Since the early 1970’s, the provision of maternal and child health services received greater emphasis in the overall health delivery system. This led to a more concerted effort to strengthen the health infrastructure to provide an efficient and effective family health service through out the country.

Health is one of the devolved subjects and family health services are being provided in coordination with central and the provincial health authorities.

At national level, the Family Health Bureau is the central organization of the Ministry of Health responsible for planning, coordination, monitoring and evaluation of maternal and child health and family planning programmes within the country.

At Provincial level, Provincial Director of Health Services (PDHS) is the departmental head and is assisted by Regional Directors of Health Services (RDHS) who are the regional (district) heads of department in each of the districts. The RDHS is supported by a team of technical officers and others. The technical team includes Medical Officer / Maternal & Child Health (MOMCH), Regional Epidemiologist (RE),

Supervising Public Health inspector, Divisional (SPHID), Regional Supervising Public Health Nursing Officer (RSPHNO), Health Education Officer 1-3 (HEO), Regional Dental Surgeon (RDS), Statistical Survey Officer (SSO) and Programme Planning Officers (PPO). MO (MCH) is responsible for planning and monitoring the MCH care and services.

Within a region (district) services are provided through a network of medical institutions and Health Units. Medical Officer of Health area is the smallest Health unit which is managed by Medical Officer of Health (MOH) and each district comprises of seven to twenty Health Divisions (7-20).

The MOH is supported by a team of public health personnel comprising of Public Health Nursing Sisters (PHNS), Public Health Inspectors (PHI), Supervising Public Health Midwives (SPHM) and Public Health Midwives (PHMs).

The Public Health Midwife (PHM) is the “front line” health worker providing domiciliary care to mothers and children within the community. The PHM is given a well-demarcated area having a population ranging from about 2000 to 5000. Through systematic home visiting, she provides care to pregnant women, newborns, infants and preschool children and offers family planning services within her area. She provides education and advice on health and health related activities and necessary counseling on family planning to potential clients. She also distributes contraceptives (orals and condoms) and regularly follows-up contraceptive users within her area. She also motivates women above 35 years to attend the area Well Woman Clinic and thereafter follows them in the field to ensure that the instructions are carried out by the individual clients. In addition to her domiciliary care, she also participates in the area clinics linking the community with the health care system.

This system had been well developed and effective in delivering preventive and promotive maternal and child health services to the population and had been highly spoken of as a model for other developing countries.

 
 
 
 

 
 

Goal

Ensure care during pregnancy, delivery and post partum period.
Programme Objectives
 
1. Provision of comprehensive pre-pregnancy care.
2. Provide quality domiciliary and institution based maternal care.
3. Improve nutritional status of pregnant and post partum women.
4. Ensure skilled attendance at delivery in an enabling environment.
5. Provision of EmOC services based on recommended norms .
6. Improve the quality of domiciliary post natal care.
7. Implementing of a surveillance system for antenatal and postnatal morbidity.
8. Coordinate and monitor the maternal death surveillance system.
9. Assist the Ministry of Health for development of policies on maternal care.
10. Designing to strategies to improve maternal care in the country.
11. Introduction to guidelines / protocols on maternal care services protocols.
   
 
 

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Goal

Maintain better standard of care provided to the new born, particularly during the neonatal period.
  Programme Objectives
 
1. Assist the Ministry of Health for development of policies on neonatal care.
2. Designing of strategies to improve neonatal care in the country.
3. Introduction of guidelines/protocols on neonatal care services and management protocols.
4. Protection and promotion of breastfeeding practices in the country.
5. Implementation and monitoring of Baby Friendly Hospital Initiative (BFHI)
6. Coordination of activities on Sri Lanka Code on Marketing of Breastmilk Substitutes.
7. Monitoring and evaluation of neonatal health and neonatal care services in the country.  
8. Surveillance on perinatal morbidity and mortality.  
9. Provision of expert opinion on issues related to neonatal care.  
10. Production of IEC material to promote neonatal health.  
11. Adaptation and organisation of training programmes related to neonatal care at national level to improve neonatal care services and ensure it is implementing at provincial level.  
12. Procurement of essential newborn care equipment from international donor agencies and allocation to deserving institutions to improve quality of neonatal care services.  
13. Coordination with all the stakeholders regarding activities on newborn care.  
     
 

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Goal

Enable children to survive and reach their full potential for growth and development, incorporating physical,
  cognitive and psychosocial aspects.
 
Programme Objectives
1. Provision of quality services, both domiciliary and at clinics, to all infants and children.
2. Ensure Age appropriate immunization of all infants and children.
3. Standard treatment for common childhood illnesses for infants and preschool children.
4. Establish a surveillance system on morbidity and mortality among infants and preschool children.
5. Promote appropriate infant and young child feeding practices.
6. Strengthen growth monitoring and promotion, with a special focus on vulnerable infants and children, providing food supplements where necessary.
7. Implement interventions to optimize psychosocial development for children.
   
 

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Goal

To ensure that children are healthy, capable of promoting their own health and health of the family & community,
  and are able to optimally benefit from educational opportunities provided.
 
Programme Objectives
1. To strengthen the partnership between health & education sectors for promotion of the health of the school child.
2. To identify the range of needs of the school children for optimal development.
3. To provide appropriate health promotional activities to enable children to have control over and promote their own health.
4. To empower school children to act as change agents to improve health within the family & community.
5. To promote, healthful & safe school environment, that would facilitate learning.
6. To protect children, from communicable diseases including vaccine preventable diseases.
7. To screen school children for early detection & correction of health problems.
8. To improve nutritional status of school children by continuous monitoring and appropriate intervention.
9. To enhance community participation for the promotion of school health activities.
10. To provide a system of monitoring and evaluation to assess the effectiveness of the school health programme.
 

