Meeting the current and future health-care needs of Sri Lanka’s ageing population

Samaraweera, D. N.; Maduwage, Shiromi

doi:10.4103/2224-3151.206259

Cited by 23 publications

(25 citation statements)

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“…Historically, care for elderly patients is delivered by general physicians on general medical wards and through specialist health services, including mental health, disability and rehabilitation, though such services are not speci cally aimed at older adults. In 2013, however, the University of Colombo Postgraduate Institute of Medicine (PGIM) pioneered the rst 'speciality training' Postgraduate Diploma in Geriatric Medicine, supported by the Ministry of Health authorising successful applicants a 1 year period of release from their posts (68). Since 2017, the PGIM also offers an MD in Geriatric Medicine (69), with two seats available (70).…”

Section: Sri Lankamentioning

confidence: 99%

“…Following the Protection of the Rights of Elders Act in 2000, the government established a National Council for Elders, with representatives from government ministries, the voluntary sector and individual experts, to develop and implement programmes to protect and promote the rights of elders. Such activities include funding access to psychological counselling, day centres and home-care, as well as trained carers for the elderly (68,72). There are also several initiatives in progress to improve government health service provision for the elderly, including elderly-friendly hospital wards, health clinics, a stroke unit in each district general hospital and a stroke centre in each province (68).…”

Section: Sri Lankamentioning

confidence: 99%

“…Such activities include funding access to psychological counselling, day centres and home-care, as well as trained carers for the elderly (68,72). There are also several initiatives in progress to improve government health service provision for the elderly, including elderly-friendly hospital wards, health clinics, a stroke unit in each district general hospital and a stroke centre in each province (68). In 2014, Sri Lankan doctors also launched the Sri Lanka Association of Geriatric Medicine to promote geriatric education and research amongst the medical profession and public, by facilitating "elderly-friendly environments" in health care institutions and communities and coordinating the work of different organisations promoting the welfare of the elderly (73).…”

Section: Sri Lankamentioning

confidence: 99%

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Health and socioeconomic resource provision for older people in South Asian countries: Bangladesh, India, Nepal, Pakistan and Sri Lanka

Matthews

Porter

Varghese

et al. 2020

Preprint

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BackgroundThe global population is ageing rapidly, with low- and middle-income countries (LMICs) undergoing a fast demographic transition. This necessitates effective services to address the increasing physical and mental health needs of multimorbid and frail older people in LMICs. We review the current provision of health and socioeconomic resources for older people in South Asian countries: Bangladesh, India, Nepal, Pakistan and Sri Lanka, to identify gaps in available resources and assess areas for improvement. MethodsWe conducted a search of grey and published literature via Google Search and Compendex, EBSCO, JSTOR, Medline, Ovid, ProQuest databases, Scopus and Web of Science to extract data on population demographics, human resources, health funding and social security provision for older people. Local informants were consulted to supplement and verify the data. ResultsIn most study countries, care of the elderly is provided by general physicians or primary care doctors, nurses and community health workers, though in very low numbers per capita. The number of geriatricians and specialist allied health professionals were largely unknown, with minimal postgraduate programmes available for specific training in geriatric medicine or psychiatry. Total average healthcare expenditure as a percentage of GDP was between 2.5-5.5%, markedly below the global average of 10.0%, with between 48.1-72.0% of healthcare costs covered by out-of-pocket payments. All countries, except Pakistan, had a social pension offering a minimum level of protection against financial constraints, but with varying coverage of those eligible. Financial provision for people with dementia was only available in India and Nepal. A modest number of state and charity-run care homes were established in all countries, though numbers were disproportionate to the growing number of older adults requiring long term care.ConclusionsInadequate health funding, a lack of specific healthcare and training and insufficient government pension and social security schemes are a current threat to achieving universal health coverage in LMICs. Governing bodies must establish geriatrics and geriatric psychiatry as specialities and scale up training programmes for specific healthcare providers for the elderly. This needs to occur alongside increased social protection provision to improve access to those in need and prevent catastrophic health expenditure.

