HUMAN RESOURCES, HUMAN TISSUES, HYGIENE, ILLNESS, IMMUNIZATION, INCOME, INCOME COUNTRIES, INDEPENDENT MEDICAL PRACTITIONERS, INEQUALITIES IN HEALTH CARE, INFORMATION SYSTEM, INPATIENT CARE, INSURANCE, INSURANCE COMPANIES, INSURANCE FIRMS, INSURANCE PREMIUM, INSURANCE PREMIUMS, INTEREST RATE, IRON, LABORATORY SERVICES, LABORATORY TECHNICIANS, LABORATORY TESTING, LEGAL FRAMEWORK, LIFE EXPECTANCY, LIFE INSURANCE, MARKETING, MEDICAL BENEFITS, MEDICAL BILLS, MEDICAL EQUIPMENT, MEDICAL GOODS, MEDICAL INSURANCE, MEDICAL RECORDS, MEDICAL SERVICES, MEDICAL STAFF, MEDICAL SUPPLIES, MEDICATION, MEDICINES, MENTAL HEALTH, MINISTRY OF FINANCE, MORBIDITY, MORTALITY, NONPROFIT SECTOR, NOTIFIABLE DISEASES, NURSES, NURSING, NURSING CARE, NURSING HOMES, NUTRITION, OUTCOME INDICATORS, OUTPATIENT CARE, OUTPATIENT SERVICES, PATIENT, PATIENT SATISFACTION, PATIENTS, PEDIATRICS, PHARMACISTS, PHYSICIAN, POCKET PAYMENTS, POCKET PAYMENTS BY HOUSEHOLDS, POLICY RESEARCH, POSTNATAL CARE, PREVENTIVE CARE, PREVENTIVE HEALTH SERVICES, PRIMARY CARE, PRIMARY HEALTH CARE, PRIVATE FINANCING, PRIVATE HEALTH INSURANCE, PRIVATE HEALTH SERVICES, PRIVATE HOSPITAL SECTOR, PRIVATE HOSPITALS, PRIVATE INSURANCE, PRIVATE PHARMACIES, PRIVATE PROVIDERS, PRIVATE SECTOR, PRIVATE SECTOR ACTORS, PRIVATE SECTOR FINANCING, PRIVATE SECTORS, PRIVATE SPENDING, PROVISION OF HEALTH CARE, PROVISION OF HEALTH SERVICES, PROVISION OF SERVICES, PUBLIC EXPENDITURE, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH CARE SYSTEM, PUBLIC HEALTH OBJECTIVES, PUBLIC HEALTH PROGRAMS, PUBLIC HEALTH SERVICES, PUBLIC HEALTH SYSTEM, PUBLIC HOSPITAL, PUBLIC HOSPITALS, PUBLIC SECTOR, PUBLIC SECTORS, PUBLIC SERVICES, QUALITY OF CARE, QUALITY OF HEALTH, QUALITY OF HEALTH CARE, QUALITY OF SERVICES, QUALITY STANDARDS, REGULATORY FRAMEWORK, RURAL HOSPITALS, SCHOOL HEALTH, SCREENING, SERVICE PROVIDERS, SHARE OF HEALTH EXPENDITURE, SMOKING, SMOKING CESSATION, SURGERY, TEACHING HOSPITALS, TOTAL EXPENDITURE, TRANSPARENCY, TREATMENTS, UNIVERSAL ACCESS, VACCINATION, VISITS, WASTE