The Health System Enhancement Project (HSEP) is a primary health care serve development project financed by ADB. The value of the project is USD 60 million comprising USD 37.5 million in concessionary loan, USD 12.5 million grant and USD 10 million as counterpart contribution from the Government of Sri Lanka . The project is delivered through a project investment modality and is effective from 05th February 2019 and will be closed on November 2023. The project will be implemented in all nine districts of Central, North Central, Uva and Sabaragamuwa Provinces.
The proposed project will improve efficiency, equity, and responsiveness of the primary health care (PHC) system based on the concept of providing universal health coverage and continuum of care to quality essential health services.
The project pursues an equity perspective in planning and delivering of essential primary health services. It expects to further inform and operationalize government PHC reform initiatives to reduce bypassing of PHC facilities by providing more comprehensive services, including for NCDs, develop a referral system, and functionally integrating preventive and curative services. Furthermore, the project will target underserved communities’ access to PHC, and address selected gaps in core public health surveillance in line with the international health regulations (IHR).
The project is targeting all nine districts in four provinces of Central, North Central, Sabaragamuwa, and Uva with a special focus on the geographically, socially, and economicallydeprived populations. The beneficiary population of the project is approximately 7 million which is 33% of the Sri Lanka population (21 million) while the target population within the four provinces, is estimated to be approximately 2.4 million.
Impact and Outcome
The expected project impact is to contribute to the Government development objective1 of ensuring a healthier nation with a more comprehensive PHC system. The project outcome is to improve efficiency, equity, and responsiveness of the PHC system.
Key indicators for monitoring
The project outcomes are assessed by observing a
(i) 20% increase in outpatient utilization at PHC.
(ii) 20% increase in patient satisfaction, knowledge and attitudes on utilization.
(iii) 90% of notified notifiable diseases investigated within the stipulated time in the medical officer of health areas in the target provinces.
(iv) cluster system reform implemented and evaluated in all nine clusters.