Abstract :

Introduction: The government of Sri Lanka identifies health laboratory service as an essential component in the health care service and is committed to providing quality essential laboratory services to healthcare seekers. Ministry of Health, Sri Lanka is responsible for the establishment and enactment of relevant legislation, and for providing technical and managerial guidelines for the maintenance of laboratories which comply with nationally and internationally accepted standards. Epidemiological and demographic transitions in Sri Lanka have compelled it to focus its attention to combat noncommunicable diseases, which are accounting for an estimated 80% of the annual deaths in the country. Improvement of diagnostics was identified as a priority in Health Master Plan 2016-2025 and by Primary Health Care System Strengthening Project.

Methodology and results: Qualitative methods such as key informant interviews, attending meetings and desk reviews were used to collect the factors affecting the expansion of laboratory services and the most crucial factors were identified by using the 80:20 rule. Issues related to the implementation of the National Laboratory Policy, laboratory financing, human resource issues, accreditation, and lack of making sense of data were found to be the most crucial factors that need to be addressed strategically to successfully expand laboratory services across healthcare institutions.

Conclusions: It is essential to improve the competencies and capabilities of the Policy Analysis and Development Unit of the Ministry of Health to facilitate policy analysis, reviews, and preparation of groundwork for National Policy enactment. Lack of accredited health laboratories and a plan to accredit may reflect adversely on the technical competence. Widespread unavailability and compartmentalization of information management systems have led to underutilization of laboratory-related data and this has resulted in a lack of a viable plan for evidence-based laboratory finance allocation and human resource development.

---

Keywords :

Expansion, Factors., Laboratory Services, Sri Lanka.

---

References :

1. World Health Organization. (2019, December 10). WHO congratulates Sri Lanka for eliminating mother-to-child transmission of HIV, Syphilis. World Health Organization. Retrieved January 26, 2023, from https://www.who.int/southeastasia/news/detail/10-12-2019-who-congratulates-sri-lanka-for-eliminating-mother-to-child-transmission-of-hiv-syphilis
2. World Health Organization. (2020, February 11). Who country office Sri Lanka launches a Model Health Corner. World Health Organization. Retrieved January 26, 2023, from https://www.who.int/srilanka/news/detail/11-02-2020-who-country-office-sri-lanka-launches-a-model-health-corner
3. Ministry of Health Sri Lanka. (2016). National Health Strategic Master Plan 2016 – 2025 vol. IV. World Health Organization. Retrieved January 26, 2023, from

https://extranet.who.int/countryplanningcycles/sites/default/files/planning_cycle_repository/sri_lanka/health_admin_-_hrh.pdf

4. Reorganizing Primary Health Care in Sri Lanka. (2019). Retrieved 2 November 2019, from

http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/2018/ReorgPrimaryHealthCare.pdf

5. Bernabé-Ortiz, A., Zafra-Tanaka, J., Moscoso-Porras, M., Sampath, R., Vetter, B., Miranda, J., & Beran, D. (2021, March 09). Diagnostics and monitoring tools for noncommunicable diseases: A missing component in the global response – globalization and health. Retrieved December 5, 2022, from

https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00676-6

6. Policy implementation (2021) Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/policy/polaris/policyprocess/implementation/index.html (Accessed: December 14, 2022).
7. Wright, A. (2017) What’s so important about health policy implementation? Scottish Parliament Reports. Available at: https://digitalpublications.parliament.scot/ResearchBriefings/Report/2017/9/7/What-s-so-important-about-health-policy-implementation – (Accessed: December 14, 2022).
8. Strategic Framework for Strengthening Health Laboratory Services 2016–2020 (1970) World Health Organization. World Health Organization. Available at: https://apps.who.int/iris/handle/10665/254902 (Accessed: December 14, 2022).
9. Thekkur P;Fernando M;Nair D;Kumar AMV;Satyanarayana S;Chandraratne N;Chandrasiri A;Attygalle DE;Higashi H;Bandara J;Berger SD;Harries AD; (2022, November 10). Primary health care system strengthening project in Sri Lanka: Status and challenges with human resources, Information Systems, drugs, and laboratory services. Healthcare (Basel, Switzerland). Retrieved January 12, 2023, from https://pubmed.ncbi.nlm.nih.gov/36360593/
10. Ministry of Health, Sri Lanka. (2022). National Health Accounts Sri Lanka 2017 & 2018. www.health.gov.lk. Retrieved January 12, 2023, from https://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/2022/National%20Health%20Accounts%20Sri%20Lanka-%20Final%20version%20-%2023.06.2022.pdf

11. Kohn, L. T., Donaldson, M. S., & Corrigan, J. M. (2000). To err is human: Building a safer health system. National Center for Biotechnology Information. Retrieved January 29, 2023, from https://pubmed.ncbi.nlm.nih.gov/25077248/
12. Accredited organizations. Sri Lanka Accreditation Board. (n.d.). Retrieved January 29, 2023, from https://www.slab.lk/accredited-organizations/business-category/medical-laboratories/
13. Rajapaksa, Lalini, Silva, Padmal de, Abeykoon, Palitha, Somatunga, Lakshmi, Sathasivam, Sridharan. et al. (‎2021)‎. Sri Lanka health system review. Health Systems in Transition, 10 (‎1)‎, World Health Organization. Regional Office for South-East Asia. https://apps.who.int/iris/handle/10665/342323 . License: CC BY-NC-SA 3.0 IGO
14. Policy and plan for Chemical Pathology Laboratories in Sri Lanka. (2020). Retrieved January 28, 2023, from  https://ccpsrilanka.com/draft/WEBUPDATES/publications/1645255853National%20Medical%20Laboratory%20Policy%20and%20Plan%20in%20ed%2014%20Oct%20.pdf