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Goal

Enable marginalized children and those with special needs to optimally develop their mental, physical and
  social capacities to function as productive members of society.
 
Programme Objectives

1. Implement programs to address the health needs of marginalized children and those with special needs.
2. Establish a multi-sectoral mechanism to identify and review existing programs aimed at providing services to these.
3. Build the capacities of all categories of health workers regarding their roles in implementing the programs for marginalized children and those with special needs.
     
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Goal

Improve the health and well being of adolescents.
 
Programme Objectives
1. Promotion of life skills of adolescents
2. Establish adolescent friendly health services in the country.
3. Capacity building of health staff on promotion of adolescent health.
4. Establish a well structured network of stakeholders at different levels to coordinate adolescent health programs.
5. Improve parenting skills to make a positive impact on adolescent health.
6. Promote healthy lifestyles which includes diet and physical activity, and address substance use, STIs and HIV/AIDS.
   
 

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Goal

Address family planning needs of potential clients and acceptors and offer counseling and guidance regarding
  services to sub-fertile couples.
 
Programme Objectives
1. Ensure the availability and accessibility of quality FP services.
2. Ensure availability of sterilization services.
3. Address the unmet needs of FP in the community.
4. Strengthen the contraceptive logistics management Information System (LMIS) and ensure Reproductive Health Commodity Security (RHCS).
5. Provide family planning counseling and services to those for whom pregnancy is medically contraindicated. 6. Provide post-abortion counseling and services.
   

 

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Goal

Address the special health needs of women, especially the early detection of diseases, and the relevant health
  needs of migrant women and their families.
   
Programme Objectives
1. Establish quality Well woman clinic services in all parts of the country.
2. Strengthen the specialized services in hospitals for management of patients with health problems detected in WWCs.
3. Strengthen cervical cancer screening services at institutional laboratories.
4. Establish a collaborative system for the benefit of families of migrant workers.
5. Address the MCH-related needs of the migrant workers and their families.
   
 

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Goal

Create an environment that is conducive to the achievement of gender equality and equity.
   
Programme Objectives

1. Develop a mechanism to improve MCH-related gender equity and equality.
2. Ensure gender main streaming in basic and in service training of health staff.
3. Sensitize health workers in curative and preventive sectors regarding their role in achieving gender equity and equality and build their capacities accordingly.
   
   
   
   
   
   
   
   

 

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Goal

Ensure the timely availability of information and the evidence needed for policy formulation and for the
  implementation, monitoring and evaluation of MCH programs.
 
Programme Objectives
 
1. Update and review the implementation of the MCH information system periodically.
2. Ensure the utilization of the MCH information generated at all levels and timely feed back reports on MCH/FP.
3. Generate the evidence base needed for policy formulation and improved program management in relation to MCH.
4. Improve the existing hospital information system for maternal and newborn care.
   
 

Goal

Promote oral health in children and mothers and thereby the family as an important part of an overall MCH care programme achieving sustained oral health improvements and quality of life.
 
 
Programme Objectives
1. Develop and integrate new oral health programmes with relevant components ( Maternal Health, Child Health, School Health and Women's Health programmes ) of the existing programmes of the FHB.
 
2. Strengthening oral healthcare delivery by improving the resources and technical expertise.
3. Strengthening oral healthcare delivery by improving information system, monitoring and evaluation.
4. Improving partnering with other government and non governmental agencies.
5. Develop and implement suitable oral health programmes for eligible couples and pregnant mothers through the Community Dental Services to target specific issue such as prevention of transmission of oral flora from mother to the child to reduce dental caries and reduce adverse pregnancy outcomes related to Periodontal Disease.
6. Production of suitable IEC material for Community Dental Surgeons and other Primary Healthcare staff for oral health promotion and incorporate them in the MCH package.
7. Oral health promotion of expectant mothers and children and the family.
8. Encourage research on oral health.
 
 

   
 
 
 

 
     
   
The Reproductive Health Centre situated at the Family Health Bureau now provides you with an information service on Family planning, subfertility, screening for cervical cancer and other related reproductive health services. Any ealth care provider including doctors, nurses, public health sisters and midwifes can obtain information (Monday to Friday between 9 am & 4 pm) from;
     
    ♦ Help line - 0113040541
♦ Email - fhbrhcentre@yahoo.com
♦ Information desk at the centre
     
   
Information provided will include;
1. Suitability of clients for different methods of family planning.
2. Commencement of family planning methods.
3. Management of side effects and complications.
4. Primary & secondary level care of sub fertile couples.
5. Details about cervical cancer screening (Pap smear) technique.
6. Follow up & management of abnormal cervical smear
7. Details about services provided at the RHC
     
   

Service

Day

Time of Attendance

Male & Female sterilization

Mondays, Tuesdays, Thursdays & Fridays

8.00 a.m.

Well women clinic

Tuesdays

1.30 p.m.

Sub fertility clinic

Wednesdays

8.00 a.m.

Family Planning Implant clinic

Wednesdays

1.00 p.m.

DMPA injections, IUD Insertions

Mondays, Tuesdays, Thursdays & Fridays

1.30 a.m.

OCP & Condoms

Mondays, Tuesdays, Thursdays & Fridays

8.30 a.m. to 4.00 p.m.