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Multi-sectoral collaboration vital for Sri Lanka to achieve Universal Health Coverage

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The Institute of Policy Studies of Sri Lanka (IPS) together with the Sri Lanka Medical Association (SLMA) and the Center for Policy Impact in Global Health (CPIGH) of the Duke University, USA organised a virtual policy dialogue on ‘Planning for Universal Health Coverage amidst the 4Ds of Health Transitions’ on 25 August 2021. The dialogue was structured around a recent IPS study aimed at understanding how government, donors and key country stakeholders in the health sector perceive these transition challenges and their impact on the progress towards UHC, where they see the biggest gaps emerging, and what actions can help to address these challenges and gaps.

Health sector experts who spoke at the Dialogue flagged the need for multi-sectoral collaboration to achieve universal health coverage (UHC) in Sri Lanka.

Commencing the discussion, Dr Nisha Arunatilake, Director of Research, IPS explained that there are four major, inter-linked transitions in diseases, demography, development assistance for health and domestic health financing – the “4Ds” of global health transition – that complicate Sri Lanka’s efforts to achieve UHC. The associated challenges of these have been worsened by the COVID-19 pandemic. In this context, IPS and Duke University have conducted research that brings into focus the importance of achieving UHC and the sustainable development goals (SDGs).

Speaking next, Dr Padma Gunaratne, President, SLMA reflected on some of the achievements of the national health system including increased life expectancy and quality of healthcare. She noted that while these achievements are commendable, inequities and inefficiencies in healthcare continue to persist and a meaningful dialogue on planning for UHC is most timely.

Delivering the keynote address thereafter, Dr S Sridharan, Deputy Director-General (Planning), Ministry of Health pointed out that donor support for the health sector is declining. Meanwhile, there is rising demand for health services, an ageing population, and inadequate domestic financing for health. He recommended seven steps to address the challenges: (1) strengthening community response systems; (2) supporting reproductive health – adolescence, maternity and new-born health; (3) supporting platforms for integrated service delivery; (4) strengthening country population and supply chain; (5) investing in human resources (HR) for health and data systems for health; (6) strengthening and aligning national and global strategies; and (7) strengthening financial management and oversight.

The next speaker, Ipchita Bharali, Policy Associate, Duke University provided the audience with evidence on health transitions in an international context. She stated that many Middle-Income Countries (MICs) are expected to transition away from concessional multilateral and bilateral development assistance soon. However, they still face several health sector challenges such as high mortality rates, weak health systems, and large pockets of poverty in the countries. These challenges are intensified with the onset of the COVID-19 pandemic.

Session 1: Knowledge, capacity, and policy gaps that hinder UHC progress in Sri Lanka in the context of the 4Ds of health transitions and potential opportunities to tackle these gaps.

Knowledge gaps and opportunities

Ashani Abayasekara, Research Economist, IPS presented a summary of the study findings identifying the knowledge gaps. One of the findings highlighted was the rising burden of NCDs, as there was an acute focus on curing such illnesses by only considering drugs as the solution and understanding them as disease issues and not health issues. Prominence was also given to the gender disparities regarding NCDs. Lack of detailed and accurate data, poor research and development (R&D), and knowledge dissemination were some of the many gaps that were further identified as areas that needed immediate action.

Dr Susie Perera, Deputy Director-General (Public Health Services II), Ministry of Health in her reflections explained that one of the ways of alleviating the gaps is by targetted investments and incentivising stakeholders to conduct proper R&D, data collection, and knowledge dissemination. She noted that Sri Lanka has had many opportunities to strengthen its primary health and education systems with donor support, both of which are relevant to reducing the NCD burden. “A whole of government, multi-sector approach is needed,” she emphasised adding that digital literacy needs to be fostered in the health sector, along with a culture of innovation.

Prof. Amala De Silva, Professor in Economics, University of Colombo shared similar sentiments and noted that NCDs have an indirect relationship with economic performance. She flagged the need for multidisciplinary studies and proper accountable agency in research activities to achieve UHC in Sri Lanka.

