Introduction
Curative health services are the most demanding aspect of the health care in the province as well as in Sri Lanka. In the Sabaragamuwa province the curative services have been provided through a network of health care institutions and outreach clinics which are arranged in ten Shared Care Clusters with the following institutions operating as “Apex Hospitals” of the cluster. TH-Ratnapura, BH(B)-Eheliyagoda, BH(A)-Balangoda, BH(B)-Kahwatta, BH(B)- Kalawana, BH(B)-Kolonna in Ratnapura district and DGH-Kegalle, BH(A)-Karawanella, BH(B)- Mawanella and BH(B)-Warakapola in Kegalle district
Curative care institutions in the Sabaragamuwa Province
Shared care clusters in the Sabaragamuwa province
Primary Medical Care Services
The objectives of the administration of the province along with the MOHs are to establish the criteria of primary health care restructuring in the PHC network including the essential services package through each level of PHC delivery. Teaching, Provincial General, District General and Base Hospitals will be the “Apex Hospital” in a “Shared Care Cluster” system introduced to the PHC network through the Health System Enhancement Project (HSEP) and provide the specialist care establishing points of referral. Primary health care institutions play a major role in registering the empaneled population and providing the NCD screening, mental health counselling through outreach clinics by specialists from Apex hospitals. A cluster wise laboratory network providing basic laboratory services to the doorstep is a highlight of the PSSP programme. “Primary Health Care is a whole of society approach to health, that aims at ensuring the highest possible level of health and wellbeing and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care and as close as feasible to people’s everyday environment” (WHO). The network of institutions (133 institutions which provide primary health care especially at Out Patient Departments (OPDs) and 30 MOH services) are distributed in each and every corner of the province to ensure the provision of efficient primary health care services to the public. Some of the selected basic information regarding facilities available and service provided by Primary Health Care Institutions (with and without beds) are mentioned below.
Secondary care provided by the province
The demand of the secondary health care of the people in the Sabaragamuwa province is catered through 11 health care institutions. Out of those, two institutions are under the line ministry, namely TH Ratnapura and DGH Kegalle, six are under the RDHS Ratnapura and three are under the RDHS Kegalle. According to the “Policy on health care delivery for universal health coverage” each institution should provide all specialist care regarding essential service package including general surgery, general medicine, general paediatrics, gynecology and obstetrics, dental surgery, anaesthesia, radiology, microbiology, histopathology, ENT, ophthalmology, dermatology, venereology, psychology, psychiatry, forensic medicine, oral and maxillofacial(OMF), blood bank, accident and emergency services (A&E), stroke unit, planning unit and quality unit. Development of all the apex hospitals for provision of all the services according to the demand had been done.
Tertiary care provided by Teaching Hospital and District General Hospitals
Teaching Hospital Ratnapura is the largest tertiary care hospital in the Sabaragamuwa province administered under the purview of the Ministry of Health, Nutrition and Indigenous Medicine. It provides specialized health care services mainly to the Sabaragamuwa province, which consists of Ratnapura and Kegalle districts, covering a population of 2,070,000 in an extent of 4968 km2 area. People coming from other provinces such as Uva, Southern and Eastern also seek specialized medical care from the hospital. The hospital was started in 1877 in Ratnapura main city. Then it was relocated 2.8 km away from the main city due to frequent floods in 1958 by the late Hon. Prime Minister Mr S.W.R.D. Bandaranayake. The hospital was upgraded as a Teaching Hospital on the 11th of October in 2018 to provide comprehensive clinical training to the students of the newly established medical faculty of the University of Sabaragamuwa.
The hospital is responsible for rendering advanced tertiary and secondary medical, surgical and rehabilitative services to the population. It comprises of 25 units with 41 wards, theatres and ICUs for inpatient services. Emergency Treatment Unit, Outpatient services and specialized clinic services are also provided by the hospital. Further, it is equipped to perform advanced investigations such as CT scanning, interventional radiography and angiography. These services are provided free of charge. The hospital also provides teaching and training to intern medical officers, postgraduate trainees from the Postgraduate Institute of Medicine-Colombo and nursing students from the College of Nursing- Ratnapura.