Introduction:Despite Sri Lanka's remarkable success of achieving higher health status, there are many areas in the system which need immediate and priority attention to further improve the provision of healthcare. Patient transfer procedure is one such area.Objectives: This study was undertaken to evaluate the patient transfers from peripheral hospitals to District General Hospital (DGH), Matara and to make recommendations to improve the process. Materials and Methods:A descriptive cross-sectional study was carried out using three study instruments. A questionnaire was administered to a convenience sample of 427 transferred patients and medical officers who attended them at the Primary Care Unit (PCU). Two checklists were used to assess the completeness of the components of the transfer process. Data were triangulated and analyzed regarding proportions (quantitative data) and associations (using chi-square test).Results: Involvement of the patient/guardian to the decision-making process was inadequate as 62.5% of the patients/guardians were not aware of the reason for the transfer. Pre-transfer communication was not done in 90.9% occasions. Majority of transferred patients (74.5%) were accompanied by staff attendants irrespective of the nature of the transfer. There were many lapses in the documentation of the transfer form. Discussion:Guidelines for inter-hospital patient transfers need to be revised. The transfer form used at present need to be redesigned.

Public Health Midwives (PHM) are the front-line health workers responsible for the provision of Maternal and child health (MCH) care. Despite having the best MCH indicators in the region, the Demographic and Health Survey (2016) reported significant disparities in MCH care between districts in Sri Lanka. The objective of the study was to assess the factors which impact the performance of PHMs of the medical officer of health areas in Nuwara Eliya District. A descriptive cross-sectional study was carried out among a convenient sample of 169 PHMs in the Nuwara Eliya district using a self-administered questionnaire. The data were analysed concerning proportions (quantitative data) and associations (multiple linear regression). The main findings indicate that independent variables job satisfaction and supervision had a significant positive linear correlation with performance while motivation had a significant negative linear correlation with performance. Leadership’s moderating effect on the relationship between independent variables and the dependent variable ‘performance’ was insignificant. Hence, the factors related to the job satisfaction of the midwives need to be optimized in the district to obtain maximum service from them. The impact of motivation on the performance of PHMs needs to be further studied. The moderating effect of the Medical Officer of Health’s (MOH) leadership also needs to be further investigated since the leadership role of the MOH may be deficient.

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Introduction: COVID-19 is caused by Severe Acute Respiratory Syndrome coronavirus 2 and it spread throughout the world and turned into a severe global pandemic in 2020. The severity of the COVID-19 is wide, ranging from asymptomatic to severe illness that requires mechanical ventilation. Although the curative sector response of Sri Lanka was somewhat different from other countries, it was remarkably effective in preventing community spread. objective: To assess the average cost of treating Covid 19 patients at Covid Treatment Centre (CTC) in District General Hospital (DGH) Hambantota.Methodology: This retrospective costing study was conducted in CTC at DGH, Hambantota in December 2020. The step-down costing method was used in this study. Key informant interviews with the accountant, deputy director, and staff of CTC, reviewing expenditure records of the accountant's office, visiting and taking measurements of the floor area, reviewing relevant literature were used to gather data in this costing study. Results: The average cost of treating a Covid 19 patient per day at CTC, DGH Hambantota was Rs 2317.60. The total cost of treating a Covid 19 Patient at DGH Hambantota for 10 days was Rs 23176.00. The cost of treating Covid patients at CTC, DGHH was exceptionally low when compared to other countries. Discussion and conclusion:Treating Covid 19 patients is an economic burden to any health system. Treatment cost was extremely low at DGH, Hambantota and only about 23000 rupees was spent for one patient for 10 days. Drug cost was comparatively low and transport cost was relatively high.

ABSTRACT Ethics is the “study of morality – careful and systematic analysis of moral decisions and behaviors and practicing those decisions”. The four ethical principles form the basis of ethical medical practice, namely, autonomy, justice, beneficence, and non-maleficence. A descriptive cross-sectional study was done among 120 specialist medical officers in four selected allopathic healthcare institutions in Sri Lanka, using a pretested validated self-administered questionnaire in 2021 to describe their knowledge, attitudes and practices related to medical ethics. The response rate was 90.00%(n=108). When considering the knowledge and attitudes related to medical ethics it was found that the majority(n=64,59.30%) of the specialist medical officers strongly disagree that “confidentiality is not so important aspect of treatment”. Among the total respondents 26(24.10%) strongly agree and 54 respondents (50%) agree with statement “close relatives should be told about patients condition”. When considering the practices related to medical ethics, we found that “ if a patient wishes to die, he or she should be assisted in doing so no matter what their illness” is  the ethical practice to which 32(29.60%) respondents  strongly disagree with and 56(51.90%) disagree with. We further discovered that 48(44.40%) of the respondents strongly agree and 52(48.10%) agree with the practice “ethics as a part of syllabus should be taught in every medical teaching institution”. These findings imply that Sri Lankan specialist doctors have a sound knowledge and positive attitudes towards the basic ethical principles. But they still need to improve their knowledge and attitudes related to ethical issues regarding their own colleagues. Continuous medical education for specialist medical officers, establishing ethics committees in hospitals, appointing ethicists to hospitals and conducting clinical case conferences regarding unethical practice are recommended to improve the situation.    RESUMEN  La ética es el "estudio de la moralidad, es decir, el análisis cuidadoso y sistemático de las decisiones y comportamientos morales y la práctica de esas decisiones". Los cuatro principios éticos constituyen la base de la práctica médica ética, a saber, la autonomía, la justicia, la beneficencia y la no maleficencia. Se realizó un estudio transversal descriptivo entre 120 médicos especialistas de cuatro instituciones sanitarias alopáticas seleccionadas en Sri Lanka, utilizando un cuestionario autoadministrado validado previamente en 2021 para describir sus conocimientos, actitudes y prácticas relacionadas con la ética médica. La tasa de respuesta fue del 90,00% (n=108). Al considerar los conocimientos y las actitudes relacionados con la ética médica, se descubrió que la mayoría (n=64, 59,30%) de los médicos especialistas están muy en desacuerdo con que "la confidencialidad no es un aspecto tan importante del tratamiento". Del total de encuestados, 26 (24,10%) están muy de acuerdo y 54 (50%) están de acuerdo con la afirmación "se debe informar a los familiares cercanos sobre el estado del paciente". Al considerar las prácticas relacionadas con la ética médica, descubrimos que "si un paciente desea morir, se le debe ayudar a hacerlo sin importar su enfermedad" es la práctica ética con la que 32 (29,60%) encuestados están muy en desacuerdo y 56 (51,90%) están en desacuerdo. Además, descubrimos que 48 (44,40%) de los encuestados están muy de acuerdo y 52 (48,10%) están de acuerdo con la práctica "la ética como parte del programa de estudios debería enseñarse en todas las instituciones de enseñanza médica". Estos resultados implican que los médicos especialistas de Sri Lanka tienen un buen conocimiento y actitudes positivas hacia los principios éticos básicos. Sin embargo, todavía necesitan mejorar sus conocimientos y actitudes en relación con las cuestiones éticas de sus propios colegas. Para mejorar la situación, se recomienda la formación médica continua de los médicos especialistas, la creación de comités de ética en los hospitales, el nombramiento de especialistas en ética en los hospitales y la realización de conferencias sobre casos clínicos relacionados con prácticas no éticas.