Strengthening Geriatric Care in Sri Lanka: Challenges and Opportunities for an Integrated Primary Healthcare Approach — A Narrative Review

Author

Abeywickrama S N, Miskin N Z, Perera D L G


Abstract

 Background: Population ageing presents growing challenges for healthcare systems, particularly in low- and middle-income countries where the demand for chronic disease management, rehabilitation, community-based support and long-term care is increasing. Sri Lanka is experiencing a substantial demographic transition, creating an urgent need to strengthen services for older people within its publicly funded healthcare system.

Objective: This narrative review examines the challenges and opportunities for strengthening geriatric care in Sri Lanka, with particular emphasis on integrated primary healthcare, continuity of care and the implications for health policy and service delivery.

Methods: A focused narrative search of publicly accessible scholarly literature, national policy documents, demographic reports and international guidance was undertaken to inform the review. Sources relating to population ageing, healthcare utilisation, integrated care, long-term care and primary healthcare reform were examined. International evidence was considered alongside Sri Lankan research to identify approaches potentially adaptable to the national context.

Discussion: Sri Lanka has an established public healthcare system and a policy foundation for elderly healthcare. Nevertheless, demographic ageing increases the need for coordinated management of multimorbidity, functional decline, medication-related problems and long-term care requirements. Important priorities include strengthening primary healthcare capacity, improving referral and discharge pathways, developing multidisciplinary teams, supporting family caregivers and establishing sustainable community-based services. The World Health Organization’s Integrated Care for Older People framework provides a useful basis for person-centred assessment and individualised care planning. Implementation requires appropriate workforce development, financing, information systems and intersectoral collaboration.

Conclusion: Strengthening geriatric care in Sri Lanka requires a coordinated, equitable and person-centred approach linking primary healthcare, hospitals, rehabilitation and community-based support. A phased model adapted to local resources could improve continuity of care and provide relevant lessons for other countries experiencing similar demographic transitions.


Keywords

Geriatric care; population ageing; integrated primary healthcare; older adults; health systems; long-term care; Sri Lanka.



Full Text:

Download Paper PDF


References


Asian Development Bank (2021) Country Diagnostic Study on Long-Term Care in Sri Lanka. Manila: Asian Development Bank. doi: 10.22617/TCS210218-2.

De Zoysa, W. et al. (2025) ‘Multimorbidity, medications, and their association with falls, physical activity, and cognitive functions in older adults: multicenter study in Sri Lanka’, Scientific Reports, 15, article 6233. doi: 10.1038/s41598-025-91037-5.

Department of Census and Statistics, Sri Lanka (2026) Census of Population and Housing 2024: Final Report. Colombo: Department of Census and Statistics.

Ministry of Health, Sri Lanka (2022) National Health Policy Review 2022. Colombo: Ministry of Health.

Perera, S., Nieveras, O., de Silva, P. and Wijesundara, C. (2019) ‘Accelerating reforms of primary health care towards universal health coverage in Sri Lanka’, WHO South-East Asia Journal of Public Health, 8(1), pp. 21–25. doi: 10.4103/2224-3151.255345.

Perera, S.R. and Samarakoon, Y.M. (2025) ‘Addressing the urgency for healthy aging in Sri Lanka: policy dialogues’, WHO South-East Asia Journal of Public Health, 14(1), pp. 61–67. doi: 10.4103/WHO-SEAJPH.WHO-SEAJPH_173_24.

Wickramarachchi, B.I., Siop, S.J. and Perera, B. (2022) ‘Associated factors of doctor visits made by urban-dwelling older adults in Sri Lanka: an application of Anderson’s model of health service utilization’, BMC Geriatrics, 22, article 571. doi: 10.1186/s12877-022-03249-3.

World Health Organization (2015) World Report on Ageing and Health. Geneva: World Health Organization.

World Health Organization (2020) Decade of Healthy Ageing: Plan of Action 2021–2030. Geneva: World Health Organization.

World Health Organization (2025) Integrated Care for Older People (ICOPE): Guidance for Person-Centred Assessment and Pathways in Primary Care. 2nd edn. Geneva: World Health Organization. ISBN 978-92-4-010372-6.

 

 

 

Share your valuable work from Social Media Buttons