Home | Contact Us | Site Map

Textsize - Large Medium Small 

About Us Research Publications Training Topics News Resources
You are here :  Home > Publications SEARCH IHP find
  
ABOUT US
RESEARCH
PUBLICATIONS
  • Recent Publications
  • IHP Books
  • Research Study Series
  • Technical Reports
  • Working Paper Series
  • Project Reports
  • External Publications
  • Presentations
  • Search Publications
  • Policy Briefs
  • TRAINING
    TOPICS
    NEWS
    RESOURCES
      

    Sri Lanka: �Good Practice� in Expanding Health Care Coverage

    "Chapter 11: Sri Lanka: Good Practice in Expanding Health Care Coverage"Good Practices in Health Financing Lessons from Reforms in Low- and Middle-Income Countries. Washington, DC: World Ba

    www.howtoaddlikebutton.com einfach hier schauen..

      Download from Lancet website (Registration required)
     
    Ravi P. Rannan-Eliya, Lankani Sikurajapathy
    1 Jun 2008 | ISBN 978-0-8213-7511-2| 44 pages

    Abstract: This case study of Sri Lankan experience was commissioned by the World Bank as part of a project to showcase best practice in healthcare financing. Sri Lanka was selected as one of these case studies given the Bank�s recognition of its exceptional performance in reaching the poor with health services, at low cost and through reliance on tax-finanaced, government provided healthcare services.

    Sri Lanka is a lower-middle-income country, with GDP per capita of US$965 in 2004. The expansion of health care coverage in Sri Lanka, with its focus on the poor, dates from the 1930s, and many of the initial motivations continue to be important influences. By far the most important one for health services has been democracy. In the 1920s, conditions in the island were much like those in most other British colonies. Government intervention in health was limited to providing health care to a small urban population that operated the colonial infrastructure and administration and an equally small workforce involved in export agriculture, and to a sanitary regime designed to control major epidemic threats such as cholera. Democracy based on universal suffrage was introduced in 1931 expressly to empower the poorer groups in society and women and to put pressure on the elites to pay closer attention to social and health conditions.

    After 1931, the political economy of the island changed irrevocably as the political power base shifted from urban residents to the majority rural population. The impact of democracy on health was accentuated by the emergence of competitive politics along a left-right dimension with two-party competition well embedded by the late 1950s, a rural bias in the delimitation of electorates where each national legislator typically represented fewer than 10,000 voters in the 1930s, and a single-member constituency system that encouraged politicians to engage in parish-pump politics to maximize the government infrastructure built in their districts. The introduction of democratic politics forced successive governments to continuously expand free public health services into rural areas where voters wanted the same standards established earlier for the urban population. Once democracy had served to establish a widely dispersed government health infrastructure, accessible by all, it then acted to ensure its survival under often difficult, fiscal conditions.

    Subsequently, successful market-oriented and reform-minded governments in Sri Lanka have generally understood that the cost of adequate public sector health services accessible to the poor was a small fiscal price to pay for the political support that they engender to enable other more important economic reforms.


     

     

     

    cover page image

    Related Publications

    © Copyright 2024 IHP. All rights reserved.
    For more information contact