EDUCATION

For a long time training (both basic and in-service/continuing education) and research activities of the department of health were conducted by various units of the department. At the central level there was very little coordination among the various training programmes. Similarly various research activities were undertaken by different units of the department on an ad hoc basis and there was very little progress on documentation of research work.

Education activities pertaining to training programmes like curricula development, curricula revisions were not up to the expected levels. Hence a necessity arose to coordinate all educational, training and research work in one unit so that these three important areas could be well coordinated and further advances could be made.

Thus an Education, Training and Research Unit was created under a Deputy Director General of Health Services in the Department of Health in the year 1996.

(1) Is to develop and implement strategies to ensure availability of adequately trained health manpower to cater to the needs of the health care delivery services of Sri Lanka.

(2) Is to undertake and promote Health Systems research to improve the health care delivery services and thereby to improve the health status of the people of Sri Lanka.

Ensuring planned development of adequately trained health manpower for the improvement of health care delivery services and to undertake and promote Health Systems Research to achieve policy objectives, which leads to the improvement of health status of the people of Sri Lanka.

4.1 To develop/to revise all relevant educational materials required for all para-medical training programmes.

4.2 To plan, and to conduct all necessary para-medical training programmes so as to develop adequate by trained health manpower for the needs of the Health Care Services.

4.3 To coordinate and promote all health research activities carried out by the various Units of the Department of Health.

The primary role of this unit, is to plan, coordinate and monitor all aspects of education, training and research functions both locally and abroad with in the purview of Department of Health.

5.2.1 To coordinate the preparation of all educational and training plans for all relevant training programmes.

5.2.2 To monitor the norms and standards for curricula, teaching methods and teaching materials.

5.2.6 To improve all training institutions so as to meet the demands of the health care delivery system.

5.2.7 To coordinate with all relevant officials to improve management in education, training and research facilities for all categories of health personnel.

5.2.8 To establish linkages with universities, University Grants Commission, Postgraduate Institute of Medicine for effective functional coordination of medical and postgraduate training as well as for the establishment of higher levels of training for para-medical education.

5.2.9 To establish and implement continuing education/in service training for all categories of health personnel.

5.2.10 To plan, promote, monitor and implement health systems research activities.

5.2.12 To be responsible for overall supervision and administration of the education, training and research unit of the Department of Health and be answerable to the director general of health services in all its matters.

The Education, Training and Research Unit is headed by the Deputy Director General (Education, Training and Research). He is assisted by four directors. They are namely

The following basic training programmes in the para – medical education are currently in progress, and are being planned, implemented, coordinated and monitored by the E.T& R unit.

Table to show the para-medical training programmes their places of training and the duration of the programme, coordinated by the ET& R unit.

In keeping with the mission and objectives of the National Institute of Health Sciences(NIHS) , steps were taken to develop selected health manpower for the provision of health care, and to provide primary Health care services to a population of 262560 living within the field practice area.

Health manpower development for Primary Health Care programme being the main function of NIHS several basic and continuing education programmes were conducted during the year 2002. Basic training programmes conducted were indicated below.

Trainee Ward Sisters from the Post Basic School (PBS) of Nursing followed the community orientation-training programme for a period of four (04) weeks.

Teacher training programmes, Management training for Middle Level Supervisors of Health workers community orientation for Medical Officers of Health, Health systems research methodology are some of the important training programmes conducted for local participants. Unfortunately medical records officers (MRO) training was not done during 2002. As the specially trained officers who co-ordinated the ICD 10 training programme were not available at NIHS, since they were following the MSC Community medicine course at the Post Graduate Institute of Medicine (PGIM) this programme was not conducted in 2002.

For the very first time a training programme for one year was conducted at NIHS for a group of trainees community health workers from Maldives. Further another group of Moldavian students followed a two months training programme on Primary Health Care.

Though the medical care institutions were taken away from the administration of NIHS, still some laboratory services are provided by NIHS to General Hospital Kalutara.

In addition Base hospital, Panadura & Horana utilize the laboratory services of NIHS.

The food laboratory serves most parts of the country. Apart form the food laboratory situated in Anuradhapura, NIHS food laboratory is the focal point for food quality control and relevant activities.

Production of Health learning materials was given high priority during the year 2002 by the trainers. Several books were published. In addition PHI, SPHM & PHM curriculum revision was done.

