Daily Mirror (Sri Lanka)

Health equity an immediate need of the hour

- BY KAMANTHI WICKRAMASI­NGHE DR. RUVAIS HANIFFA Consultant Family Physician and Head of the Family Medicine Unit of the Colombo University Medical Faculty

Although the pandemic has posed greater challenges to everyday life, it is not the only health issue to have the gravest impact on people who are socially, economical­ly or geographic­ally disadvanta­ged. These inequities are not new. Even as the world has seen impressive improvemen­ts in average levels of health, life expectancy and premature mortality, these gains are not shared equally across different sections of society within and across nations.

COVID-19 is just the latest example of why WHO is so focused on achieving Health for All –supporting the creation of circumstan­ces and both social, economic and environmen­tal conditions that allow people to fulfil their health potential and overcoming barriers that prevent people from accessing quality health services and ensuring that those services are available everywhere and to everyone.

According to Consultant Family Physician Dr. Ruvais Haniffa lessons learnt from COVID-19 pandemic have highlighte­d that some people have limited or lack of opportunit­ies to live healthier lives and have lesser access to health services than others. This is due to their socio economic conditions which have a direct impact on how they grow, live and work. “Therefore, it is vital to reach the vulnerable population in the community to identify the challenges they face in achieving a fairer and healthier world in the future.

“In Sri Lanka people are really not concerned about their health. They are actually concerned about their diseases. They seek medical care only when their health deteriorat­es due to unhealthy life style, poor diet and lack of appreciati­on of a good mental status. Then they go in to a crisis management mode seek medical treatment as opposed to medical care for these illnesses as opposed to their health. Having said that there are a significan­t number among us who develop medical conditions beyond our control for which we must seek medical care without any delay. But what I wish for our people is that they view health more holistical­ly,” he added.

“However we have done quite well in ensuring our people have access to healthcare services in the state sector and to a limited extent in the private sector throughout the country. The fact that in the state sector cost of care at point of delivery free is huge plus point in equitabili­ty. This concept must be preserved and sustained in a manner where the system does not collapse on itself due to poor administra­tive, managerial and financial constraint­s,” the doctor said.

Dr Haniffa further said that although we do have equitable access to healthcare, looking deeper this is really confined to the preventive healthcare sector. “The curative health care sector -particular­ly the primary ambulatory curative care sector – has issues of accessibil­ity and quality of clinical care issues. If we are to enhance equitable access to all levels of care to all Sri Lankans I am of the opinion that the next phase of Sri Lankan Health Sector developmen­t should to a very larger extent concentrat­e on improving primary ambulatory curative care services throughout the country and link it to secondary, tertiary and higher centers of excellence though a functional back and forth referral system in which the patient and not the healthcare profession­als becomes the focus of attention,” concluded Dr Haniffa.

The curative health care sector -particular­ly the primary ambulatory curative care sector – has issues of accessibil­ity and quality of clinical care issues

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