Health care spending in Srilanka by government


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Health care spending in Srilanka by government

  1. 1. 2008/09 Batch10th May 2013
  2. 2. World Health Organization Ranking; TheWorld’s Health Systems Sri Lanka-76 France-1 Singapore-6 USA -37 India- 112 Pakistan-122 China-144
  3. 3.  Total health expenditure, driven mostly by privatespending, has increased since the early 1990s. Contribution from the Government to the total healthexpenditure was 45.8% in 2009, while the contribution fromthe private sector was 54.2% The government health expenditure as a percentage of totalgovernment expenditure was 4.9% in 2007, which is adecrease of over half from the 7.2% recorded in 2006. It isincreasingly evident that private sector financing has becomemore prominent over time
  4. 4.  GDP per capita Srilanka -1402.12 USD Gross National Product ≈7400000 LKR millionsHealth expenditure; total (% of GDP) in Sri Lanka
  5. 5. Total Expenditure on Health01000020000300004000050000600007000080000900001000002002 2003 2004 2005 2006 2007 2008 2009 2010 2011Rs million
  6. 6.  Health expenditure per capita (US dollar) in Sri Lanka
  7. 7.  Health services account for 8 percent of governmentbudgetary spending. Private fnancing is mostly out-of-pocket spending byhouseholds, with smaller contributions from employersand insurance. Spending by non-governmental organizations (NGOs)is small. Government expenditures have concentrated onhospitals since the health reforms of the1930s, directed primarily at increasing equity in accessand improving risk protection. Hospital spending accounted for about 70 percent ofgovernment recurrent spending in the 1950s, and theshare has changed little since then .
  8. 8. SL health expenditure bysource
  9. 9.  Government hospitals have been the primary mode bywhich modern medical treatment has been madeavailable to people in rural areas. Most private spending is for outpatient care and forpurchasing medicines, but the share of hospitalspending in private outlays has increased.(partlybecause of expanded delivery of outpatient services byprivate hospitals and partly because of the increasedavailability of private insurance.) until recently more than 85 percent of hospitalspending was by government, while more than 80percent of nonhospital and outpatient care spendingwas financed privately
  10. 10.  Curative care services tertiary care institutions secondary care institutions primary care institutions specialized institutionsFinancialprovisionfor CurativeCare ($million)2010-11(actual)2011-12(original)2011-12(revised)212-13(estimate)Governmentsector664 722 684.4 751
  11. 11.  BCG vaccinations specialized outpatient clinics○ TB and Chest○ Dermatology○ HIV/AIDS Dental treatment casesone of the curative care aim is to provide specializedoutpatient treatment for various illnesses… Specialized outpatient clinics provide curative services topatients with tuberculosis (TB) and chest diseases, skindiseases or human immunodeficiency virus (HIV)infection. Dental service is provided to hospital patients,emergency cases and groups with special oral healthcareneedskey performancemeasures in respect ofcurative care
  12. 12.  Preventive health services Maternal and Child Health School Health Well-women services Family Planning Environment Health Occupational Health Prevention and control of communicable diseases Prevention and control of NCD Active ageing Mental Health well being Health Promotion Oral health care
  13. 13. Financialprovisionfor diseaseprevention($ million)2010-11(actual)2011-12(original)2011-12(revised)2012-13(estimate)Governmentsector1617.3 2204.8 1777.6 2365•Targets by funding for preventive section•achieving a high participation rate of new born babies of local mothersattending 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
  14. 14. Financialprovisionfor Healthpromotion($ million)2010-11(actual)2011-12(original)2011-12(revised)2012-13(estimate)Governmentsector199.3 249.1 259.8 298.4• 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 activitiesHealth promotion
  15. 15.  Special Campaigns Respiratory Disease Control Unit STD HIV/AIDS Control Programme Rabies Control activities Malaria Control Programme.
  16. 16. Expenditure for Activities of Healthcampaigns ( Rs. Millions)Campaign 2007 2008 2009 2010 2011STD 53.5 51.8 58.7 69.4 75.2Malaria* 150.0 207 204 335 556Leprosy* 40.0 35.8 32.9 42.1 38.5RespiratoryDiseasesn.a. 332.3 454 555 514Filariasis * n.a. n.a 13.7 21.9 23.1
  17. 17. Allocation of provisions to programmesstatutory functionspreventionhealth promotioncurative carerehabilitationdrug abusetreatment for civil servantspersonnel mx of civil servantsworking in hospital
  18. 18. Total public healthexpenditure percapita by province(RS)
  19. 19. References Sri Lanka Health Accounts,National HealthExpenditure,1990-2008 Annual health bulletin 2007 Progress Review,Ministry of Healthcare & Nutrition Sri Lanka: “Good Practice”in ExpandingHealthCare Coverage by Ravi P. Rannan-Eliya &Lankani Sikurajapathy