Climate Change &

Healthcare Organization:

Sri Lanka’s perspective

2008 Global Ministerial Forum

on Research for Health

- Bamako - 17-19 November 2008 -

Neelamani Rajapaksa Hewageegana Sarath Samarage

Country Description

Sri Lanka• 20 M population

• 62,705 Sq km

• Adult Literacy rate 90.7

• Life expectancy at Birth 76.4-Female

71.7-Male• Population growth Rate 1.1

• Total fertility rate 1.9

• Human Development index 0.743

Vital Statistics• Crude Birth rate 18.7 per

population

• Neonatal Mortality rate 8.4 per 1,000 live births

• Infant Mortality rate 11.7 per 1,000 live births

• Maternal Mortality rate 14.3 per 100,000 live births

(data Annual Health Bulletin 2006)

Provincial Level

Regional and Divisional Level

Updated on August 2004

MO Special Clinics(STD/Chest)

Supervising SchoolDental Therapist

DivisionalPharmacist

RegionalSupervising Public

Health NursingOfficer

DivisionalRegistered Medical

Officer

Statistical SurveyOfficer

Supervising PublicHealth Inspector

(Divisional)

Food & DrugInspector

Health EducationOfficer

Provincial Planing Unit

Planing & Prog.Officer/Planing &

Prog.Assistant

Provincial

Accountant

DS AdolesentDental Clinics

Public HealthNursing Sister

Divisional Director of HealthServices/Medical Officer of Health

Deputy Provincial Director ofHealth Services

Assistant Medical Officer of Health

Supervising PublicHealth Inspector

Provincial Secretary (Health Services)

Provincial Director of Health Services

Deputy Provincial Director

Administration (SLAS)

Organization Chart for the Health Services Under Provincial Councils

RegionalEpidemiologist

Regional DentalSurgeon

Medical Officer(MCH)

MS DistrictGeneral Hospital

DMO DistrictHospital

MO P

Field Staff Regional MalariaOfficer

Provincial Minister of Health (Health Services)

Planning andProgramming

Officer

PHI (ControlProgrammes)

Public HealthMidwife

MS ProvincialHospitals

Public HealthInspecor

Supervising PublicHealth Midwife

MS BaseHospitals

MO I/C RuralHospitals

A.M.C. & A.F.C.

SDT SchoolDental Clinics

Annex 1.

MO/RMO/AMOCentral

Dispansary

Visiting Stations& Clinics

BranchDispensary

MobileDispensary

MO/RMO/AMOCD & MH

MO I/CPeripheral Unit

The information flow of the notifiable diseases of Sri Lanka

Hospital MOH Office

Bed-head Tickets

Notification Card

Notification Register(Ward)

Notification Register

(Institution)

Special Notifications

CholeraAcute Flaccid Paralysis

Neonatal tetanusMeasles/Other EPI DiseasesJapanese EncephalitisDengue Haemorrhagic FeverRabies

Notification Register

Weekly Return of Communicable Diseases

InfectiousDiseases Register

EPIDEMIOLOGICAL UNIT

PHI

BY TELEPHONE/TELEGRAM

FOR SURVEILLANCE INVESTIGATION

Responding to climate change and health • Major Activities in epidemiology

• 1.Disease surveillance (communicable and non-communicable diseases)

2.Planning, monitoring and evaluation of the Expanded Programme on Immunization

3.Control of diarrhoeal diseases and acute respiratory infections

4. Control of dengue haemorrhagic fever, Japanese encephalitis and rubella

5.Planning, monitoring and evaluation of the new, emerging and re-emerging iseases (NERD)

Establishment of epidemic preparedness, rapid response teams at central and divisional levels

6.Providing feed back on selected communicable diseases

7.Conduct research activities relevant to epidemiology

Leading Causes of Hospitalization, 2006 SL Rank Order Causes of Hospitalization

1 Traumatic injuries

2 Diseases of the respiratory system,

3 Symptoms, signs and abnormal clinical and laboratory findings

4 Viral diseases

5 Diseases of the gastrointestinal tract

6&7 Direct and indirect obstetric causes

8 Diseases of the urinary system

9 Intestinal infectious diseases

10 Diseases of the skin and subcutaneous tissue

Diarrhoea associated withFloods and Drought

• Aggravate the problem of access to safe drinking water

• Contaminated water supplies.

• Poor hygiene, and increased risk of illness.

Vector dynamics with respect to to climate change

• Vector-borne diseases (Malaria, Filariasis, Chikun Gunya, Dengue, Japanese

Encephalitis,Leptospirosis)

• Premises Index• Container Index• Breatue Index

Climate change and Health…

• Increased accidents due to Lightning and Tornadoes

• Increased Road Traffic Accidents

• Psychological problems

– Loss of income

– loss or displaced family members

The way forward

• Research on climate change related health issues

• Improve health surveillance systems to allow assessment of the impact of climate variability and change on health

• to facilitate better integration of data sets across sectors

• review and redistribute the existing roles and responsibilities of the community health worker the PHM and PHI in Sri Lanka

Thank you.