1
HEALTH SERVICES DELIVERY
1.4
DISEASE CONTROL PROGRAMME
1.4.2.f
Communicable Disease Control :
Food and Water-Borne Diseases Control
1.Prevention and Control of Diarrhoeal Diseases (as of March 2008)
A Focal Point
B Implementing Agencies
C Target Areas & Beneficiaries
DDG/PHS I
Epidemiological Unit
Provincial Director of Health Services
Provincial Director of Health Services
Medical Officer of Health
The entire population
Deputy
Project Summary:
Diarrhoeal diseases are still a major public health problems in Sri Lanka. During the last 20
years admissions to government hospitals due to diarrhoeal diseases has been fluctuating
between 676 and 961 cases per 100,000 population. It was the 5th leading cause of
hospitalization in year 2000 although the mortality has been reduced drastically.
With the implementation of National Programme for the Control of Diarrhoeal Diseases the
death
rate due to diarrhoeal diseases has reduced remarkably. But the morbidity rate has remained
at
same.
It is therefore important to initiate a special programme for the control and prevention of diarrhoea. The
objective of the project is to prevent and control diarrhoeal diseases in Sri Lanka. The major components are.
 Strengthen the surveillance of diarrhoeal diseases
 Outbreak prediction and prevention
 Training of hospital staff and PHC staff on prevention and control of diarrhoea.
1.
Justification:
Diarrhoeal diseases are major health problem in Sri Lanka. It was the 5th leading cause of
hospitalization in year 2001. During last 20 years admissions to general hospitals due to
diarrhoeal diseases has been fluctuating between 676 and 961 cases for 100,000 population.
With the implementation of the national programme for control of diarrhoeal diseases the
mortality rate due to diarrhoeal diseases has decreased dramatically. The morbidity rate has
not changed much.
This is probably due to the fact that the causes for the occurrence of diarrhoeal diseases are
multifactorial, social, economic and environmental factors together with changing behaviour in
society are playing a major role in keeping the morbidity rate high.
The main contributory factors are the scarcity of water during the dry season and lack of proper
sanitary facilities.
2.
Important Assumptions/Risks/Conditions:
Provincial Councils and Local Authorities should provide adequate support for development of
human resources and policy implementation required for rabies elimination strategies.
3.
Project Objective:
Objective
Indicators
Prevention and Control of  Mortality due to
diarrhoeal diseases
in diarrhoeal diseases
Sri Lanka
 Morbidity due to
diarrhoeal diseases
 Report of hospital
admissions due to diarrhoea
 Number of outbreaks
reported in a year
4.
Project Output/Product:
Outputs
Indicators
Morbidity and mortality  Admissions rate
due to diarrhoeal diseases  Morbidity rate Mortality
reduced
rate
 Case Fatality Rate
Diarrhoeal
diseases  Notification rate
surveillance strengthened
Investigation rate Percentage
of outbreak investigations
Diarrhoeal
outbreaks  No. of outbreaks due to
reduced
diarrhoea
5.
Means of Verification
 Review of institutional data
received
from
medical statistician
 Review of institutional data
from medical statistician and
notification data
received
from MOOH
 Sentinel
surveillance
of diarrhoeal diseases
 Review of RE data
Means of Verification
Review hospital data
from medical
statistician
and notifications.

Review data at
Epidemiological Unit,review at
district/MOH level
 Review data at
Epidemiological Unit, review
at
districts/MOH level

Related Projects:
Project No.
Project Title
Provision of safe drinking water
Provision of hygenic latrine facility
IEC activities for diarrhoea related behaviour change
Promotion of clean environment in food establishment
Monitoring of water quality/food safety
Laboratory Surveillance
- Monitoring of organism
Monitoring of ABST
6.
Relevant Agencies to be Coordinated:
UN and other developmental partners
7.
8.
Monitoring & Evaluation:
1. Who?
DGHS/Epidemiologist
2. When?
Quarterly
Activities:
Activities
1
2
Expected Results
Implement standard case management Reduce the mortality
of diarrhoeal diseases in all hospitals
rate
Train hospital and PHC staff on Reduce the morbidity
prevention and control of diarrhoea
of diarrhoeal diseases
Reduce
the
hospitalization due to
diarrhoeal diseases
4
Develop and print IEC materials for
social mobilization
Strengthen surveillance of diarrhoeal
diseases and outbreak investigation
IEC
material
developed
100% notification
and investigation rate
5
Strengthen laboratory surveillance
(monitoring of organism)
Laboratory
surveillance
strengthened
All households have
access
to
safe
drinking water and
sanitary toilets
3
Improve environmental sanitation
6
Process Indicators
Percentage of hospitals
implemented
the
standard
case
management
of
diarrhoeal diseases
Percentage of hospital
staff
training
on
prevention and control of
diarrhoea
Percentage
of
PHC
staff
training
on
prevention and control of
diarrhoea
Designing material
Pilot testing
Notification rate by
districts.
Investigation
rate by districts
Identify the need for
improvement
Develop a proposal
Identify the need for
improvement
Develop a proposal