Dr S Sridharan

Ministry of Health

Colombo – 08

Sri Lanka

Health SystemsHealth Systems

GoalsImproving the health of the population they

serve

Responding to peoples expectations

Providing financial protection against the cost of ill health

2

Overall level of health Distribution of health in the population Institutions with overall level of

responsiveness Distribution of such institutions with

responsiveness Distribution of financial contribution

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World Health Report 2000 page 31

“Some systems are highly unresponsive

A common complaint in many countries about public sector health workers

focus on their rudeness in relation with patients”

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Responsiveness

•Reducing the damage to ones dignity and autonomy and the fear and shame that sickness often brings with it

•Treat the people with individual dignity

•Their needs should be promptly attended to minimise long delays in waiting for diagnosis and treatment

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•Respect the value of peoples time and reduce their anxiety

•Ensure confidentiality

•Allow choices

•Treat them with dignity

• Ensure there is no error, delays, rudeness, hostility and indifference by the health worker

• Protect them against financial cost of illness

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•Ensure there is no error, delays, rudeness, hostility and indifference by the health worker

•Protect them against financial cost of illness

7

“Is not a measure of how the system responds to health needs which shows up in health outcomes

but, of how the system performs relative to

non – health aspects meeting or not meeting a populations expectations of how it should be treated by providers of prevention, curative or non personal services.”

8

World Health Report 2000 World Health Report 2000 page 33page 33

“ the poor was identified as the main disadvantaged group. They are treated with less respect for their dignity to have less choice of providers & to be offered poorer quality amenities (basic needs) than the non poor. They were granted as being treated worse than urban dwellers”

Respect for persons1. Dignity

Being shown respect

Maintaining privacy during physical examination

2. Confidentiality of information Medical history kept confidential

Consulting with health providers in a manner that your discussions could not be overheard

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3.Autonomy

Being involved in deciding on your case and treatment if you want to

Having the providers ask your permission before starting treatments or tests

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4. Communication having the provider to listen to you

carefully.

having the provider explain things so you can understand

having patients to ask questions12

Client orientation5. Prompt attentionHaving health care provider within

reasonable distance and travel time form home

Duties and treatmentsHaving fast care in emergenciesHaving short working times for

appointments and consultations and getting test done13

6. Quality of basic amenities

Enough space, seating, fresh air in waiting rooms and wards

Clean facilities ( toilets, eating places)Clean healthy foodHaving short waiting list for non

emergency cases14

Social support during care

- being allowed visits from relatives and friends

- being allowed provision of food and other gifts

from relatives

- having freedom for religious practices

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7. Choice of provider

being able to chose the doctor or other person providing you health care

being able to change the provider