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Introduction: Circulars help official communications from higher authority to operational level. Government circulars issued by the Ministry of Health (MOH) and other institutions affect the Medical Officers (MOs) in numerous ways and serve multiple purposes. objective: To assess the knowledge, attitude and practices (KAP) among MOs of District General Hospital (DGH), Matara on circulars issued by MOH.Methodology: This descriptive cross-sectional study was carried out at DGH, Matara by interviewing 216 MOs using a self-administered questionnaire. Data were analyzed with regards to proportions. Associations were checked using chi square test.Results and Discussion: Among 185 respondents, most were grade II MOs (n=102, 55%) and only 18% (n=33) had administrative experience. All knew that circulars are issued by MOH. 95% knew about the circular on Disturbance, Availability and Transport (DAT) allowance of MOs but only 35%-62% knew about other circulars. Majority accepted that circulars are important for better administration (85%) and medical practice (88%). Only 55% (n=102) identified the importance of referring circulars frequently. Reasons for referring circulars were mainly related to personal interest. Main perceived barriers for referring circulars were difficulty in accessing 75% (n=138), lack of interest 61% (n=113) and difficulty of understanding technical language 44% (n=81).Administrative post experience had a statistically significant association with the level of knowledge (p=0.035), good attitudes (p=0.048) and good practices(p=0.042) while Grade seniority affected positively on KAP of circulars. Conclusions and Recommendations:Most were aware about the circulars issued by the MOH and majority accessed circulars for personal interest. Good KAP were shown by doctors with administrative experience. Sensitize newly-appointed MOs on use of circulars and increase accessibility is recommended.

Introduction: Hospital based HIV Rapid Diagnostic Testing (RDT) was introduced in 2018, following programmatic decision. However, being the province with the highest HIV prevalence in the country, the number of hospital based rapid testing carried out in Western province was not impressive, leading to missed opportunities and late diagnosis. Therefore, RDT was re-implemented in selected medical wards of NHSL. Objective: To assess the case detection rate, the feasibility and challenges of the rapid HIV testing services among inpatients of medical wards of NHSL. Method: A descriptive demonstration study, carried out among consecutive 3,395 new admissions to selected medical wards of the NHSL within three months period. HIV status was tested on finger prick blood, using FDA and WHO approved 4th generation HIV RDT (with 100% sensitivity, 99.7% specificity) following informed consent. Patient information were extracted from bed head tickets. Focus Group Discussions (FGD) were carried out with the relevant hospital staff to assess the challenges. Confidentiality of patients ensured by training all the health care workers involved in RDT and followed up of the positive test results, according to the national guidelines Results: Among the 3395 participants, eight (8) were found to be positive, with the HIV prevalence of 0.23 %. The patient acceptance rate was 96%. Out of the positives, majority were males (n=6) and married (n=5) and half of them were from the Colombo district. Only two (25 %) had AIDS defining symptoms while the majority (n=5) had baseline CD4 count less than 200 cells/μl . Work overload, consent taking, lack of confidence in post-test HIV counselling were identified as major areas of concern. Conclusions: Hospital-based HIV rapid testing is one of the high yielding programmatic strategies implemented in the country so far. The positivity rate of the study sample was 0.23% which is higher than the HIV positivity rate reported through different testing strategies including the general public (0.03%), and STD samples (0.1%). Further, beating up the challenge of missed opportunities and late diagnosis was highlighted. Therefore, addressing the identified barriers through policy and administrative support and further scaling up of hospital-based HIV testing is highly recommended.