The World Bank approved on Wednesday a concessionary loan of S$ 200 million to Sri Lanka for the Second Health Sector Development Project (SHSDP) to help the Government of Sri Lanka upgrade the standards of performance of the public health system and enable it to better respond to the challenges of a middle income country.
The project is expected to benefit the whole population of 21 million people of the country, especially the poorer and more vulnerable population groups who depend more on public health services.
Those who will benefit directly from this project are those vulnerable to under-nutrition, maternal and childcare problems, persons affected with continuing, emerging and re-emerging communicable diseases (tuberculosis, dengue, leptospirosis, HIV/AIDS; rabies and other zoonotic diseases); and persons with acute and chronic non-communicable diseases like injuries, heart diseases, strokes, hypertension, diabetes mellitus, cancers and mental disorders.
“Investing in further improvement of the health system will be a critical pre-requisite for Sri Lanka’s vision as reflected in the ‘Mahinda Chintana,’” said Diarietou Gaye, Country Director, World Bank Sri Lanka.
“A more modernised and efficient health system employing more international standards will not only help achieve the objective of improving living standards and social inclusion, but it will also contribute to the broader objectives set out in ‘Mahinda Chinthana’ document, including sustained economic growth, and a move towards a knowledge-based and competitive economy,” she added.
The World Bank has supported the Sri Lankan health sector through analytical work and International Development Association (IDA) credits/grants since the late 1980s with the most recent being the Health Sector Development Project (HSDP) from 2004 to 2010. That project contributed to improving service delivery across the country and building system capacity at the central, provincial and district levels.
Against the backdrop of the impressive achievements in most health indicators related to mother and child services and communicable disease control there are many new challenges emerging. An increasing proportion of the population is suffering from non-communicable diseases and this increase is associated with a rapidly changing age distribution, economic development, urbanization, increased motorization and lifestyle changes.
Sri Lanka is also in the midst of a nutrition transition whereby both over-nutrition and under-nutrition coexist, sometimes even in the same family.
During the past half-century, the proportion of deaths due to cardiovascular diseases has increased from 3% to 24% while that due to infectious diseases has decreased from 42% to 20%.
Mental health related illness prevalence also is significant. Furthermore, the cancers of breast and the cervix and the oral cavity are the commonest types of cancers for women and men respectively.
The burden of injuries due to traffic accidents, natural disasters, industrial faults, burns, drowning, falls and violence are also substantial. Injuries affect mainly the young male population and account for 15% of all registered deaths and for approximately 18% of all public hospital admissions annually.
“The current health system needs improvements to deal effectively with emerging health problems of a middle-income country such as ours,” said Kumari Vinodhani Navaratne, World Bank Senior Health Specialist.
“Developing a modern health management information system, establishment of a quality assurance system, strengthening the capacity for results based planning and management and strengthening the coordination between institutions and agencies for coordinated development and continuing human resource development are essential to improve the health system and better address the changing health needs of Sri Lanka,” she said.
The project will provide approximately US$ 190 million to support the implementation of the recently prepared National Health Development Plan 2013 to 2017 of the Ministry of Health and US$ 10 million will be made available for implementing innovations to improve the quality of care and efficiency of the health sector, for improving results monitoring and capacity building of the health sector staff across the country.
The IDA terms for this concessionary loan are at 1.25% interest rate with a grace period of five years and a 20 year payment period.