Sri Lanka is the fastest ageing country in the South East Asian region. With the increasing ageing population many challenges are imposed pertaining to health, social and financial issues. The increase of health implications such as Non Communicable Diseases, disability, rehabilitation needs, and long term care needs imposes a greater burden to the health system of Sri Lanka. The Primary Health Care institutions are underutilised in Sri Lanka. Therefore, currently, we are in the process of strengthening our Primary Health Care service utilisation by improving infrastructure and human resources. Alining with the UN Decade of Healthy Ageing and providing integrated care for older persons initiating ICOPE at our primary health care institutions will help to face many challenges pertaining to care provision of older persons. Accessibility to health care, transportation issues, increasing out of pocket expenditure, prevailing economic crisis and overcrowding of the tertiary hospitals are some of the challenges that will be addressed by initiating ICOPE at the primary healthcare level.

Older people in general, Older people with chronic health conditions or disability, Older people with vulnerabilities

Health, Information and Communication, Social protection, Other

Academia, Health Care, Private Sector

Older people were part of the process at multiple or all stages

Intersectoral collaboration was identified as a vital pillar in the success of any programme. Therefore, we at the directorate have collaborated with different sectors from the beginning of the programme. Academia has been actively involved in the adaptation of the trainers’ manual to Sri Lanka. Furthermore, they have played a vital role as a resource person for the training program targeting Primary Care Physicians and Nursing Officers at the Primary Health care level. The social service sector has also played an important role in the implementation of the ICOPE programme at the community level. The curative health care sector and the administrative health care sector have given their fullest support in conducting the training programmes for primary health care workers and the activities targeted at older persons at the community level. The WHO Country Office in Sri Lanka has also collaborated with this programme by providing financial assistance to conduct this programme.

The older persons who participated in the clinics at the ground level were screened using the ICOPE tool and the older persons who wanted specialised care were referred to the psychiatric clinic, special clinic, dental clinic and eye clinic at secondary and tertiary level health institutions. This will help to early identify the physical and mental health abnormalities of older persons and their by improve their health and wellbeing and increasing healthy life expectancy at the age of 60 years. Finally, at the community level, this will improve overall health and wellbeing of older persons with a greater return on investment.

Program planning and implementation is a challenging exercise where issues pertaining to planning, finances and coordination emerge. The adaptation of the manual to the Sri Lankan context needed significant time for the process. Experts from geriatric care, public health specialists and clinicians were involved in the manual adaptation process which helped to bring out the best possible outcome of the adaptation through good coordination. Planning of the training workshops needed coordination between the national level and regional level health sector. Participant recruitment for the training workshops was done by prior planning and notification to the relevant administrative authorities. Permission was granted to conduct the training for selected participants from primary health care institutions without disruption of services. Identifying resource persons to conduct the lectures was challenging as the trained personnel on ICOPE and geriatric care is scarce. Resource personnel were identified by contacting professional colleagues and academia. Identifying the best resource persons enabled the best outcome of the training program. Ground level implementation imposes different challenges such as lack of human resources and issues with logistics. The proper planning with good leadership and best usage of existing human resources and facilities at the ground level enabled the implementation of ICOPE at the ground level.

Planning, conducting and implementing the ICOPE program brought us a lot of learning experiences in each stage. Being aware of the novel concept of ICOPE prior to planning the adaptation of the manual, training program and implementation at ground level helped us to understand the ICOPE principles. Team work in planning and organizing the program at all levels is a vital component for the effectiveness and the best return of investment. Multisectoral collaboration ensures the sustainability of the program at all levels.

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