Sri Lanka Health System Review

Page 30

Catholics and 6.2% belong to other Christian denominations (Department of Census and Statistics, 2015a). Both Sinhalese and Sri Lankan Tamil cultures place a high value on education. National statistics indicate that secondary school enrolment (calculated as the percentage of children 10 years old who are in school) is high (97.7%, 2016). Adult literacy was high at 91.3% for males and 82.0% for females in 1981, which increased to 92.9% for males and 90.9% for females in 2017 (World Bank, 2020). In 2018, Sri Lanka was placed seventy-sixth globally on the Human Development Index (HDI) (0.770). It is noted that between 1990 and 2018, Sri Lanka’s HDI value increased from 0.625 to 0.770, an increase of 23.2% (United Nations Development Programme, 2016). The population of Sri Lanka is ageing progressively. The population of those 65 years and over has increased from 3.7% in 1970 to 10.8% in 2019, while those 80 years and over has increased from 0.5% to 1.6% during the same period (World Bank, 2020). An important feature of this process is its feminization, as seen in Figure 1.2, and indicated by the higher LE at birth for females (78.6 years) compared to males (71.9 years). Population projections (standard) suggest that the share of the population 60 years and over will reach 16.3% by 2022 and 23% by 2024. By the year 2052, one in every four persons will be 60 years or over. This amounts to an addition of 4 million oldage persons during the period 2012–2052 (De Silva and De Silva, 2015). Table 1.3 Trends in ageing and dependency in Sri Lanka, 1970–2019 Indicators

1970 1980 1990 2000 2010 2016 2017 2018 2019

Population aged 0–14 years (% of total)

40.3

35.9

32.1

26.8

25.4

24.6

24.4

24.2

24

Population aged 65 years and above (% of total)

3.7

4.4

5.5

6.2

7.4

9.8

10.1

10.5

10.8

Population aged 80 years and above of both sexes (% of total)

0.49

0.51

0.81

1.03

1.41

1.58

1.6

1.62

1.64

Child (0–14 years) dependency ratio

71.9

60

51.4

40

37.8

37.4

37.3

37

36.7

Elder (65+ years) dependency ratio

6.6

7.3

8.8

9.3

11.1

14.9

15.5

16

16.6

Age dependency ratio* (population 0-14 and 65+ years / population 15-64 years)

78.5

67.4

60.2

49.2

48.8

52.4

52.7

53.1

53.4

* The age dependency ratio is an age – population ratio of those typically not in the labour force (the dependent part, ages 0–14 and 65+ years) and those typically in the labour force (the productive part ages,15–64 years). The total dependency ratio can be broken down into the child dependency ratio (0–14 years) and the aged dependency ratio (65 years and above). Source: World Bank, 2020 6


Articles inside

9. Appendices ................................................................................................ 206 9.1 References

21min
pages 230-247

9.3 About the authors

4min
pages 250-254

7.6 Transparency and accountability

18min
pages 220-229

9.2 HiT methodology and production process

2min
pages 248-249

7.4 Health outcomes, health service outcomes and quality of care

5min
pages 203-205

7.3 User experience and equity of access to health care

14min
pages 195-202

7.1 Objectives of the health system

4min
pages 182-183

7. Assessment of the health system .......................................................... 157 Chapter summary

1min
page 181

6.3 Future developments

10min
pages 174-180

developments in Sri Lanka

1min
page 164

6.2 Analysis of recent major reforms

17min
pages 165-173

6. Principal health reforms ......................................................................... 139 Chapter summary

1min
page 163

medicine

2min
page 162

5.11 Mental health care

5min
pages 157-159

5.13 Health services for specific populations

1min
page 161

5.8 Rehabilitation

3min
pages 153-154

5.7 Pharmaceutical care

3min
pages 151-152

5.6 Emergency care

2min
page 150

5.2 Curative care services

3min
pages 145-146

5.4 Inpatient care

3min
pages 148-149

4.2 Human resources

6min
pages 117-120

5. Provision of services ................................................................................ 113 Chapter summary

1min
page 137

4.1 Physical resources

1min
page 104

4. Physical and human resources ................................................................ 78 Chapter summary

3min
pages 102-103

3.7 Payment mechanisms

1min
pages 100-101

3.6 Other financing

1min
page 99

Figure 3.8 OOP spending on health by expenditure deciles, 2016

11min
pages 86-92

3.5 Voluntary private health insurance

3min
pages 97-98

3.2 Sources of revenue and financial flows

2min
pages 81-82

3.3 Overview of the public financing schemes

2min
page 85

Figure 3.6 Financing system related to health-care provision

1min
page 83

3. Health financing ......................................................................................... 48 Chapter summary

1min
page 72

2.9 Patient empowerment

7min
pages 68-71

2.8 Regulation

8min
pages 64-67

2.7 Health information management

5min
pages 61-63

2.6 Intersectorality

3min
pages 59-60

2.4 Decentralization and centralization

3min
pages 56-57

2.2 Overview of the health system

1min
page 52

2.1 Historical background

2min
page 51

2.3 Organization

1min
page 53

2. Organization and governance ................................................................... 26 Chapter summary

1min
page 50

1. Introduction .................................................................................................. 1 Chapter summary

1min
page 25

1.4 Health status

11min
pages 37-43

1.3 Political context

2min
page 36

1.5 Human-induced and natural disasters

3min
pages 48-49

Figure 1.1 Map of Sri Lanka

1min
pages 27-28

1.1 Geography and sociodemography

1min
page 26

1.2 Economic context

2min
page 35

1 Analysis of the significant health reforms that affected health

2min
page 30
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