Publication: Prevention and Control of Selected Chronic NCDs in Sri Lanka : Policy Options and Action
Loading...
Published
2010-10
ISSN
Date
2013-05-29
Editor(s)
Abstract
Strategic decisions to reorient population-based prevention and clinic- and hospital-based care policies toward non-communicable diseases (NCDs) will enable healthier aging and reduce loss of productivity among the working-age population in Sri Lanka. This report aims to stimulate policy dialogue for NCDs and to provide an evidence base to facilitate decisions. Its focus is mainly on chronic NCDs-that is, cardiovascular disease (CVD), diabetes, and asthma/chronic obstructive pulmonary disease (COPD), and to a lesser extent cancer-and their major modifiable risk factors (tobacco use, unhealthy diet, lack of exercise, and harmful alcohol use). This is not to detract, though, from the importance of injuries and mental health since both are major issues that carry a huge burden, as supported by evidence in this report. Several major areas for policies and actions emerged from the analysis of Sri Lanka's health sector organization and capacity as well as its NCD orientation. Some areas are not specific to NCDs but, rather, will strengthen the health sector generally while leading to better NCD prevention and control. These areas include: (i) increasing financial resources for NCD prevention and control, (ii) increasing access to NCD drugs, especially for the poor, (iii) addressing social determinants, (iv) focusing on specific NCDs, (v) addressing under nutrition and over nutrition, (vi) creating an intensified national NCD program, strengthening and reorganizing NCD prevention and curative care services, (vii) moving services closer to clients and improving efficiency, (viii) further decentralizing and devolving health service delivery, (ix) human resource development for NCD prevention and control, (x) creating a national NCD surveillance system, and (xi) developing public-private partnerships and aligning service delivery.
Link to Data Set
Citation
“Engelgau, Michael; Okamoto, Kyoko; Navaratne, Kumari Vinodhani; Gopalan, Sundararajan. 2010. Prevention and Control of Selected Chronic NCDs in Sri Lanka : Policy Options and Action. Health, Nutrition and Population (HNP)
discussion paper;. © World Bank. http://hdl.handle.net/10986/13607 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Related items
Showing items related by metadata.
Publication The Economic Costs of Noncommunicable Diseases in the Pacific Islands(Washington, DC, 2012-11)There are three main messages running throughout this report. First, Non Communicable Diseases (NCDs) can impose large health, financial and economic costs on countries. This is particularly important in the Pacific where Government already finances, and provides, the bulk of health services. Second, risk factors in the Pacific are feeding a pipeline of potentially expensive to treat NCDs, including diabetes and heart disease, but governments are already fiscally constrained in how much more they can provide to the health system. Third, from public health and public finance perspective, many of the NCDs are avoidable, or their health and financial costs can at least be postponed, through good primary and secondary prevention. This will require a more coherent approach to health system financing, and health system operations more generally.Publication The Economic Costs of Noncommunicable Diseases in the Pacific Islands : A Rapid Stocktake of the Situation in Samoa, Tonga, and Vanuatu(World Bank, Washington, DC, 2013-09)There is increasing recognition that non-communicable diseases (NCDs) are an important international and development issue globally, undermining health gains and imposing financial and economic costs on governments and households. NCDs are an important health challenge in the Pacific. First, (NCDs) can impose large but often preventable health, financial, and economic costs on countries. This is particularly important in the Pacific, where government already finances and provides the bulk of health services. Second, risk factors in the Pacific are feeding a pipeline of potentially expensive-to-treat NCDs, including diabetes and heart disease, but governments are already fiscally constrained in how much more they can provide to the health system. Third, from a public health and public finance perspective, many of the NCDs are avoidable or their health and financial costs can at least be postponed through good primary and secondary prevention. This will require a more coherent approach to health system financing and to health system operations, more generally. Improving both allocative efficiency ("doing the right things") and technical efficiency ("doing things right") are critical strategies to improve health outcomes in a financially sustainable way in the resource-constrained Pacific.Publication The Growing Burden of Non-Communicable Diseases in the Eastern Caribbean(World Bank, Washington, DC, 2012)The purpose of this