Capacity gaps and opportunities

Thisali de Silva, Research Assistant, IPS presented the findings of the study on the capacity gaps that hinder UHC in the country. Poor financial and HR capacity was found to be the notable gaps in Sri Lanka. Some of the financial capacity gaps included inefficiencies in financial allocation, and financial management issues to name but two. On the other hand, the lopsided distribution of medical professionals and the lack of engagement in the financial side of the health sector have made for concerning capacity gaps in labour.

First to give thoughts on the study was Dr Dileep de Silva, Head of Human Resource Department, Ministry of Health. On the HR front, he explained that the issue in the lopsided distribution of medical professionals was due to the low applicants especially when looking at nurses, therapists, midwives and PHIs. Furthermore, one of the major reasons for the financial capacity gaps is a result of the underutilisation of capital budgets for the health sector.

Dr Anuji Gamage, Senior Lecturer in Community Medicine, Sir John Kotelawala Defence University identified healthcare migration as a problem driven by economic factors, unsatisfactory work environment, and professional career opportunities. She stated that a way of solving the uneven distribution of labour is a mechanism that would assure safety, and this is particularly important in a time of a global pandemic. “It is important to use strategies to keep the workforce safe and improve their wellbeing,” she affirmed.

Policy gaps and opportunities

The frequent changes made to the number of ministries, reversal of implemented policies and several other implementation hurdles, especially at the provincial level were shown to be some of the major policy gaps identified through the study. Ashani Abayasekara highlighted several opportunities to focus amid all these gaps such as creating a knowledge hub, and collaboration and coordination with non-state sectors.

Dr Ruvaiz Haniffa, Past President, SLMA in his reflections, called for a grassroots level approach through family doctors and homecare. “Too many people are currently missing out on health coverage in the primary preventive care sector. We have not put in policies in the primary curative sector,” he said stressing that the need of the hour is to provide holistic primary curative care. Uditha Palihakkara (Past Chairman of the Finance Commission), speaking in his personal capacity, expressed the view that the policy gaps are a result of low national budgets to the health sector as a whole.

Session 2: Multi-sectoral collaboration for Sri Lanka’s health systems – reflections from development partners, private sector, academia and civil society.

Based on the study, Dr Deepika Attygalle, Senior Health Specialist, World Bank and Ms Shiranthi Rathnayake, Additional Director General, Department of National Planning asserted that multi-sectoral collaboration is vital for Sri Lanka’s goal of achieving UHC of which, collaboration between the finance and medical sectors is particularly important. Dr Olivia Nieveras, Public Health Administrator, World Health Organization spoke about how donors should more agile in their activities. Sampath Manthreenayake, Additional Director-General, Department of External Resources added that there should be a collective system for better results on donor financing.

Way Forward

Moderated by Dr Nisha Arunatilake, a fruitful question and answer session took place with several important questions raised from participants around the world. The proceedings were wrapped up with an iteration on the need for a strong primary curative healthcare system and multi-sectoral collaborations as the way forward.

Link to original blog: https://www.ips.lk/talkingeconomics/2021/08/27/multi-sectoral-collaboration-vital-for-sri-lanka-to-achieve-universal-health-coverage/



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Lanka inflation hit 70.2% in August

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Food prices climbed 84.6 percent, while prices of non-food items rose 57.1 percent in the crisis-hit island nation.

(Al Jazeera) Consumer inflation in Sri Lanka accelerated to 70.2 percent in August, the statistics department has said, as the island nation reels under its worst economic crisis in decades.The National Consumer Price Index (NCPI) rose 70.2 percent last month from a year earlier, after a 66.7 percent increase in July, the Department of Census and Statistics said in a statement on Wednesday.

Food prices climbed 84.6 percent, while prices of non-food items rose 57.1 percent in the tourism-dependent South Asian country of 22 million people.The Central Bank of Sri Lanka (CBSL) in August said the inflation rate would moderate after peaking at about 70 percent as the country’s economy slowed.

