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Speeches & Transcripts September 15, 2018

Closing Ceremony of the Second Health Sector Development Project

Honorable Minister Dr. Rajitha Senaratne, Ministry of Health, Nutrition and Indigenous Medicine;

Mrs. B.G.S. Gunathilake, Secretary, Ministry of Health, Nutrition and Indigenous Medicine;

Mr. H. T. Kamal Pathmasiri, Secretary, Ministry of Provincial Councils, Local Government and Sports,

Distinguished invitees and colleagues. Good Morning!

It is my honor to be here with you today to acknowledge the contributions and successful implementation of the Second Health Sector Development Project; and to recognize the many agencies and individuals that were involved that made this project a success.

Sri Lanka has succeeded exceedingly well in delivering health care to its population. Between 2005 and 2015, the rate of under-five mortality decreased from 14.3 to 9.6 per 1,000 live births. In the same period, the rate of maternal mortality decreased from 43 to 30 per 100,000 live births and the health-adjusted life expectancy increased by more than one year.  These results compare very well and, in many cases, exceed those of peer South Asian countries.

Let me talk a little about the Project that we are here to discuss today.  This project began in mid-2013 and after 5 years of implementation, it will officially close at the end of this month. And it is closing on a high note with some impressive results. Let me highlight a few:

  • First, it has increased the availability of standard emergency and trauma services to nearly half of the centrally-managed hospitals; and to 4 of the 5 provincial hospitals.
  • Second, it has established at least two, if not more, Healthy Lifestyle Centers in 9 out of the 10 Medical Officers of Health areas; and to at least three health and community support groups in nearly all Medical Officers of Health areas.
  • Third, it has succeeded in ensuring that there are functioning quality management units in 100% of centrally managed hospitals and nearly all provincial hospitals.
  • Fourth, it has increased the percentage of provincially managed hospitals reporting on their mortality and morbidity data electronically.

These results are more than just numbers. They will improve people’s lives through:

  • increasing the capacity of health providers to respond to the growing need of the population for accidents and emergencies services;
  • increasing the availability and demand for non-communicable disease prevention and treatment through the screening of more than a quarter of all adults over the age of 40 at the Healthy Lifestyle Centers.
  • raising awareness of better health and nutrition through the mobilization of mother’s groups;
  • initiating a quality improvement culture for improved patient satisfaction and safety through the establishment of hospital quality management units in nearly all the hospitals; and
  • helping health policy makers and administrators plan better for the health needs of the population through better and more timely information.

Of importance to note also is the fact that the Project will be closing within the envisaged timeframe. Why is this important? Because time is money and unnecessary delays are a cost to the government and a loss in services to the beneficiaries. Let me therefore take the opportunity to thank all the government entities that have been involved in its implementation.  These include the central government, Provincial Health authorities under the Ministry of Provincial Councils and the Local Governments. It’s important that I also acknowledge the Department of External Resources, National Planning Department, the budget and treasury departments, Department of Project Management and Monitoring.  I will also apologize upfront if I am missing other critical players.  There is no doubt that leadership and collaboration are important; and I must also thank the Minister for his strong support.

We all know that a story that ends well has a history behind it. Let me pan back to 2013 for a minute to reflect on a couple of notable design features that allowed this project to deliver the outputs and outcomes we see today.

  • First, the Project was designed not as a stand-alone project intervention, but as a mechanism to generally support the implementation of the Government’s National Health Development Plan. From the Government’s strategy, the Ministry of Health and the Bank agreed to focus on 20 key indicators -- indicators to measure progress against the objective of upgrading the standards of performance of the public health system and enabling it to better respond to the challenges of malnutrition and non-communicable diseases.
  • Second , the Government requested and the Bank released funds not against inputs such as contracts for goods, works or services but against verified annual progress of several indicators.  An example of such an indicator, is the increase in the percentage of central and provincial health facilities with Emergency and Trauma Units having necessary requirements to respond to the emergency health needs of the population.

The emphasis was on supporting the Government’s strategy to deliver using its country systems for budgeting and execution. Key officials in the Ministry of Health took a leap of faith that this approach would bring about better project outcomes – and it did!

I invite you to listen with intent and interest as the project is presented by those who have spent time, effort and care to deliver the results we see today. I have tracked the project’s progress intently over the time I have been here, and I have been impressed. The provincial health authorities do deserve a special mention for their achievements.

I know you will have many success stories to share, but as with every development effort, I expect that there will be many lessons learned about what can be improved and how these interventions need to be strengthened in the future. I sincerely hope that you share with us these aspects of the project as well.

The partnership that the World Bank has had with the Government in health spans over the last three decades.  The partnership has focused on developing the best mechanisms and tools to respond to the changing health needs and rising expectations of the population for quality and responsive health care. We feel proud in having contributed to Sri Lanka’s efforts to develop the health sector to address these new challenges while maintaining its track record of achieving pro-poor health outcomes at relatively low cost. These efforts are highly relevant to the World Bank’s core objective of eliminating poverty and increasing shared prosperity.

As we embark on the newly approved project that focusses on strengthening the primary health care system to address the growing burden of non-communicable diseases, we look forward to building on the successes and lessons from the Second Health Sector Development Project.

I would be amiss if I did not end my speech with a few more thank yous!  As such, let me acknowledge the tireless efforts of the Minister of Health, Nutrition and Indigenous Medicine Dr. Rajitha Senaratne and Dr. Champika Wickramasinghe, the Deputy Director General for Non-Communicable Disease at the Ministry of Health and the Project Director on behalf of the Ministry for the Second Health Sector Development Project.  On behalf of the World Bank team, we are grateful for your professionalism, dedication and collegiality over these years.

I would also like to thank the organizers for the invitation to be a guest speaker at this important event.  I am humbled to have been given the opportunity.

Bohom Isthuti. Nandri.  And I wish you all a good day!