PolicyRepository.pdf - Policy Repository Of Ministry of Health Sri Lanka Compiled by Policy Analysis Development Unit Ministry of Health Sri Lanka

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Unformatted text preview: Policy Repository Of Ministry of Health Sri Lanka Compiled by Policy Analysis & Development Unit Ministry of Health Sri Lanka Message from the Hon Minister of Health , Nutrition & Indigenous Medicine Explicit Policies are a special feature of Good Governance . As such the Ministry of Health , Nutrition & Indigenous ; takes every effort to provide best services through explicit policies . On the other hand the citizens of our country have a right to know the details of services provided by the Ministry of Health , Nutrition & Indigenous Medicine ; as indicated in health sub sectoral policies . Although many programe directorates of the Ministry of Health , Nutrition & Indigenous Medicine ; have developed programe specific policies and strategic framework to improve services to the citizens of our country , until the preparation of this document , no single document was available , with all sub sectoral policies as a one single document Therefore I appreciate the effort taken by the Policy Analysis & Development unit of the Ministry of Health , Nutrition & Indigenous Medicine , to publish this document titled ‘ Policy Repository of Ministry of Health - Sri Lanka ‘ After evaluating this policy repository I hope the community leaders , general public , media & development partners will understand the efforts taken by the Ministry of Health , Nutrition & Indigenous Medicine , to uplift the health status of the citizens of Sri Lanka Dr Rajitha Senarathna Hon. Minister of Health , Nutrition & Indigenous Medicine i Message from the Secretary Ministry of Health , Nutrition & Indigenous Medicine Policies are a set of principles complied together to implement for the betterment of mankind . Health , as a dynamic and diverse subject , indeed relevant to the physical mental and spiritual wellbeing of the people , necessitates various policies and strategies to address the sub sectoral issues Over the past , various Directorates under the Ministry of Health , had developed sub sector policies and strategic plans , for which the approval had been granted by the Cabinet of Ministers of Government of Sri Lanka , as and when the Cabinet Memorandum submitted by the Hon Minister of Health of Sri Lanka However , until the preparation of this document , it was not possible to study all said policies in one place . Therefore I feel that this effort to collect all sub sectoral policies in to one document is a most needed duty . Further I noticed that reference has been made to the relevant Cabinet Decisions ( Reference number and date of the decision of the office of the Cabinet of Ministers , and also the reference number and date of the Cabinet memorandum ) As such the efforts taken by the Policy Analysis & Development unit , to prepare this document titled ‘ Policy Repository of Ministry of Health - Sri Lanka ‘ is appreciated much as it has covered a most needed document . Anura Jayawickrama Secretary Ministry of Health , Nutrition & Indigenous Medicine ii Message from the Director General of Health Services It was a long felt need to have all health sub sectoral policies in one place for reference as a repository . Policy makers , Development Partners ( WHO , UNICEF , UNFPA , JICA , World Bank ) , Post Graduate students , all need such facility so as to study the sector at length and design the future innovative programs to uplift the health status of citizens of Sri Lanka .In addition the community leaders , general public and media too need to understand the steps ( in the form of sub sectoral policies and relevant Strategic plans ) taken by health authorities to improve the health services of the country . Therefore I recognize this effort to prepare the Health Policy Repository , by the Director Policy Analysis & Development , Dr D.A.B.Dangalla and staff of PA & D unit , as a special event in the Medical Administration I hope , the policies will be revised timely by the relevant directorates of programs , to incorporate the needs of the citizens of the country as well as the demands created by medical technological advancements , and it is very much essential to develop indicators to monitor the policy tools ; in other words , the outcome indicators of policies are to be monitored by relevant directorates to assess the impact of implementation of sub sectoral policies on health status of citizens of the country Dr P. G. Mahipala Director General of Health Services iii Contents 01. 02. 03. 04. 05. 06. 07. 08. 09. