Health Care Service Provision to Leprosy Patients in Western Province, Sri Lanka

Abstract

Introduction: Both the curative and preventive sectors of the health system provide services to leprosy patients in Sri Lanka. Identification of the needs and gaps of service delivery would help to redesign the leprosy control activities in the country. Objectives:To assess healthcare service provision to adult leprosy patients in Western Province Methods: A descriptive cross-sectional study was conducted in 12 hospital dermatology clinics and 22 medical officer of health (MOH) offices in the Western Province. The sample was selected through a stratified random sampling method. A pretested checklist was used as the study instrument. Data were gathered by observations, interviewing hospital and MOH office staff.Results: Overall service provision was satisfactory in all selected hospitals. All the hospitals' scores were above 75% indicating an overall satisfactory service provision in all categories of hospitals in the province. However, many deficiencies were identified in the service provision in individual hospitals in selected areas. In 2017, Colombo District had the highest number of leprosy cases (n=157). Case distribution in Western Province showed that Moratuwa (n=88), Negombo (n=31) and Beruwala (n=43) MOH areas had the highest number of cases in the Colombo, Gampaha and Kalutara Districts, respectively. Considering the maintenance of the registers and records of the 22 MOH offices surveyed, most (n=15; 68.2%) of the areas satisfactorily maintained their records. Contact tracing and health education were the main deficiencies identified.Conclusions & Recommendations: Service provision was satisfactory in dermatology clinics. Unsatisfactory record-keeping in some MOH areas was found, while delay in case investigations, poor health education and contact tracing coverage were found in many MOH areas. MOH areas with poor performances should be closely monitored by the supervising officers to ensure the quality of service provision.