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Section: Sri Lankamentioning

confidence: 99%

Section: Sri Lankamentioning

confidence: 99%

Section: Sri Lankamentioning

confidence: 99%

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Health and socioeconomic resource provision for older people in South Asian countries: Bangladesh, India, Nepal, Pakistan and Sri Lanka

Matthews

Porter

Varghese

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…In 2016, 52.8% of men and 52.1% of women aged 60 years and above were suffering from heart diseases, while 43.8% of older men and 48.6% of older women were suffering from diabetes in Sri Lanka (7,8). Vision and hearing impairments are also common among older people that contributes to the morbidity giving rise to low quality of life (QOL) (7,9). Social security systems and other financial benefits available for older people living today in Sri Lanka is grossly inadequate to meet expenses related to their NCD health care (3, 10).…”

Section: Introductionmentioning

confidence: 99%

Non-communicable disease burden and quality of life of selected group of older people in Galle, Sri Lanka

et al. 2019

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Chronic ill health due to non-communicable diseases have already posed a great threat to the well-being of older people in Sri Lanka impairing their quality of life to a greater extent. This study was aimed to examine the impact of some chronic disease conditions on quality of life (QOL) of older people in Galle, Sri Lanka. This cross-sectional study was conducted in 70 older people (male=21, female=49) aged 60 years. Validated self-reported version of World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire which measures QOL in four dimensions; physical, psychological, environmental and social was used to assess the QOL. The age range of the participants was 60-90 years (mean = 70.3 years, SD = 6.2 years). Of the total, 41 subjects were living with their spouse and 22 were widowed. Visual impairment (67%), hypertension (47%) and arthritis (34%) were the most prevalent chronic diseases reported. QOL mean scores for all the four domains which measured in a 1-100 scale were all higher than 65 for both men and women. Further, mean scores of QOL in all the domains in both sexes were found to be low among those who were suffering from chronic conditions, although significant differences were found in physical and psychological domains between those with and without cardiovascular diseases and hypertension (p < 0.1). QOL of older people in Galle is relatively higher compared to the QOL of community dwelling older people in many other countries. Although NCDs and other chronic conditions are prevalent in this study population, cultural and environmental factors may have contributed to improve the QOL of this population group.

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“…Sri Lanka, which has a population of 20.4 million, has one of the fastest aging populations, and in 2015, 12.4% of the population were aged over 60 years [7]. Health care is provided free at the point of delivery in the government sector, but as in many other middle-income countries, Sri Lanka has a shortage of skilled eye health care workers, including optometrists, rehabilitation assistants, counsellors and those able to provide low vision care.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, causes and magnitude of functional low vision in Sri Lanka: results from a national population based survey

et al. 2018

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Introduction The following definition of functional low vision is used in surveys to estimate the need for low vision services: corrected visual acuity in the better eye of less than 6/18 down to and including light perception from causes not amenable to treatment. However, such data for Sri Lanka is lacking. Objectives To determine the prevalence, causes and magnitude of functional low vision in a nationally representative sample of adults aged 40 years and above in Sri Lanka. Methods Distance visual acuity was measured using a LogMAR E chart. If the acuity was less than 3/60 in either eye, the ability to see hand movements, count fingers or perceive light was assessed. All underwent autorefraction followed by subjective refraction and measurement of best corrected acuity if indicated. Participants with a presenting acuity of <6/12 in the better eye were examined in details and a cause of visual loss was assigned. Analysis included those who fulfilled the definition of functional low vision. Results Among those examined, 59 participants fulfilled the definition of functional low vision: prevalence 1.02% (95% confidence interval 0.77-1.31%). The commonest causes were complications of cataract surgery (42.4%), and posterior segment conditions (30.5%) principally and age related macular degeneration (5 cases) and other retinal conditions (11 cases). Based on these estimates, 77,600 adults in Sri Lanka may benefit from low vision services. Conclusions The prevalence of functional low vision is slightly lower than the prevalence of blindness from all causes. Complications of cataract surgery are potentially avoidable causes.

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Meeting the current and future health-care needs of Sri Lanka’s ageing population

Cited by 23 publications

References 0 publications

Health and socioeconomic resource provision for older people in South Asian countries: Bangladesh, India, Nepal, Pakistan and Sri Lanka

Health and socioeconomic resource provision for older people in South Asian countries: Bangladesh, India, Nepal, Pakistan and Sri Lanka

Non-communicable disease burden and quality of life of selected group of older people in Galle, Sri Lanka

Prevalence, causes and magnitude of functional low vision in Sri Lanka: results from a national population based survey

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