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. National Health Policy ( 1996 ) ………………………………………………………………………………………..01 Population & Reproductive Health Policy ………………………………………………………………………..03 National Policy on Maternal & Child Health …………………………………………………………………..12 National Immunization Policy ……………………………………………………………………………………………32 National Policy & Strategy on Cleaner Production for Health sector …………………………..42 Mental Health Policy of Sri Lanka …………………………………………………………………………………….45 National Medicinal Drugs Policy for Sri Lanka …………………………………………………………………52 National Health Promotion Policy ……………………………………………………………………………………..57 Sri Lanka National Migration Policy …………………………………………………………………………………..85 National HIV – AIDS Policy for Sri Lanka ……………………………………………………………………….101 National Blood policy ………………………………………………………………………………………………………105 National Policy & Strategic framework for Prevention & Control of NCD …………………..107 National Health Laboratory Policy ……………………………………………………………………………………121 Accident & Emergency Care Policy of Sri Lanka …………………………………………………………….125 National Policy on Health Care Quality & Safety …………………………………………………………..142 National Policy & Strategic framework for Cancer Prevention and Control …………………153 Sri Lanka National Policy on Alcohol Control …………………………………………………………………164 Policy & Strategic framework on Elimination of Human Rabies in Sri Lanka ……………….174 National Policy & Strategic framework on Prevention of Injuries …………………………………197 National Environmental Health Policy ………………………………………………………………………………208 National Objectives for Development of Physical Rehabilitation Care ………………………….215 National Oral Health Policy of Sri Lanka ………………………………………………………………………..223 National Policy & Strategy on Health of the Young Persons ……………………………………….226 National Nutrition Policy of Sri Lanka …………………………………………………………………………….236 Policy Guidelines for Fortification of Food in Sri Lanka ………………………………………………..251 National Policy on Health Information ……………………………………………………………………………270 Proposed Policy on Re structuring Primary Level Curative Services ……………………………..299 Proposed Policy on Health Services in the Plantations ( Estate Health ) …………………..311 iv First Edition - 2016 Policy repository of Ministry of Health Sri Lanka - Colombo ; Ministry of Health . 2016 360 p ; 28 cm ISBN 978-955-0505-82-1 i . 362.110995493 DDC23 1. Medical policy - Sri Lanka 2. Public health - Sri Lanka Bar code 9 789550 505821 Message from Director / Policy Analysis & Development unit .......... The Policy Analysis & Development unit is much grateful to all the Programme Directors and the Consultants attached to those programs , for releasing the Policy documents of those programmes for the publication in the Policy Repository of Ministry of Health . The Computer type -setting of the whole document was attended by Miss Dhanushika Madhubhashini Wijebandara ( a trainee from National Apprentice & Industrial Training Authority NAITA ) , and her dedicated service is much appreciated . Revisions of exciting Policies and introduction of new Policies will be incorporated in to the next edition of this book ..……… Dr D.A.B.Dangalla Director - Policy Analysis & Development v National Health Policy 1996 Certificate of Authorization The National Health Policy of Sri Lanka was published in 1996 by the Ministry of Health & Social Services Introduction: Sri Lanka has achieved a commendable health status measured in terms of traditional health indices in relation to its Gross Domestic Product (GDP). This has been mainly due to the social policies adopted by successive government in the past few decades. Health Policy: The health policy of the Government will be directed at consolidating the earlier as well as adopting new policies to raise the health status of the people The broad aim of the Health Policy is to: I. II. Further increase life expectancy by reducing preventable deaths due to both communicable and non-communicable diseases. Improve the quality of life by reducing preventable diseases, health problems and disability; and also emphasizing the positive aspects of health through health promotion. In this respect the Government has identified the following diseases/health problems as priority areas needing focused attention: Maternal and child health problems, adolescent health, malnutrition & nutritional deficiencies, problems of the elderly, malaria, oral health , bowel disease, respiratory disease, mental health problems, physical disabilities, deliberate self-harm / suicide, accidents, rabies, coronary health disease, hypertension, diabetes, cerebro- vascular disease, real disease, malignancies, STD/HIV – AIDS, substance abuse and problems related to the family unit Measures will be taken to raise the health status of the population in general and minimize the impact of the above mentioned diseases/health problems in particular by adopting the following health strategies. 1. Improve the existing preventive health programmers and in addition develop more comprehensive coordinated and focused programmers that woulda. Reduce the burden of disease in the community; b. Enable early detection of preventable diseases/health problems and their complications; c. Focus on promoting positive health behavior. Policy Repository - Ministry of Health - Sri Lanka Page 1 2. Improve the existing medical facilities and develop additional services to meet a wider range and level of medical needs including rehabilitation and continuing care, both institutional and community based. 