The resurgence of tuberculosis globally, and its association with HIV and the emergence of multi-drug resistant TB has made tuberculosis a communicable disease of high priority. Respiratory Disease control unit of Kalmunai RDHS region is attached to the Base Hospital Sammanthurai. Respiratory Disease control unit is functioning separately, while inward patient care located at all base Hospitals of the region. All these units are functions under purview of the consultants general physicians with the support of chest physicians.
Early case detection and management, partner notification, contact tracing, health education, counseling, condom promotion, surveillance and dissemination of information are the major strategies adopted by the National Sexually Transmitted Diseases/ AIDS Control Programme (NSACP), for the prevention and control of STI and HIV/AIDS. Main clinic of Kalmunai RDHS region is situated at the premises of the base Hospital clinics and are coordinated by MO/STD at RDHS premises.
Rabies control measures were launched in Sri Lanka in 1975 and were decentralized to the Provinces in the early 90s. The Eastern Province initiated the streamlining of rabies control activities in 1998 through the formation of dog vaccination teams and destruction teams. Kalmunai region has joined this drive with the formation of a separate RDHS region for Kalmunai since 2000.
During mid 2006 the Ministry of Healthcare and Nutrition revised the strategy to be more humane towards dogs by promoting dog birth control measures instead of destruction of stray dog population. The region has already implemented this change of strategy in the Provincial strategy. There is a dog vaccination team in the region with one more for the Ampara region. Dog sterilization programmes are conducted with the support of qualified veterinary teams.
Malaria was more prevalent and an important public health problem in the entire Eastern Province of Sri Lanka for centuries. Thousands of malaria cases have been reported with periodic epidemics every 3-6 years prior to 1992. However, since 1992, the number of malaria cases in the Eastern Province including Kalmunai RDHS region shows a decreasing trend of malaria, only a few imported P. vivax cases were reported with no indigenous transmission of malaria in Kalmunai region. This is a significant achievement for the entire Province. Malaria control activities are coordinated by Regional Epidemiologist.
Some of the very important contributory factors for this success were:
- Institution of evidence based malaria control activities.
- Support given by the Provincial and Central government authorities.
- Implementation of Global Malaria control strategies in 1993.
- Institution of rotational and rational residual insecticide spraying based on the GN level stratification according to the risk of malaria transmission.
- Institution of integrated vector control measures using insecticide treated bed nets, use of larvicides, introduction of larvivorous fish and source reduction where ever applicable.
- Conducting Mobile clinics in remote areas and to cover migratory populations such as security camp, sand mining areas, development project sites and chena cultivation areas for early detection and prompt treatment of malaria cases in order to reduce the parasite reservoir in the human population.
- Investigation of cases and carrying out timely remedial measures including mass blood surreys and focal spraying.
- The improvement of the socio-economic status even in the rural communities.
The Anti malaria programme embarked into pre-elimination phase of malaria in Sri Lanka in early 2008. Within this concept, Kalmunai was placed as an area to maintain very low level transmission of malaria. Thus, the objective of the malaria control programme for Kalmunai region will be “to maintain zero level transmission of malaria in Kalmunai region”.
Major strategies of Mental Health Program
- Promotion of mental well being
- Prevention of suicide
- Prevention and control of substance use including alcohol
- Prevention of violence
- Strengthen infrastructure and human resources for mental health
- Monitoring and evaluation of the Mental Health Program
The Directorate of Mental Health is the National level focal point responsible for National Mental Health program within the Ministry of Health, Sri Lanka. The Directorate is responsible for policy development and strategic planning, co-ordination, supporting implementation, monitoring and evaluation of the Mental Health services in the country.
Mental health services are implemented in close collaboration with Sri Lanka College of Psychiatrists and relevant professional organizations, other related ministries and departments, non- governmental organizations, civil societies and consumer groups. At the country level, the services are delivered through provincial and district health system in which curative health institutions under the provincial and the central ministries play a major role.
The changes in policy and management followed in October 2005 when the Mental Health Policy of Sri Lanka 2005-2015 was approved. The main objectives of the policy were to provide mental health services of good quality at primary, secondary and tertiary levels; to ensure the active involvement of communities, families and service users; to make mental health services culturally appropriate and evidence based; and to protect the human rights and dignity of all people with mental health disorders.