The library and documentation centre of NIHS is well equipped and is a V member of the Hellis network too. Internet facility and facilities for med line search too is available in the library of NIHS.

During the year 2002, some officers of the training unit got the opportunity to further improve their knowledge and skills for conducting training on Health systems research methodology. They underwent training in Thailand.

As regards the provision of primary health care services special inputs were received from the donor agencies namely UNICEF, Hemas drugs etc. for strengthening physical facilities of the preschools in a selected DDHS area coming under NIHS administration. Positive end results have been clearly seen. Further Divisional Director Health Service area Beruwala which is one of the two DDHS areas constituting the field practice area of NIHS is one of the eleven DDHS areas selected by the Health Ministry to introduce the Early Child Care & Development Programme (ECCD) sponsored by UNICEF.

The evaluation and research unit initiated simple research studies on sports injuries and utilization of regional training centres etc.

Efforts of the Ministry of Health for development of a master plan through support from JICA and World Bank were assisted by active participation of selected officers from NIHS. A study was conducted to identify the opportunities given for in- service training to health care providers and also to determine the motivating factors for service delivery as a data collecting mechanism for JICA study.

The National Institute Sciences Field Practice area consists of 2 Divisional Directors of Health Services (DDHS) namely Beruwala and Kalutara and cater to a population of about 262560 and is responsible for provision of total health care for the residents. DDHSS are supported by a team of Primary Health Care (PHC) workers namely Public Health Nursing Sisters (PHNS), Public Health Inspectors (PHI), Supervising Public Health Midwife (SPHM), Public Health Midwives (PHM) & School Dental Therapists (SDT). Dental surgeons attached in government dental clinics.

PHMM are mainly responsible for providing Maternal & Child Care and Family Planning Services. PHil are mainly responsible for environmental sanitation, food safety, school health and control of communicable diseases. There is a group of Supervisors consisting of PHNSS, SPHM and SPHI attached to each DDHS office. Their main 'V responsibility is to supervise and provide guidance to PHMM and PHil and assist DDHS/MOH in preparing work plans, job performance reports and consolidation of data.

Dental Health Services are provided by community Dental Surgeons and School Dental Therapists. Those who need special care are referred to General Hospital, Kalutara.

DDFS is responsible for ensuring provision of primary health care services for the people who are residing in NIHS field practice area, as well as for the field-training component of all training activities, which NIHS has under taken. In order to perform this responsibility DDFS is supported by a team of supervisors namely SPHI (D), RSPHNO, RDS and Food & Drugs Inspector. (F & DI ).

Food and Drugs Inspector is responsible for issue of licences to pharmacies in NIHS field practice area, and checking available drugs with special reference to quality of drugs issued in keeping with the legislative procedures. In addition F & DI extends his assistance to training activities as well as for service provision.

Entire field staff attached to NIHS is responsible for assisting in providing field training for basic trainees and to those following continuing education programmes, as well as to local and international students groups and officials who come to observe the activities of NIHS.

General Administrative functions

The Administrative officer supported by the Chief clerk and other clerks are

responsible for handling general administrative procedures.

The Accountant is responsible for financial management functions supported by a team of financial clerks.

Minor Staff

There are sanitary labours (male & female) , ordinary labours, and casual labours headed by the overseer. None of them have accommodation facilities within the NIHS premises.

Transport facilities

Director, DD/Training & DD(FS) are provided with vehicles for transport. In addition there are two buses (60 seater) a small bus, two vans and a three wheeler available for training and other purposes. Two vehicles met with accident and one is under repair and the other will be condemned.

Other facilities available at NIHS

Hostel facilities are available to trainees attached to NIHS. This facility needs further strengthening. Cafeteria, though available could not meet the demands due to many reasons. Recreational facilities are available but needs further strengthening.

Quarters are available within the NIHS premises for selected officers namely Director, Deputy Director Training, Deputy Director Field Services and officers attached to the training unit.

Though there is a canteen available at NIHS it cannot meet the demands. The varieties of food items are limited and the quality of food is not up to the expected standards.

The canteen needs further expansion as the student load is ever increasing. Additional facilities too are needed.