The NCPI captures broader retail price inflation and is released with a lag of 21 days every month.The more closely monitored Colombo Consumer Price Index (CCPI), released at the end of each month, rose 64.3 percent in August. It acts as a leading indicator for national prices and shows how inflation is evolving in Sri Lanka’s biggest city.

Sri Lanka’s economy shrank 8.4 percent in the quarter through June from a year ago in one of the steepest declines seen in a three-month period, amid fertiliser and fuel shortages.

“Inflation is expected to taper from September,” said Dimantha Mathew, head of research for Colombo-based investment firm First Capital. “However, inflation is only likely to moderate and reach single digits in the second half of 2023.”

An acute dollar shortage, caused by economic mismanagement and the effects of the COVID-19 pandemic, has left Sri Lanka struggling to pay for essential imports including food, fuel, fertiliser and medicine.

The country earlier this month reached a preliminary deal with the International Monetary Fund for a loan of about $2.9bn, contingent on it receiving financing assurances from official creditors and negotiations with private creditors.

India on Tuesday said it had begun talks with Sri Lanka on restructuring its debt and promised to support the crisis-hit neighbour mainly through long-term investments after providing nearly $4bn of financial aid.

The High Commission of India in Colombo said it held the first round of debt talks with Sri Lankan officials on September 16.

“The discussions held in a cordial atmosphere symbolise India’s support to early conclusion and approval of a suitable IMF programme for Sri Lanka,” the High Commission said.

Sri Lanka will make a presentation to its international creditors on Friday, laying out the full extent of its economic troubles and plans for a debt restructuring.

The Indian High Commission also said New Delhi would continue to support Colombo “in all possible ways, in particular by promoting long-term investments from India in key economic sectors”.

India’s support to Sri Lanka this year has included a $400m currency swap, a $1bn credit line for essential goods and a $500m line for fuel. In addition, India has also deferred payment on Sri Lankan imports of about $1.2bn and given a credit line of $55m for fertiliser imports.

The High Commission said India had continuing development projects worth about $3.5bn in Sri Lanka, whose president earlier this month asked his officials to resolve obstacles to projects backed by India. He did not specify the obstacles or the projects.

President Ranil Wickremesinghe has said Sri Lanka will turn a free trade agreement with India into a comprehensive economic and technological partnership.

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Raigam Wayamba Salterns Group turnover tops 1 bn

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Raigam Wayamba Salterns PLC saw its group turnover increase from Rs. 959.6 million to Rs. 1,147 million recording a growth rate of 19.5% year on year.Despite the fact that the financial year 2021/2022 was filled with many challenges, as a result of prudent management practices implemented and followed, the Raigam Wayamba Group was capable of reporting its ever-highest growth in 2021/2022,” said Chairman, Raigam Group, Dr. Ravi Liyanage.

Raigam Wayamba Salterns PLC, which was listed in the Colombo Stock Exchange (CSE) in 2010 is the front line player in the value added salt market in Sri Lanka and it supplies a range of consumer salt products under the popular brands “Isi”, “Ruchi”, “Welcome” and “Triple Washed” as well as various salt products used as an input for different industries in bulk form.All the consumer products of Raigam Wayamba Salters are SLS certified for its quality and consistency and the processes are ISO certified.’8

The Raigam Wayamba Salterns Group is equipped with salterns, salt refineries and processing plants located in Puttalam and Hambantota districts. In addition to that the raw material supply for these operations has been ensured by the 1,800 Acre saltern established in Kuchchaweli in Trincomalee District by the parent company of the Raigam Group. Further the Puttalam Salt Limited (one of the successor to the National Salt Corporation) is also an associate company of the Raigam Group.

The well-known Raigam brand and state of the art island wide distribution network are distinct strengths of the Raigam Group. The Raigam distribution network operates on a latest IT platform and also includes distribution channels for modern trade, industry and bakery sectors.

