Ramanayake R P Janaka C, Perera Dinusha P, Jayasinghe J A Piyumi H, Munasinghe M M Erandi M, de Soyza E C Eric S, Jayawardana M A Vindya S
Department of Family Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
J Family Med Prim Care. 2022 Nov;11(11):6830-6836. doi: 10.4103/jfmpc.jfmpc_789_22. Epub 2022 Dec 16.
In the background of a rising burden of non-communicable disease (NCD) Sri Lanka has prioritised reorganising primary care based on a family medicine approach.
This study explored the integration of a relatively new specialist family physician (SFP) role into the state public health sector of Sri Lanka. Methods: In-depth qualitative interviews were conducted with 11 SFPs attached to the Ministry of Health. Data were analysed using inductive thematic analysis.
SFPs had faced initial challenges related to recognition and collaboration within the state health sector. They provided comprehensive primary care in a variety of roles; most importantly in care of NCD and elderly care, and focused on professional development of medical officers and support staff in the settings where they worked. Challenges were insufficient laboratory facilities, medication availability, primary care trained manpower and linkages with secondary care. These barriers hindered the ability of the SFPs to provide a full range of family practice-oriented health services.
SFPs have integrated well into the public health sector of Sri Lanka providing comprehensive primary care services. The findings identify areas that need strengthening to further improve primary care services in the country and operationalise proposed new primary care service models.
在非传染性疾病（NCD）负担不断加重的背景下，斯里兰卡已将基于家庭医学方法重组初级保健作为优先事项。
本研究探讨了相对较新的专科家庭医生（SFP）角色融入斯里兰卡国家公共卫生部门的情况。方法：对隶属于卫生部的11名专科家庭医生进行了深入的定性访谈。使用归纳主题分析法对数据进行了分析。
专科家庭医生在国家卫生部门面临着与认可和协作相关的初步挑战。他们以多种角色提供全面的初级保健；最重要的是在非传染性疾病护理和老年护理方面，并专注于其工作场所医务人员和辅助人员的专业发展。挑战包括实验室设施不足、药品供应、接受过初级保健培训的人力以及与二级保健的联系。这些障碍阻碍了专科家庭医生提供全方位以家庭医疗为导向的健康服务的能力。
专科家庭医生已很好地融入斯里兰卡公共卫生部门，提供全面的初级保健服务。研究结果确定了该国需要加强的领域，以进一步改善初级保健服务并实施提议的新初级保健服务模式。