PUBLICATION 2002

1. Diabetes and Management of Diabetes

2. Student Guide Solutions, Reagents and Standards in Clinical Chemistry

3. Human Intestinal Parasites.

4. Public health Inspector Diploma Course Curriculum 2001

5. Blood Bank Immunology.

Mission of NIHS

The mission is to assist in accelerating, facilitating and support the government policy in establishing and extending an integrated PHC delivery system to serve the entire population in this effort.

Objectives of the NIHS

· To address itself to all aspects of the manpower development in Sri Lanka and to advice the Ministry of Health in its policy relating to health manpower development.

· To co-ordinate health manpower development activities in Sri Lanka between the education and health services agencies.

· To initiate and undertake training programmes for members of the PHC team with a view to multidisciplinary approach to training.

· To initiate and undertake continuing education of the PHC teams.

· To conduct research related to health services and manpower development.

The Medical Research Institute was established in 1900. Over the years this institute has expanded in all spheres and now it includes the following departments i.e. Nutrition, Rabies, Vaccines, Bacteriology, Virology, Parasitology, Immunology, Electron Microscopy and an Animal Centre.

The institute functions under a director and a deputy director and has a staff of over 200 personnel. This institute was upgraded to international standards with Japanese assistance.

The MRI plays a vital role in the country’s health sector. Its functions include

The MRI conducts teaching and training programmes for Medical Undergraduates and Postgraduates, Non Medical Scientists and Medical Laboratory Technologists.

The MLT School established in 1959 produces about 50 MLT per year. The MRI has the only high security laboratory in the country that can handle dangerous pathogens.

Polio Reference Laboratory for the South East Asian Region is also located at MRI. It handles specimens sent for analysis from the SEAR counties. This is a very important activity that is being carried out in the eradication of poliovirus from this region.

The nursing and midwifery education comes under the purview of DDG (E.T.&R.) and Director Nursing (Education) who has to plan, coordinate implement academic functions of all the schools of nursing.

There are eleven nursing schools. Mulleriyawa Nursing School does the psychiatric nursing affiliation training programme for all other schools of nursing. Each nursing school has one principal, senior tutors. The student capacity of schools vary from 200 – 400.

(i) First year (Part I) of the 1 1/2 years midwifery course for midwives is conducted in schools of nursing.

(ii) Schools of Nursing also conduct the six months midwifery course for staff nurses. The nurses and midwives trained in the schools of nursing only are eligible for registration in the Medical Council as nurses and midwives.

The NHRC is a national body promoting, coordinating and assisting in research activities in health and health related fields. The NHRC has wide representation of professional bodies, universities, other research institutions and the Department of Health. In the year 2000, it convened 10 monthly meetings.

(1) Conducted a training programme for Medical Officers in Research proposal writing.

(4) Provided funds in collaboration with WHO for 12 research proposals for postgraduate microbiology trainees.

(5) Provided funds in collaboration with WHO for eight research proposals for M.Sc. Community Medicine trainees.

	Training Course	Locations of Training Schools	Duration of the Course
1.0	Nurses (Basic Training)	Colombo Badulla Galle Kandana Kandy Rathnapura Anuradhapura Kurunegala Batticaloa Jaffna Sri Jayawardenepura	3 years
2.0	Medical Laboratory Technologists	Colombo Peradeniya (Kandy) ,Kalutara	2 years
3.0	Pharmacists	Colombo , Kalutara	2 years
4.0	Physiotherapists	Colombo	2 years
5.0	Occupational Therapists	Colombo	2 years
6.0	Radiography	Colombo	2 years
7.0	Public Health Midwives	Training at all Nursing Schools	18 months
8.0	Public Health Inspectors	Kalutara (National Institute of Health Sciences) Kurunegala Regional Galle Training Kadugannawa Centres Batticaloa	18 months
	Training Course	Locations of Training Schools	Duration of the Course
9.0	Entomological Assistants	Colombo (Medical Research Institute)	2 years
10.0	Microscopists	Kalutara	15 months
11.0	E.C.G Technicians	Colombo	1 year
12.0	E.E.G Recordists	Colombo	09 months
13.0	Ophthalmic Technologists	Colombo	2 years
14.0	Speech and Language Therapists	University of Kelaniya	2 years
15.0	Orthopaedic Technicians	Colombo	18 months
16.0	Public Health Field Assistants	Kalutara	12 months
17.0	Dispensers	At major Provincial Hospitals	12 months
18.0	Dental Technicians	Colombo	2 years
19.0	School Dental Therapists	Colombo	2 years