Tag Archives: Sri Lanka

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CaHRU team at Imperial College London for international partnership to improve primary care with South Asia

icl_cahruMembers of the Community and Health Research Unit, Dr Stephanie Armstrong, Dr Murray Smith, Professor Graham Law and Professor Niro Siriwardena attended a week long meeting with colleagues from Imperial College London (Professor Azeem Majeed, Dr Matthew Harris, Dr Yasser Bhatti, Dr Mala Rao, Professor Peter Childs and Professor James Barlow), Sri Lanka (Drs Rivaiz Haniffa and Dr Sajeeva Ranaweera, University of Colombo), Pakistan (Dr Asim Mahmood of Integrated Health Services) and Bangladesh (Dr Foysol Chowdhury of BRAC) to develop a collaboration exploring frugal innovation and quality improvement in primary care in middle income countries in South Asia.

The meeting consisted of seminars, presentations and discussions on the current systems of primary care in Sri Lanka, Pakistan, Bangladesh, other countries such as Brazil, and the United Kingdom, those systems being developed to improve care, how we could introduce frugal low cost innovations to enhance care in low and middle income countries and how these innovations could be introduced into the UK through ‘reverse innovation’. There were also presentations on research ethics and intellectual property.

taj2During the week’s meeting professor Siriwardena was invited to give a presentation on his work on quality improvement, specifically on ‘Quality Improvement Collaboratives: theory, design and effects’. This summarised work on three large scale QICs, Resources for Effective Sleep Treatment (REST), the Ambulance Services Cardiovascular Quality Initiative (ASCQI) and Scaling up PINCER, a pharmacist intervention to reduce clinically important prescribing errors in primary care, all funded by the Health Foundation and the last also co-funded by East Midlands Academic Health Science network. The talk developed the idea that collaboratives had different purposes and that syntheses should take this into account.

The meeting finished with partners agreeing to work together in future, support each other on the need to develop primary care and to implement frugal innovations as part of quality improvement initiatives in the countries involved.

By Professor Niro Siriwardena

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/03/QICs_ICSiriwardena.pdf” width=”660″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

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Comparing national multimorbidity policies and guidelines

CaHRU_logotypePeople living with a long-term condition often have more than one condition to contend with. This is known as ‘multimorbidity’, commonly defined as the co-occurrence of two or more chronic conditions within one person. In this situation it is important that the person, not the disease, is the focus. Policies referring to multimorbidity are considered a crucial element in safe health systems.

NadeekaChandraratneThe CaHRU team of Dr Nadeeka Chandraratne and Dr Ravindra Pathirathna, international visiting fellows attached to CaHRU from the Postgraduate Institute of Medicine at the University of Colombo, Sri Lanka, together with Prof Niro Siriwardena and Dr Christopher Harrison from the University of Sydney conducted a content analysis of policy documents and guidelines on multimorbidity from the UK, Australia and Sri Lanka. Despite considerable differences in healthcare structure and financing, all three countries face the challenge of multimorbidity. An understanding of how each country is addressing this challenge was considered important for identifying policy initiatives, gaps and opportunities for further improvement.

RavindraPathirathneThe article describing the study and its findings, ‘A comparison of policies and guidelines related to multimorbidity in the UK, Australia and Sri Lanka‘, was published this month in the first issue of the Australian Journal of General Practice 2018 with an accompanying editorial on Multimorbidity written by Niro Siriwardena and Christopher Harrison.

The team found overall a lack of health policy and guidance for multimorbidity: the guideline ‘Multimorbidity: Clinical assessment and management’ from The National Institute for Health and Care Excellence (NICE), UK was the only specific guideline on multimorbidity. Australia and Sri Lanka lack specific national documents addressing multimorbidity. The promising features observed in Australia were policies that are directly concerned with the health of socially disadvantaged groups, which are at higher risk of multimorbidity. Policies in Sri Lanka were more concerned with preventing chronic conditions, and on community mobilisation and empowerment.

lilyThe paper highlights that Sri Lanka needs to focus on policies that emphasise integration and patient-centred healthcare delivery for people with multimorbidity, whereas in the UK and Australia, policies on community-based approaches to address determinants of multimorbidity are needed.

