Are we Contented in Achieving Universal Health Coverage in Treating Dengue Patients in Sri Lanka?

Abstract BackgroundAmong infectious diseases, Dengue illness causes a major public health threat in Sri Lanka. The preventive and the curative services place a financial burden on the state health sector and household cost and out of pocket expenditure also are important cost components embedded with Dengue infection. ObjectiveTo estimate the household costs and out of pocket expenditure incurred due to Dengue infection among adults who received institutional care.MethodsA longitudinal study was conducted from July to December 2018. Fifty patients each from DF and DHF categories were recruited with systematic sampling admitted to an institution in Colombo District, Sri Lanka. Adults residing in Colombo District of Sri Lanka for more than six months prior to Dengue/DHF episode, were recruited based on a systematic sampling method. Details were obtained via an interviewer administered questionnaire. They were interviewed on day of discharge from the hospital and were followed up for two weeks. Unit cost per patient was calculated. The household costs were calculated for three phases; ambulatory cost, costs incurred during hospitalization and post hospitalization costs. These components were described using mean, median, standard deviation and inter-quartile range and out of pocket expenditure were calculatedResultsThe median age in DF group was 38.5 years and in DHF group was 28.5 years. Average household cost was US$127.69(SD=93.32) and US$134.71(SD=94.31) for DF and DHF patients respectively. Among DF patients 98.03% was borne using OOPE and among DHF patients it was 95.57%. In 2016, the average monthly income of a household in Colombo was US$571.82. Therefore nearly 25% of the monthly income had been spent on a single adult with Dengue.ConclusionsIf an adult member is hospitalized with Dengue infection the Out of pocket expenditure is high, which is nearly 25% of a family’s monthly income. Strengthening the Dengue control programme is the key towards Universal Health Coverage.

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Are We Contented in Achieving Universal Health Coverage in Treating Dengue Patients in Sri Lanka?

10.21203/rs.3.rs-37783/v1 ◽

2020 ◽

Author(s):

Nadeeka Perera ◽

Amala De Silva ◽

Dulshika Amarasinghe Wass ◽

Ananda Wijewickrama ◽

Shamini Prathapan

Keyword(s):

Sri Lanka ◽

Universal Health Coverage ◽

Dengue Infection ◽

Systematic Sampling ◽

Health Coverage ◽

Monthly Income ◽

Hospitalization Costs ◽

Household Costs ◽

Universal Health ◽

Household Cost

Abstract BackgroundAmong infectious diseases, Dengue illness causes a major public health threat in Sri Lanka. The preventive and the curative services place a financial burden on the state health sectorand household cost and out of pocket expenditure also are important cost components embedded with Dengue infection. ObjectiveTo estimate the household costs andout of pocket expenditure incurred due to Dengue infection among adults who received institutional care.MethodsA longitudinal study was conducted from July to December 2018. Fifty patients each from DF and DHF categories were recruited with systematic sampling admitted to an institution in Colombo District, Sri Lanka.Adults residing in Colombo District of Sri Lanka for more than six months prior to Dengue/DHF episode, were recruited based on a systematic sampling method. Details were obtained via an interviewer administered questionnaire. They were interviewed on day of discharge from the hospital and were followed up for two weeks. Unit cost per patient was calculated. The household costs were calculated for three phases; ambulatory cost, costs incurred during hospitalization and post hospitalization costs. These components were described using mean, median, standard deviation and inter-quartile range and out of pocket expenditure were calculatedResultsThe median age in DF group was 38.5 years and in DHF group was 28.5 years.Average household cost was US$127.69(SD=93.32) and US$134.71(SD=94.31) for DF and DHF patients respectively. Among DF patients 98.03% was borne using OOPE and among DHF patients it was 95.57%. In 2016, the average monthly income of a household in Colombo was US$571.82. Thereforenearly 25% of the monthly income had been spent on a single adult with Dengue.Conclusions and RecommendationsIf an adult member is hospitalized with Dengueinfection the Out of pocket expenditure is high, which is nearly 25% of a family’s monthly income.Strengthening the Dengue control programme is the key towards Universal Health Coverage.

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Sri Lanka and the possibilities of achieving universal health coverage in a poor country

Global Public Health ◽

10.1080/17441692.2018.1501080 ◽

2018 ◽

Vol 14 (2) ◽

pp. 271-283

Author(s):

Audrey R. Chapman ◽

Samath D. Dharmaratne

Keyword(s):

Sri Lanka ◽

Universal Health Coverage ◽

Poor Country ◽

Health Coverage ◽

Universal Health

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Public–private partnerships for universal health coverage? The future of “free health” in Sri Lanka

Globalization and Health ◽

10.1186/s12992-019-0522-6 ◽

2019 ◽

Vol 15 (S1) ◽

Author(s):

Ramya Kumar

Keyword(s):

Sri Lanka ◽

Healthcare System ◽

Universal Health Coverage ◽

Historical Context ◽

Health Indicators ◽

Public Private Partnerships ◽

Health Coverage ◽

Private Interests ◽

Free Healthcare ◽

Universal Health

AbstractSri Lanka reports impressive health indicators compared to its peers in the South Asian region. Maternal and infant mortality are relatively low, and several intractable communicable diseases have been eliminated. The publicly financed and delivered “free” healthcare system has been critical to these health achievements. Placing the country’s healthcare system in historical context, this commentary analyses the contradictions and political tensions surrounding Sri Lanka’s 2018 Universal Health Coverage (UHC) policy, with attention to the Ministry of Health’s plans for public–private partnerships (PPP). As economic exigencies and private interests increasingly erode the 1951 “Free Health” policy, this commentary calls for a re-envisioning of UHC that can meet people’s aspirations for health and social justice.

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Reaching Equal Health in Sri Lanka: A Gender Perspective

Asian Journal of Interdisciplinary Research ◽

10.34256/ajir2134 ◽

2021 ◽

Vol 4 (3) ◽

pp. 37-43

Author(s):

Janaki Vidanapathirana ◽

Keyword(s):

Sri Lanka ◽

Gender Equity ◽

Gender Gap ◽

Universal Health Coverage ◽

Unmet Need ◽

Gender Inequalities ◽

Sri Lankan ◽

Health Coverage ◽

Gender Perspective ◽

Universal Health

Gender equity is at the cornerstone of the Universal health coverage (UHC), where no one is to be left behind. This paper highlights the Sustainable Development goal 5 and goal 3 with relevance to the Sri Lankan situation under the topic of “Reaching equal health: a Gender Perspective. The Sri Lankan Gender Gap Index holds the 116th position out of 152 countries. Higher mortalities are observed in males, while higher morbidity is observed in females. Social isolation and poverty in females are common in addition to the diseases at old age. Gender roles and masculine identities have led men to be more vulnerable to risk behaviours and seek access to healthcare services less. The Gender equity is at the cornerstone of the Universal Health Coverage which should be targeted to provide health services for all individuals and communities which they need, without suffering financial hardship by 2030. Sexual and Gender Based Violence (SGBV) is a major determinant of health and females are more vulnerable for that. Unmet need of family planning and abortions are leading causes for maternal mortality. 25,000 abortions occur every year in Sri Lanka. Lesbian, Gay, bisexual, transgender, and queer populations and people with special need are more vulnerable for not getting equal health. Strengthening the health policies and guidelines should be addressed to reduce gender inequalities. Indicators of sex disaggregated data should be included in the routine assessment of all healthcare settings and research agenda should be in place to identify gender inequalities in health research.

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