1. Primary Health Care System Strengthening Project in Sri Lanka: Status and Challenges with Human Resources, Information Systems, Drugs and Laboratory Services.
- Author
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Thekkur, Pruthu, Fernando, Manoj, Nair, Divya, Kumar, Ajay M. V., Satyanarayana, Srinath, Chandraratne, Nadeeka, Chandrasiri, Amila, Attygalle, Deepika Eranjanie, Higashi, Hideki, Bandara, Jayasundara, Berger, Selma Dar, and Harries, Anthony D.
- Subjects
DRUG delivery systems ,MEDICAL quality control ,EVALUATION of human services programs ,LABOR productivity ,HEALTH services accessibility ,MANAGEMENT of medical records ,ESSENTIAL drugs ,RESEARCH methodology ,CROSS-sectional method ,ATTITUDES of medical personnel ,MOTIVATION (Psychology) ,MEDICAL care ,MEDICAL supplies ,INTERVIEWING ,MEDICAL personnel ,ACQUISITION of data ,PRIMARY health care ,SUPPLY chains ,MEDICAL care use ,HOSPITAL laboratories ,SYSTEM analysis ,RESEARCH funding ,DESCRIPTIVE statistics ,MEDICAL records ,INFORMATION storage & retrieval systems ,SUSTAINABLE development ,STATISTICAL sampling ,JUDGMENT sampling ,DATA analysis software ,HEALTH care rationing ,PERSONNEL management ,INTERNET service providers - Abstract
A Primary Healthcare-System-Strengthening Project (PSSP) is implemented by the Ministry of Health, Sri Lanka, with funding support from the World Bank for providing quality care through primary medical care institutions (PMCIs). We used an explanatory mixed-methods study to assess progress and challenges in human resources, drug availability, laboratory services and the health management information system (HMIS) at PMCIs. We conducted a checklist-based assessment followed by in-depth interviews of healthcare workers in one PMCI each in all nine provinces. All PMCIs had medical/nursing officers, but data entry operators (44%) and laboratory technicians (33%) were mostly not available. Existing staff were assigned additional responsibilities in PSSP, decreasing their motivation and efficiency. While 11/18 (61%) essential drugs were available in all PMCIs, buffer stocks were not maintained in >50% due to poor supply chain management and storage infrastructure. Only 6/14 (43%) essential laboratory investigations were available in >50% of PMCIs, non-availability was due to shortages of reagents/consumables and lack of sample collection–transportation system. The HMIS was installed in PMCIs but its usage was sub-optimal due to perceived lack of utility, few trained operators and poor internet connectivity. The PSSP needs to address these bottlenecks as a priority to ensure sustainability and successful scale-up. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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