Mallawaarachchi D S Virginie, Wickremasinghe Shiranee C, Somatunga Lakshmi C, Siriwardena Vithanage Tsk, Gunawardena Nalika S
Ministry of Health, Nutrition and Indigenous Medicine, Colombo, Sri Lanka.
World Health Organization Country Office, Colombo, Sri Lanka.
WHO South East Asia J Public Health. 2016 Sep;5(2):89-95. doi: 10.4103/2224-3151.206258.
The Ministry of Health in Sri Lanka initiated the Healthy Lifestyle Centres (HLCs) in 2011, to address the lack of a structured noncommunicable disease (NCD) screening service through the lowest level of primary health-care institutions. The main service objective of the HLCs is to reduce the risk of NCDs of 40-65 year olds by detecting risk factors early and improving access to specialized care for those with a higher risk of cardiovascular disease (CVD). The screened clients are managed at HLCs, based on the total-risk approach to assess their 10-year CVD risk, using the World Health Organization/International Society of Hypertension risk-prediction chart. Those with a 10-year CVD risk of more than 30% are referred to the specialized medical clinics, while others are managed with lifestyle modification and are requested to visit the HLC for rescreening, based on the levels of CVD risk and intermediate risk factors. Identified challenges to date include: underutilization of services, especially by men; weak staff adherence to protocols; lack of integration into pre-existing NCD-screening services; non-inclusion of screening for all the major NCDs; and human resources. The government plans to address these challenges as a priority, within the context of the National multisectoral action plan for the prevention and control of NCDs in Sri Lanka 2016-2020. Key interventions include: extended opening hours for HLCs, outreach activities in workplaces, and integration with "well woman clinics". Costs related to actions have been realistically estimated. Some actions have already been initiated, while others are being designed with identified funds.
斯里兰卡卫生部于2011年启动了健康生活方式中心（HLCs），旨在通过基层初级卫生保健机构提供结构化的非传染性疾病（NCD）筛查服务。健康生活方式中心的主要服务目标是通过早期发现风险因素并改善心血管疾病（CVD）高风险人群获得专科护理的机会，降低40至65岁人群患非传染性疾病的风险。根据总体风险评估方法，利用世界卫生组织/国际高血压学会风险预测图表，在健康生活方式中心对筛查出的客户进行管理，评估他们10年心血管疾病风险。10年心血管疾病风险超过30%的人群被转诊至专科医疗诊所，而其他人群则通过改变生活方式进行管理，并根据心血管疾病风险水平和中间风险因素被要求前往健康生活方式中心进行复查。迄今为止发现的挑战包括：服务利用不足，尤其是男性；工作人员对协议的遵守不力；缺乏与现有非传染性疾病筛查服务的整合；未涵盖所有主要非传染性疾病的筛查；以及人力资源问题。政府计划在《2016 - 2020年斯里兰卡国家非传染性疾病预防和控制多部门行动计划》背景下，将解决这些挑战作为优先事项。关键干预措施包括：延长健康生活方式中心的开放时间、在工作场所开展外展活动以及与“女性健康诊所”整合。已对相关行动成本进行了实际估算。一些行动已经启动，而其他行动正在利用已确定的资金进行规划。
