The preventive care in Sri Lanka considerably depends on the grass root level of public health carried out by Public Health Midwives and Public Health Inspectors (PHMM & PHII) who are working under Medical Officers of Health (MOH) working across the country. In spite of major changes in the economic policies, the government of Sri Lanka continued to provide a health service to the population, free of charge and training of all health personnel required for the services in the state sector has been under the free education system. The health system in Sri Lanka consists of public and private health care services. Public services are the responsibility of the central Ministry of Health and nine Provincial Councils. Major municipalities also provide services of a limited nature. The public sector delivers both inpatient and outpatient services through an island-wide network of facilities. Private health care services largely consist of ambulatory services provided by full-time private practitioners, government medical staff working privately and pharmacies. There is a small, but growing, private hospital sector. The plantation estates have historically run their own facilities for their employees, but very recently it has been decided to incorporate them into the Ministry of health system. Sri Lankan health system is enriched with a primary health care delivery system which was established about 75 years back. Over the past three decades, in parallel to the government administrative system, the health administrative system had been developed. Currently Sri Lanka enjoys a widely spread preventive health care facilities delivered by grass root level Primary Health Care workers administered by the Medical Officer of Health . The MOH system had been in existence for several decades. A health unit is the smallest administrative unit which is called division or the ‘MOH area’ that could be described as a defined geographical area, hence with a defined population, under a Medical Officer of Health (MOH). The MOH is responsible for the delivery of preventive health services in the area. MOH unit is the patients’ first contact with health care system. It works as a hub from which patients are guided through the health system. It is the place where relationships between health care workers and patients develop. Health promotion and disease prevention also done through MOH. Several categories of health workers work as a team with the MOH, namely the Public Health Nurse (PHN), Public Health Inspector (PHI) and Public Health Midwife (PHM). The Maternal and Child Health services were to be provided at domiciliary level and at clinics established at ‘health centres’ (field level service outlets), within the health unit area. The PHM was responsible for antenatal, natal and postnatal services. Central Dispensary, Madiwela provide outpatient care including the provision of basic health facilities for the treatment of minor ailments, referral to secondary and tertiary care institutions for further treatment, provision of perinatal care and follow up of patients referred from secondary or tertiary care institutions.
