MP Dissanayake misdiagnoses the quality of SL’s health services

Fact Check

To check the MP’s claim, FactCheck.lk consulted Health at a Glance: Asia/Pacific by Organisation for Economic Co-operation and Development (OECD) and World Health Organisation (WHO) 2022 report (See Additional Note 1) and the Global Health Security (GHS) Index developed by the Nuclear Threat Initiative (NTI) and Johns Hopkins Center for Health Security (See Additional Note 2).

The Health at a Glance (HG) report only looks at 5 South Asian countries and leaves out 3 (Bhutan, Maldives and Afghanistan). While it does not provide an overall rank, it evaluates 19 indicators under 4 categories. In terms of ‘Health status’ and ‘Health care resources’, Sri Lanka claims the top position in all indicators. Yet, within the ‘Quality of care’ category, Sri Lanka ranks first in just 1 out of 4 indicators, and in the ‘Risk factors’ category, it secures the top spot in 2 out of 5 indicators (See Exhibit 1).

GHS Index is the only evaluation that could be found for which data is available across all the South Asian countries and provides an overall rank. It assesses health security across 195 countries in 6 categories on 37 indicators.

In the latest 2021 report, the GHS Index ranks Sri Lanka 4^th among South Asian countries, just 0.1 point more than Nepal which is 5^th (See Exhibit 2).  Sri Lanka’s overall global rank was 105 (See Exhibit 2).

On the GHS subindexes, Sri Lanka ranks number one among South Asian peers only in ‘Risk Environment’. It has the lowest rank in South Asia in terms of the ‘Health System’; and ranks in the bottom half in ‘Prevention’, ‘Compliance with International Norms’, and ‘Rapid Response’. This means, Sri Lanka is in the bottom half on 4 of the 6 indicators (See Exhibit 3).

The only health sector evaluation available among all South Asian countries ranks Sri Lanka in the 4^th position. However, for a subset of South Asian countries, there is another evaluation in which Sri Lanka has the most number 1 rankings.

Given these findings, we classify the MP’s statement as PARTLY TRUE.

*FactCheck.lk’s verdict is based on the most recent information that is publicly accessible. As with every fact check, if new information becomes available, FactCheck.lk will revisit the assessment.

Additional Note 1:

Organisation for Economic Co-operation and Development (OECD) and World Health Organisation (WHO) look at four categories:

1. Health status – life expectancy at birth for females and males, survival to age 65 for females and males and mortality rate under age 5.
2. Risk factors for health – Daily tobacco use age 15+ for females and males, access to basic sanitation and drinking water in rural areas, and overweight rate of children under age 5.
3. Quality of care – Breast and cervical cancer mortality rates, and child vaccination coverage for DTP3 and 1st dose of measles.
4. Health care resources – Per capita health spending, out-of-pocket costs, doctors, nurses, and hospital beds per 1,000 people.

Additional Note 2:

GHS Index is the only index that could be found for which data is available across all the South Asian countries and looks at six categories:

1. Prevention: Prevention of the emergence or release of pathogens
2. Detection and reporting: Early detection and reporting for epidemics of potential international concern
3. Rapid response: Rapid response to and mitigation of the spread of an epidemic
4. Health system: Sufficient and robust health system to treat the sick and protect health workers.
5. Compliance with international norms: Commitments to improving national capacity, financing plans to address gaps
6. Risk environment: Overall risk environment and country vulnerability to biological threats.

Exhibit 1 – HG indicators

Exhibit 2 – GHS Index comparison with South Asian Countries for 2021

Exhibit 3 – GHS Index subindexes score comparison with South Asian Countries for 2021