Universal health coverage and the health Sustainable Development Goal: achievements and challenges for Sri Lanka.
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Date
2016-09
Journal Title
Journal ISSN
Volume Title
Publisher
WHO Regional Office for South-East Asia
Abstract
With state-funded health care that is free at the point of delivery, a sound primary
health-care policy and widespread health-care services, Sri Lanka seems a good
example of universal health coverage. Yet, health transition and disparities in
provision and financing threaten this situation. Sri Lanka did well on the Millennium
Development Goal health indicators, but the Sustainable Development Goal (SDG)
for health has a wider purview, which is to “ensure healthy lives and promote wellbeing
for all at all ages”. The gender gap in life expectancy and the gap between
life expectancy and healthy life expectancy make achievement of the health SDG
more challenging. Although women and children do well overall, the comparative
health disadvantage for men in Sri Lanka is a cause for concern. From a financing
perspective, high out-of-pocket expenditure and high utilization of the private sector,
even by those in the lowest income quintile, are concerns, as is the emerging “third
tier”, where some individuals accessing state health care that is free at the point
of delivery actually bear some of the costs of drugs, investigations and surgery.
This cost sharing is resulting in catastrophic health expenditure for individuals,
and delays in and non-compliance with treatment. These concerns about provision
and financing must be addressed, as health transition will intensify the morbidity
burden and loss of well-being, and could derail plans to achieve the health SDG.
Description
Keywords
gender gap, healthy life expectancy, out of pocket, Sri Lanka, Sustainable Development Goals, universal health coverage
Citation
WHO South-East Asia Journal of Public Health 2016;5(2): 82-88.