HEALTH CARE SPENDING IN SL BY GOVERNMENT

OF SRILANKA

2008/09 Batch10th May 2013

World Health Organization Ranking; The World’s Health Systems

Sri Lanka-76 France-1 Singapore-6 USA -37 India- 112 Pakistan-122 China-144

Total health expenditure, driven mostly by private spending, has increased since the early 1990s.

Contribution from the Government to the total health expenditure was 45.8% in 2009, while the contribution from the private sector was 54.2%

The government health expenditure as a percentage of total government expenditure was 4.9% in 2007, which is a decrease of over half from the 7.2% recorded in 2006. It is increasingly evident that private sector financing has become more prominent over time

GDP per capita Srilanka -1402.12 USD Gross National Product ≈7400000 LKR millions

Health expenditure; total (% of GDP) in Sri Lanka

Total Expenditure on Health

2002 2003 2004 2005 2006 2007 2008 2009 2010 20110

10000

20000

30000

40000

50000

60000

70000

80000

90000

100000

Rs million

Health expenditure per capita (US dollar) in Sri Lanka

Health services account for 8 percent of government budgetary spending.

Private fnancing is mostly out-of-pocket spending by households, with smaller contributions from employers and insurance.

Spending by non-governmental organizations (NGOs) is small.

Government expenditures have concentrated on hospitals since the health reforms of the 1930s, directed primarily at increasing equity in access and improving risk protection.

Hospital spending accounted for about 70 percent of government recurrent spending in the 1950s, and the share has changed little since then .

SL health expenditure by source

Government hospitals have been the primary mode by which modern medical treatment has been made available to people in rural areas.

Most private spending is for outpatient care and for purchasing medicines, but the share of hospital spending in private outlays has increased.(partly because of expanded delivery of outpatient services by private hospitals and partly because of the increased availability of private insurance.)

until recently more than 85 percent of hospital spending was by government, while more than 80 percent of nonhospital and outpatient care spending was financed privately

Curative care services tertiary care institutions secondary care institutions primary care institutions specialized institutions

Financial provision for Curative Care ($ million)

2010-11 (actual)

2011-12(original)

2011-12(revised)

212-13(estimate)

Government sector

664 722 684.4 751

BCG vaccinations specialized outpatient clinics

○ TB and Chest○ Dermatology○ HIV/AIDS

Dental treatment cases

one of the curative care aim is to provide specialized outpatient treatment for various illnesses…

Specialized outpatient clinics provide curative services to patients with tuberculosis (TB) and chest diseases, skin diseases or human immunodeficiency virus (HIV) infection. Dental service is provided to hospital patients, emergency cases and groups with special oral healthcare needs

key performance measures in respect of curative care

Preventive health services Maternal and Child Health School Health Well-women services Family Planning Environment Health Occupational Health Prevention and control of communicable diseases Prevention and control of NCD Active ageing Mental Health well being Health Promotion Oral health care

Financial provision for disease prevention ($ million)

2010-11 (actual)

2011-12(original)

2011-12(revised)

2012-13(estimate)

Government sector

1617.3 2204.8 1777.6 2365

•Targets by funding for preventive section• achieving a high participation rate of new born babies of local mothers

attending maternal and child health• contributing to achieving low IMR and MMR• School Dental Care Service participation• investigating reports of outbreaks of communicable diseases• coverage rate of immunization programme for school children

Financial provision for Health promotion ($ million)

2010-11 (actual)

2011-12(original)

2011-12(revised)

2012-13(estimate)

Government sector

199.3 249.1 259.8 298.4

• key performance measures in respect of health promotion • training of health promoters• production of health education materials• attendances at health education activities• AIDS counselling attendances• Adolescent Health Programme• publicity/educational activities

Health promotion

Special Campaigns Respiratory Disease Control Unit STD HIV/AIDS Control Programme Rabies Control activities Malaria Control Programme.

Expenditure for Activities of Health campaigns ( Rs. Millions)

Campaign 2007 2008 2009 2010 2011

STD 53.5 51.8 58.7 69.4 75.2

Malaria* 150.0 207 204 335 556

Leprosy* 40.0 35.8 32.9 42.1 38.5

Respiratory Diseases

n.a. 332.3 454 555 514

Filariasis * n.a. n.a 13.7 21.9 23.1

Allocation of provisions to programmes

statutory functions

prevention

health promotion

curative care

rehabilitation

drug abuse

treatment for civil servants

personnel mx of civil servants working in hospital

Total public health expenditure per capita by province (RS)

References Sri Lanka Health Accounts,National Health

Expenditure,1990-2008 Annual health bulletin 2007 Progress Review,Ministry of Healthcare & Nutrition Sri Lanka: “Good Practice”in ExpandingHealth

Care Coverage by Ravi P. Rannan-Eliya & Lankani Sikurajapathy

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