Health Economics, Health Policy and Healthcare Management

Biography

Biography: Ayesha Samankula

Abstract

Sri Lanka is a lower-middle income country in the South Asian region. Sri Lanka’s COVID-19 response is characterized by a strong preventive approach with rational utilization of available resources. All patients who tested positive were managed at healthcare institutions initially. Asymptomatic or mildly symptomatic patients were admitted to Intermediate Care Centres for monitoring, management and discharged in 14 days. The patients with critical symptoms, uncontrolled comorbidities and other complications were admitted to hospitals for closer monitoring and specialized management.

Increase in number of cases and deaths were unprecedented. The number of healthcare workers available for the functioning of the system too declined with a significant proportion acquiring the infection and the remaining workforce on the verge of physical and mental exhaustion. The priority shifted towards triaging and identifying those who need immediate medical intervention at the earliest stage of the disease to reduce severe disease and death.

A virtual triaging system for the identification and evacuation of those who needed hospitalization and to facilitate home management for mild and asymptomatic patients was proposed. Telemedicine system was introduced and an integrated patient management system was established via Short Message Services (SMSs) and telephone helplines. Four key stakeholders, the National Operation Centre for Prevention of COVID-19 Outbreak (NOCPCO), Sri Lanka Medical Association (SLMA), the Ministry of Health and National Ambulance Service were brought together with the cooperation and support of national telecommunication service providers.

This system had a major impact on the management the pandemic in the country. Within two weeks of commencement, an increase the number of available beds in both the government and private sector was observed reduction in hospital admissions, oxygen dependency, comorbidities and death counts were noted. It also reduced the unnecessary exposure of healthcare workers to infected individuals.

This innovative initiative from Sri Lanka utilized the volunteerism in a resource-constrained scenario during COVID-19 pandemic and harnessed the support from all stakeholders including underutilized sectors in the provision of healthcare, including information and communication systems.