report is to examine and propose options for policy design and implementation, based on a situational analysis for six Eastern Caribbean countries and a review of the lessons of other nations in prevention and control. A committed partner of the Organization of Eastern Caribbean States (OECS) countries, the World Bank is responding to their needs to address the increasing Non-Communicable Diseases (NCDs) burden by providing this report. This report analyzes the situation, reviews lessons learnt in other countries in the prevention and control of major NCDs, and proposes policy options to address the challenges. Specifically, this report aims to provide policy makers with an overview of the NCDs and key risk factors in the region and make inter-country comparisons; assess the economic impact of key NCDs and risk factors where data are available; outline policy options and cost effective interventions for controlling major NCDs that are common to the OECS countries; and provide input for developing a regional health strategy. In the belief that powerful information can drive strategic action, the report aims to: raise awareness of the reality and consequences of failure to take strong action; and identify priority actions that are realistic and tangible for policy makers in developing strategies and allocating resources.Publication Toward a Healthy and Harmonious Life in China(Washington, DC, 2011)China's 12th five-year plan (2011-2015) aims to promote inclusive, equitable growth and development by placing an increased emphasis on human development. Good health is an important component of human development, not only because it makes people's lives better, but also because having a healthy and long life enhances their ability to learn, acquire skills, and contributes to society. Indeed, good health is a fundamental right of every human being. Good health among a population can also enhance economic performance by improving labor productivity and reducing economic losses that arise from illnesses. The findings and recommendations can inform and promote a broad dialogue toward the development of a multisectoral response to effectively address the growing burden of Non Communicable Diseases (NCDs), including a better alignment of the health system with the population's health needs. The report also advocates implementing 'health in all' policies and actions for a multisectoral response to NCDs in China to help achieve the ultimate goal of 'harmonious' development and growth.Publication Hospital Sector Reform in Uzbekistan : A Policy Note(World Bank, Washington, DC, 2012-01)Since the mid-1990s, Uzbekistan has undergone reforms in the health sector focused on restructuring of primary health care in Uzbekistan as well as the establishment of an emergency medical care network. Reform and development initiatives in at secondary and tertiary care level have been limited to gradual downsizing of sub-national hospitals, with the exception of the emergency medical care network, and expansion of Republican specialized tertiary centers. Recent years have seen increases in out-of-pocket payments (both official and informal) for hospital and other health services, which now present a barrier to accessing health services and pharmaceuticals for some patients. The Ministry of Health (MOH) is implementing a program of development of new standards for diagnostic/curative services at each level of care that are intended to modernize practice and increase quality and efficiency. Twenty disease areas have been covered to date. Standards for equipment requirements at each level are also being defined. The Ministry now faces the challenge of developing a strategy to changing clinical and managerial practice in hospitals to bring them into line with the new standards. Uzbekistan has a large and fragmented network of hospitals and specialist clinics, characterized by multiple vertical programs and many single-specialty facilities. There is lack of clarity regarding the specific roles and linkages between the numerous hospitals and specialized care facilities. The Government has pursued a policy of increases in official user fees or "self-financing", alongside offsetting reductions in budget provision for non-salary operating costs in Republican hospitals and many Oblast hospitals in recent years. City and oblast hospitals have self-financing beds. User fees are projected to amount to an average of 18 percent of revenue in 2008 for oblast hospitals (compared to an average of 1.4 percent in 2000). Republican Specialist Centers (tertiary level hospitals) now obtain up to around 65 percent of revenue from user fees, and have a target of 80 percent. By contrast, rayon hospitals collect little user revenue (projected to be a little under 1percent in 2008, a level that is approximately unchanged since 2000). Budget funds for oblast hospital now cover little more than the costs of staff salaries and benefits, following budget reductions that offset increases in user fees.