The Ministry of Health is in the process of revising the Mental Health policy 2016-2025 as mental health promotion and services in Sri Lanka and has undergone significant changes. Mental Health is an integral part of health. Mental health problems are common, with one in four people worldwide experiencing mental health problems. Therefore, the need of addressing mental health issues in a new direction is timely.
The Health Promotion Bureau (HPB) is the center of excellence in Sri Lanka for health education, health promotion and publicity of health information. Empowering and mobilizing communities for the improvement of their quality of life through health promotion principles is the main achievement gained during the last few years.
Public awareness aiming for healthy behavior changes in the community through mass media is a unique service that has been providing for years by HPB and appraised by all sectors. In addition, HPB plays a vital role in public awareness about health promotion and healthy behavior changes by actively participating in mass scale health exhibitions, national campaign days, and community events. Various types of health education material have been produced to address emerging health issues such as Dengue, Leptospirosis, malnutrition and Non- Communicable diseases. Developing households and public places such as hospital, school, villages, work place etc. as health promotion settings is another successful program conducted by the HPB.
The ‘Suwasariya’ / Healthnet provides fast and simple expert advice in all three languages about any health issue and what to do next through telephone calls, e mails or Skype and is supported by a tri lingual web site which contains information on health. As a whole, HPB has been successful and has received recognition for its remarkable contribution to health promotion through integrated multidisciplinary approach. HPB is at present headed by the Director Health Education and Publicity. The Director is assisted by the Deputy Director, and a team of Consultant Community Physicians, Consultant in Community Dentistry, Medical Officers, Dental Surgeons, Chief Health Education Officer, Health Education Officer, Administrative and Supportive staff. Apart from undergraduate and postgraduate training, continuous in service training has been carried out for health care staff and other personal involved or interested in health promotion. Routinely, HPB provides technical consultation for advisory committees, workshops, research and surveys and is very often invited by other public organizations to share its expertise.
The Health Education services in the country dates back to the mid-twentieth century. In the initial stages it functioned as a small unit of the public health section of the Department of Health Services and consisted of two units. One at the Head Office manned by a sociologist designated as the Chief Health Education Officer, a Health Education Officer and two Publicity Officers. The other unit was the Health Education Material Production Unit (HEMPU) manned by a trained Public Health Inspector. The main focus was the prevention of common communicable diseases prevalent at the time such as malaria, worm infestations, diarrheal diseases and typhoid fever, through public meetings, distribution of public health material such as posters, leaflets and brochures. The newsletter “Sapatha” began its publications in the nineteen fifties and was useful to enhance the knowledge of health workers. The next important development was the establishment of District Level Units, where a Public Health Inspector, trained in Health Education and designated as a Health Educator was appointed as in charge of the Unit. They were responsible for the services in the district under the guidance of the Central Unit. Each district was provided with a vehicle fitted with audio/visual equipment such as projectors, loud speakers etc. While the major functions of the Health Education Officers (HEOs) continued to remain largely focused on information dissemination. They also assisted the field health staff in their health education activities by providing them with educational material and guidance in their use. The major re-organization of the services was in the mid-nineteen seventies with the appointment of a full time Medical Officer in the administrative grade with postgraduate qualifications majoring in Health Education as in charge of the Unit. The section at the Head Office was merged with the HEMPU to form a single organizational unit named as the Health Education Division of the Ministry of Health under the administrative purview of a Director who was later designated as Director Health Education and Publicity. Within the next few years with the support of the World Health Organization, there was rapid development of the organization into a fully fledged bureau on the lines similar to the Family Health Bureau. The staff at the Health Education Bureau (HEB) now consisted of a full time Director assisted by four Medical Officers, one Dental Surgeon, all with postgraduate qualifications in Health Education, five Health Education Officers with postgraduate Diplomas in Health Education and two Publicity Officers with postgraduate qualifications in charge of the mass media programme. The rising burden of Non Communicable Diseases and the threat of epidemics of Communicable Diseases identified the need to plan, implement, monitor and evaluate efficient health promotion strategies thereby leading to the upgrading of the HEB to the status of Health Promotion Bureau. Furthermore, twelve specialized Units have been established with a view to effectively implementing the strategies identified in the National Health Promotion Policy.