Sri Lanka’s economy which was under-performed for two years due to COVID pandemic situation was experiencing the impacts of the foreign exchange crisis in the latter part of the financial year 2021/2022. Despite the fact that the financial year 2021/2022 was filled with many challenges, as a result of prudent management practices implemented and followed, the Raigam Waymba Group was capable of reporting its ever-highest growth in 2021/2022.

The group turnover increased from Rs. 959.6 million to Rs. 1,147 million recording a growth rate of 19.5% Y to Y. At the same time the Profit after Tax grew from Rs. 149.7 million to Rs. 215.6 million at an annual growth rate of 44%. As a result of these successful financial performances the Earning Per share for the year stood at Rs. 0.76 compared to Rs. 0.53 in the corresponding year. This has made a significant impact on the value of the shareholders’ investment increasing the Net Asset Value Per Share form Rs. 5.06 to Rs. 5.74.

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Singer’s legendry sewing industry and Academies developing skills and entrepreneurship in Sri Lanka

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A name synonymous with Singer (Sri Lanka), Singer sewing machine has over the years become an indispensable product at local households, helping thousands of women and men to make a living through a sewing business. For over six decades, Singer has been manufacturing its trademark sewing machines in Sri Lanka. Singer brand has claimed many firsts in sewing machine innovations including the world’s first zig-zag machine and the first electronic sewing machine.

Singer Industries, a subsidiary of Singer (Sri Lanka) manufactures traditional, portable and digital sewing machines at a fully-fledged facility, where it provides direct employment for over 100 factory workers and accommodates around 150 service agents. The traditional sewing machines are of two variants such as the straight stich and the zig-zag sewing machine, while the portable and digital sewing machines cater to the modern customers. Singer Industries is mandated with assembly of sewing machines and manufacturing of cabinets and stands for sewing machines.

The sewing machine stands and cabinets are 100% locally manufactured with the help of local suppliers who also depend from sewing machine manufacturing. Singer Industries also consists of a strong R&D section for sewing machine innovations. All the sewing machines produced by Singer Industries are distributed by its parent company, Singer (Sri Lanka) through their 431 distribution touch points. Currently, Singer sustains its dominance as the market leader for domestic sewing machine industry with a market share of 85%. Among the facilities, Singer Industries provides to its customers, it has deployed special service technicians at island wide service centres for technical assistance and support related to sewing machines. Its YouTube channel has access to over 130 technical assistance videos to further support its valued customers.

The name ‘’Singer’’ is closely associated with sewing. One of its major contributions to the local sewing industry is the Singer Fashion Academy. For more than 60 years, the Academy has helped thousands of individuals to develop sewing skills and become entrepreneurs. The Fashion Academy conducts sewing courses and diplomas while a degree pathway is to be implemented soon to further support students. The Academy is also the first and only institute in the country to receive course validation status from the Chartered Society of Designers (CSD) in the UK.

As of today, the academy consists of 54 branches Island wide and offers 22 sewing courses, 2 diplomas and another 10 courses as part of its Diwi Saviya program for low-income families. Annually, over 5000 – 6000 students get enrolled in Singer Fashion Academy’s courses. In addition to the physical classes, the academy conducts online courses and also provides a recorded version of lessons to further facilitate students. During the last decade, over 60,000 students have successfully completed the Fashion Academy’s courses and some of these students have already started their own sewing businesses. The Fashion Academy has helped in developing the passion of sewing among Sri Lankans and as a result, sewing has become a hobby among many.

Sewing can be considered one of the most feasible self-employment opportunities with its potential to generate a good income. A business of one’s own is a luxury at present due to current economic crisis. Many individuals who started their sewing businesses from scratch have developed their businesses to highly profitable ones. Singer Fashion Academy has all the resources ready to help develop sewing skills and is committed to develop a skilled workforce for the betterment of the country.

(Company news release)

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