Sri Lankan Health System Response to the COVID-19 Pandemic: A Post Evaluation to Assess the Strengths and Weaknesses by Using Health Systems Building Blocks

Abstract

Abstract
 Introduction
 The COVID-19 pandemic spread across the globe, threatening almost all health systems, from the strongest to the most vulnerable, and the Sri Lankan health system was no exception. Since the COVID-19 pandemic became a serious public health threat in China, India, and other parts of the world, Sri Lanka has been on high alert and ready to respond.
 Objectives
 The purpose of this research is to describe how Sri Lanka's health system dealt with the COVID-19 pandemic using the world health organization's health systems building blocks framework, to assist policymakers in better understanding the deficiencies and planning future crisis management. 
 Methods
 COVID-19-related documents about Sri Lanka were manually and electronically searched, including peer-reviewed articles in local and international journals, government publications such as circulars, guidelines, and reports, WHO and World Bank publications, regional and international news websites, and non-governmental organizations. Thematic analysis was used.
 Results and conclusions
 The Sri Lankan health system responded in a proactive and multi-sectoral manner. Before the pandemic hit the country, the hospital system and a well-established preventive health sector were prepared. However, issues such as human resource shortages, drug shortages, and other medical equipment shortages, as well as financial constraints, were difficult to manage. Delays in decision-making during the third wave led to negative outcomes for the country. However, the country was protected during the fourth wave due to committed vaccination and other timely preventive measures.
 Keywords: COVID-19, Response, Health system, Sri Lanka, Building blocks approach,