The objective of this study conducted by the Ministry of Healthcare and Nutrition is to assess the service of public hospitals in Sri Lanka based on the three aspects: quality, efficiency and equity. The three hospitals in the study were Anuradhapura, Hambantota and Nuwara Eliya, and the majority of service receivers are of the lowest stratum of society. Quality was assessed on the views of the service receivers/ providers and was judged to be well below average. Efficiency was based on operational cost of provision of services and direct cost of receiving services. There was also found to be discrimination due to language barrier (mainly for the Tamil speaking community in NE) and lack of personal relationship to staff. The study developed some policy options such as developing methods to improve the attitudes of the staff, reduce waiting time for patients, devise a mechanism to avoid drug shortages and conduct clinics at peripheral locations to improve accessibility.

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