Sri Lanka ranks 76th in the World Health Organization's ranking of health systems. Total health expenditure in Sri Lanka has increased since the 1990s, with private spending now accounting for over half of total expenditures. The government allocates around 5% of its budget to health spending, concentrating on hospitals. Both public and private sectors finance healthcare, with the government focusing on hospitals and preventive care while private spending goes mostly to outpatient and medicine costs. Key priorities for Sri Lanka's health system include expanding access to care, improving disease prevention programs, and increasing health promotion initiatives.

1. 2008/09 Batch
10th May 2013

2. World Health Organization Ranking; The
World’s Health Systems
 Sri Lanka-76
 France-1
 Singapore-6
 USA -37
 India- 112
 Pakistan-122
 China-144

3.  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

4.  GDP per capita Srilanka -1402.12 USD
 Gross National Product ≈7400000 LKR millions
Health expenditure; total (% of GDP) in Sri Lanka

5. Total Expenditure on Health
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Rs million

7.  Health expenditure per capita (US dollar) in Sri Lanka

9.  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 .

10. SL health expenditure by
source

11.  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

14.  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

15.  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

16.  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

17. 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

19. 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

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

21. 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

22. 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

23. Total public health
expenditure per
capita by province
(RS)

24. 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
 http://www.tradingeconomics.com/sri-lanka/