3. Health care will be made more accessible to the community on an equitable basis with provision for meeting specific health needs. 4. Improve the quality of health care to a level acceptable to both the community and service providers. 5. Services activities and patient care will respect the dignity of the individual at all times. 6. Health The government will remain committed to providing basic health care free of cost to the individual at the point of delivery, in state sector institutions. 7. The government will ensure the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice. 8. Health care will be made efficient and cost effective. 9. Develop and implement a National drug policy for the rational use and distribution of drugs. 10. Promote the involvement of the community in health care 11. Allocate resources between provinces/districts based on their health needs and national priorities. 12. The health Ministry will strengthen integrated approaches with other governmental and Non-Governmental agencies to facilitate greater coordination for better health care. 13. The government will facilitate the development and regulation of the private health care sector and promote better coordination with this sector. 14. Encourage health systems research and its application. 15. Human resource development will be supported and strengthened in keeping with contemporary needs. 16. Services and programmers will be introduced to meet the emerging health needs of the elderly and those affected by physical disabilities, mental health disorders, as well as the health problems of displaced populations. 17. Development of indigenous systems of medicines and homeopathy will be encouraged. 18. The government is comment to allocate additional funds from governmental sources and through alternative mechanisms of funding, towards meeting promotion and prevention. Implementation: The national health policy will be implemented through the central and provincial health ministries. Policy Repository - Ministry of Health - Sri Lanka Page 2 POPULATION AND REPRODUCTIVE HEALTH POLICY Certificate of Authorization The Population and Reproductive Health Policy of Sri Lanka , had been published by Ministry of Health & Indigenous Medicine in 1998 The cabinet of Ministers approved the population and Reproductive Health policy on 27th August, 1998. Preamble The population and Reproductive Health Policy for Sri Lanka for the next decade is presented at a finishing moment in its demographic transition. While on the one hand, enlightened population policies and programmers have contributed to the reduction in the rate of population growth and improvement of the quality of life of to the people, on the other, the changing demographic scenario has brought into focus a host of emerging issues that need to be addressed in the coming years. 2. The consequences of excessive population growth on social and economic development are well documented. Continued increase of population at the present rate would double our population to 37 million in about five decades and would continue to expand resulting in severe stress being placed upon the natural resources and environment and constraining the efforts to improve the quality of life of the people. 3. Therefore, while it is necessary to ensure that the current declining trend in fertility is maintained to reach a stable population size at least by the middle of the next century, it is important to address the crucial emerging population and reproductive health issues such as safe motherhood, sub-fertility, induced abortion, reproductive tract infections and sexually transmitted diseases, promotion of responsible adolescent and youth behavior, achieving gender equality, provision of health care and welfare services to the elderly, promotion of economic benefits of migration and urbanization while controlling their adverse effects, increasing public awareness on population and reproductive health issues and strengthening the infrastructure for implementation and coordination at national and sub-national levels. 4. By reproductive health is meant a state of complete physical, mental and social wellbeing in all matters relating to the reproductive system, its functions and processes. Reproductive health implies that couples are able to have a satisfying and safe sex life that they have the capability to reproduce and the freedom to decide responsibly on the number of children they may have. Policy Repository - Ministry of Health - Sri Lanka Page 3 5. The population and Reproductive Health Policy for Sri Lanka aims at achieving a higher quality of life for its people by providing quality reproductive health information and services, achieving gender equality, providing health care and social support for the elderly, promoting the economic benefits of migration and urbanization while controlling their adverse social and health effects and reaching a stable population size in the long term. 6. The following eight Goals constitute the population and Reproductive Health Policy of the government in the medium term. The policy statement is structured on the basis of a rationale for each goal each is accompanied by a set of illustrative strategies. The strategies for achieving the goals will be implemented through specific programmers which will be developed by the Task force mandated to formulate the Action plan on population and Reproductive Health. 