By Dr. Nadeeka Chandraratne

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Nadeeka Chandraratne, joins CaHRU as an International Research Fellow

NadeekaChandraratneNadeeka Chandraratne joined the Community and Health Research Unit in May 2017 to work on the quality and costs of primary health care, as CaHRU’s second international research fellow.. She will study monitoring and evaluation of primary care systems in the National Health Service (NHS) and their applicability to low and middle income countries with high health standards, like Sri Lanka.

Nadeeka graduated as a medical doctor (MBBS with honours) from the Faculty of Medicine, University of Colombo in 2006. She gained her Master’s (MSc) in Community Medicine from the Postgraduate Institute of Medicine (PGIM) of the University of Colombo in 2011. She also completed a Master’s degree in Development Studies (MDS) at the Faculty of Graduate Studies, University of Colombo in 2013 and her MD in Community Medicine from the PGIM in 2016.

During her academic and professional career she has researched, published, trained and given invited presentations on a wide range of public health topics including child sexual abuse, premenstrual syndrome, gender-based violence, sexual harassment in workplaces, economic costs of tobacco and alcohol use, migrant health, child nutrition in communities and social health insurance for universal health coverage. She has won several national and academic awards and prizes for her publications.

sigiriya2Prior to joining our University, she worked as a Consultant to the World Health Organization where she was involved in preparing the WHO Country Cooperation Strategy for Sri Lanka and provided technical support to several activities including health financing for Universal Health Coverage.

She has also worked as a Consultant to UNICEF, and is an External Lecturer for the Department of Health Promotion, Rajarata University of Sri Lanka. She is also a member of the Expert Committee on Alcohol, Tobacco and Illicit Drugs and was the Secretary of the Expert Committee on Women’s Health of the Sri Lanka Medical Association.

At the Ministry of Health Nadeeka has worked in several capacities including as the Medical Officer of Health (MOH) in the most populated area in the country. She worked as a Senior Registrar in Community Medicine at the Gender and Women’s Health Unit, Family Health Bureau, Ministry of Health and a Registrar at the Department of Community Medicine, Faculty of Medicine of the University of Colombo.

 

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Ravindra Pathirathna, international research fellow from Sri Lanka joins CaHRU

RavindraPathirathneDr. Ravindra Pathirathna joined the School of Health and Social Care and CaHRU in March 2017 as its first visiting international research fellow. Ravindra graduated in medicine from the University of Peradeniya and then completed postgraduate studies at the University of Colombo, Sri Lanka, in the field of medical administration where he gained his master’s and MD.

He has worked for 14 years as a medical officer in emergency medicine, health system manager and health care researcher. As a health system manager he developed experience in various fields of hospital and public health programme management. He worked as a hospital director in many secondary and tertiary care hospitals in Sri Lanka and worked as deputy provincial director of the health department in the central province of Sri Lanka. His main interests are in operational management, system development and quality improvement in health care.

gaullesunsetRavindra has published several research papers, for example in the Journal of Medical Administration in Sri Lanka, mainly in the area of health systems. These include: a study testing a new model of evaluation of health policy; interventional research using total quality principles and systems theory in inter-hospital patient transports; and workload assessment in health care administrative staff. He has also published in the fields of: cost evaluation of healthcare training; managerial approaches to waiting time reduction in clinical settings; interventions to improve clinical facility management; an epidemiological study on dengue in different climatic conditions and an evaluation of care in older people. He is a member of several academic associations in Sri Lanka including the College of Medical Administration of Sri Lanka.

During his visiting fellowship he will be studying the prehospital emergency system in the UK, mainly focusing on policy and operational background, ambulance service quality and clinical performance improvement. His main objective is to identify and develop an appropriate prehospital care model for a developing country such as Sri Lanka.

By Dr Ravindra Pathirathna