Users also downloaded
Showing related downloaded files
Publication Taxes, Spending, and Equity: International Patterns and Lessons for Developing Countries(Washington, DC: World Bank, 2025-11-17)Taxes and public spending underpin the basic administration of government and finance the human capital and infrastructure investments needed for economic growth. They can also have a significant and immediate impact on poverty and inequality. The question of how public finance can support longer-term growth objectives while promoting equity has become even more important in recent years, given the high fiscal deficits and debt levels most countries emerged with in the aftermath of the COVID-19 pandemic. These included the increasing cost of debt and the need to restart environmentally sustainable growth while helping households address the learning losses and other social scars caused by the pandemic. This paper examines the global evidence on which households pay which taxes and who benefits from what spending, and critically, the net effect on different households across the income distribution. The aim is to identify the patterns and lessons that emerge for designing progressive fiscal policies. A global dataset of 96 countries is assembled, spanning all regions of the world and all national income levels, grounded in the Commitment to Equity (CEQ) approach to fiscal incidence.Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication Kyrgyz Republic Country Climate and Development Report(Washington, DC: World Bank, 2025-11-03)This Country Climate and Development Report (CCDR) on the Kyrgyz Republic aims to support the country’s development goals amid a changing climate. The CCDR considers two policy scenarios up to 2050: the business-as-usual (BAU) and high-growth scenarios. As it quantifies the likely impacts of climate change on the Kyrgyz economy between now and 2050, the report highlights key government actions to best prepare for and adapt to climate impacts (referred to as “with adaptation” measures), with a particular focus on the time horizon up to 2030. The CCDR also outlines a path to net zero emissions by 2050 (referred to as “with mitigation” measures, “decarbonization,” or, simply, “net zero 2050”), highlighting associated development co-benefits.Publication Continental Drying: A Threat to Our Common Future(Washington, DC: World Bank, 2025-11-04)Grounded in new evidence from satellite data, “Continental Drying: A Threat to Our Common Future” presents the first global assessment of freshwater reserves over the past two decades. The findings expose an alarming trend of “continental drying,” a persistent long-term decline in freshwater availability across vast landmasses. Not only are droughts and deluges becoming more unpredictable, but the total amount of freshwater available for use has also significantly declined. Continental drying, driven by global warming, worsening droughts, and unsustainable water and land use, is a silent but accelerating crisis—largely unknown to the public—that reshapes the global water narrative. Continental drying raises profound risks. This report reveals new empirical evidence showing how freshwater depletion leads to major job losses, reduced incomes, wildfires, and biodiversity threats. In the long term, the combined effects of drying and warming could push societies toward a tipping point where damage accelerates rapidly and adaptation becomes increasingly difficult. Against the backdrop of continental drying, global water consumption rose by 25 percent between 2000 and 2019, with about a third of this increase occurring in regions already experiencing drying. Compounding the pressure, a substantial share of water use in drying regions remains inefficient. Continental Drying identifies hot spots where rising demand and declining supply converge and explores where and how water savings can be realized. This report recommends a three-pronged approach to address the crisis: managing demand, augmenting water supply, and improving water allocation. Five cross-cutting levers—strengthening institutions, reforming water tariffs and repurposing subsidies, adopting water accounting, leveraging data and technological innovations, and valuing water in trade—are essential for effective implementation and to attract private investment to finance the approach. Beyond water, addressing trade barriers, investing in education and skills development, and improving access to markets and financial services are critical for strengthening job and livelihood resilience amid a continental drying crisis.Publication Direct and Indirect Impacts of Transport Mobility on Access to Jobs: Evidence from South Africa(Washington, DC: World Bank, 2025-11-12)Access to jobs is essential for economic growth. In Africa, unemployment rates are notably high. This paper reexamines the relationship between transport mobility and labor market outcomes, with a particular focus on the direct and indirect effects of transport connectivity. As predicted by theory, wages are influenced by the level of commuting deterrence. Generally, higher earnings are associated with longer commute times and/or higher commuting costs. Local accessibility is also important, especially for individuals with time constraints. Both direct and indirect impacts are found to be significant in South Africa, where job accessibility has been challenging since the end of apartheid. For the direct impact, the wage elasticity associated with commuting costs is significant. Returns on commute are particularly high for women. Local accessibility to socioeconomic facilities, such as shops and health services, is also found to have a significant impact, consistent with the concept of mobility of care. To enhance employment, therefore, it is crucial to connect people not only to job locations but also to various socioeconomic points of interest, such as markets and hospitals, in an integrated manner. This integration will enable individuals to spend more time working and commuting longer distances.