7. In the action plan the roles and responsibilities of the national and sub-national administrations, NGOs including CBOs and the private sector will be identified. The development of mechanisms for coordination and the provision of adequate resources will be necessary in order that easy, affordable and convenient access to services is enabled to the general population. Goal 1 Maintain current declining trends in fertility so as to achieve a stable population size at least by the middle of the 21st century Rationale Enlightened population policies and programmers since independence have contributed largely to high physical quality of life of the Sri Lankan population. However, Sri Lanka is still one of the most densely populated countries in the word. Hence maintaining the gains we have achieved in quality of life requires continuing effort in moderating the growth of population. The population of the country which is today 18.5 million increases annually at around 250000 persons i.e. at an annual growth rate of 1.3 per cent and if continued at that rate, the population is expected to double in about fifty years and will continue to expand. However, if fertility is reduced to replacement level within the next few years and maintained around that level, the population will grow slowly and stabilize at about 24 million around the year 2050. Strategies Policy Repository - Ministry of Health - Sri Lanka Page 4 a) Continue to provide comprehensive family planning information, education, communication and services through government, NGO and private sector sources. b) Improve quality of service delivery to enable couples to decide freely and responsibly the number and spacing of their children. c) Focus attention on pockets of unmet need such as the urban slums, plantations, internally displaced populations, factory labor, and the underserved rural areas. d) Effectively reach the net additional to the reproductive age group (Estimated at 500,000 over the next ten years.) Goal 2 Ensure safe motherhood and reduce reproductive health system related morbidity and mortality Rationale Maternal mortality levels in Sri Lanka are relatively low by South Asian standards. However, morbidity levels related to reproductive health still cause concern. Among the problems connected with reproductive health which will need to be addressed with increasing vigor in the future are: Anemia Sub-fertility Unwanted pregnancy Induced abortion Reproductive tract infection Sexually transmitted diseases HIV/AIDS Reproductive system malignancies (Breast, Pelvic and prostate cancers) Strategies a) Expand reproductive health care services while improving its quality. Policy Repository - Ministry of Health - Sri Lanka Page 5 b) Provide affordable, accessible and acceptable family planning services to protect against unplanned pregnancy. c) Promote family planning so that pregnancies do not take place too early in life or too late in life, are appropriately spaced and are not too many. d) Provide all men and women information, education, communication and counseling and access to safe and effective reproductive health care. e) Empower women to take responsible decision with regard to reproductive health care and ensure male participation in the process. f) Improve communication between men and women on issues of sexuality and reproductive health. Goal 3 Achieve gender equality Rationale Although a great deal has been accomplished in Sri Lanka in improving the situation of women and enhancing their role and status as equal partners with men, especially through providing equal access to education and employment in the public sector, there still remains much to be done to ensure equity and gender equality in areas such as access to employment in the privet and unregulated sector and participation in decision making in politics and community affairs. Moreover, women’s position in the family and community, their reproductive health and their participation in gender based violence and intimidation and harassment of women in the community. The full participation and partnership of both women and men in reproductive life, including shared responsibility for the care and nurturing of children is essential for the achievement of sustainable development. As women constitute nearly fifty per cent of the populations of the country, the removal of all impediments social, legal or institutional that stands in the way ...
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