Positive Outlier: Sri Lanka's Health Outcomes over Time

This case describes the development and structure of Sri Lanka’s health system and highlights factors that have led to positive health outcomes, including the availability of free health services to all citizens, government investment in the health workforce, and the care-seeking behavior of Sri Lankan citizens. After providing an overview of Sri Lanka’s history, geography, demographics, and economy, the case traces the evolution of the public sector health system and describes the relationship between the national health ministry and provincial and local governments. It examines how health professionals are trained and deployed throughout the system, the supply chain, and financing, as well as the growing private health sector, its relationship with the public sector, and the role of innovation.

Learning Objectives: This case will allow readers to appreciate (1) the capabilities of a public payer system to improve the health of the population; (2) the influence of the private sector in a “single payer system” and the downstream effects on demand and supply of services; (3) the return on investment for a country offering free public medical and nursing education; and (4) the relationship between literacy, demand generation, and health outcomes.

The Global Health Delivery (GHD) Project, an interdisciplinary collaboration between Harvard Business School, Harvard Medical School, and Brigham and Women’s Hospital, investigates the management decisions behind disease treatment and prevention globally. The Global Health Delivery (GHD) Case Collection is a set of teaching case studies that are available for all at no cost online through Harvard Business Publishing, GHDonline, and The Case Centre.