The Institute for Health Policy worked in collaboration with local institutions to establish the Sri Lanka Health and Ageing Study (SLHAS). It initially undertook a nationally representative survey (n=6,668) of adults aged 18 years and above, covering all 25 districts in Sri Lanka during 2018-2019 in Wave 1 of its data collection.
The survey collected data on past medical history of diabetes, hypertension and cardiovascular disease; behavioural risk factors such as smoking, alcohol use, diet and exercise; physical measurements including weight, height and blood pressure; and biochemical measurements including fasting blood sugar, oral glucose tolerance test, urine test and a lipid profile.
Survey instruments were used to assess depression (PHQ9), self-rated health (SF36, EQ-5D-5L), chronic pain and many other factors related to health and ageing. Modules also assessed socioeconomic status (SES), healthcare utilization (HCU), work productivity, knowledge of a diagnosis of NCD, health literacy and barriers to seeking assessment and treatment for NCD.
A tracking system was established, allowing follow-up of each individual to identify reasons for any hospitalizations and deaths in the preceding year using administrative data. Wave 2 was launched in 2021 and is ongoing, with the sample resurveyed to collect data on the impact of COVID and the subsequent Sri Lankan economic crisis on health outcomes and healthcare use, work, food security and socioeconomic status.
The SLHAS is led by a consortium of local institutions comprising of the Institute for Health Policy (IHP), the University of Colombo, the University of Peradeniya, the University of Ruhuna, and Rajarata University of Sri Lanka, with support extended by the Ministry of Health and Medical Research Institute.
Research Team
Ravindra Rannan-Eliya
Dr. Ravindra P. Rannan-Eliya is Executive Director & Fellow of the Institute of Health Policy (IHP). He has expertise in a number of areas relating to health systems equity, health financing and policy, social protection and public expenditure analysis, with research, consulting and field experience in UK, Serbia, Turkey, Kyrgyz Republic, Egypt, Lebanon, Palestine, Bangladesh, India, Sri Lanka, Thailand, Malaysia, Singapore, Indonesia, Brunei, Korea, China, Hong Kong, Taiwan, Mongolia, USA, Mexico, Guatemala, Ecuador, Bolivia, Kenya, Ghana, Zambia.
He is a leading international expert in health expenditure estimation and projection methods and health accounts systems, collaborating extensively with WHO, World Bank, OECD and Eurostat and has been lead analyst of several assessments of pension and social security schemes in Sri Lanka, and currently leading team designing new pension scheme for informal workers. He has extensive experience in design and analysis of large household and health care provider surveys, in a diverse range of settings (Africa, Asia, Latin America). His doctoral work from Harvard University USA focused on research on developing comparable indicators of trends in productivity of public sector health delivery systems.
Nilmini Wijemunige
Nilmini is a Research Associate at the Institute for Health Policy (IHP) and a Co-Investiagor of the Sri Lanka Health and Ageing Study. She has expertise in analyzing non-communicable disease policy, healthcare utilization, disease-specific health accounts and quality of healthcare, particularly in low- and middle-income countries, as well as analytical skills such as health economic modeling, including microsimulation models. She was involved in setting up the Sri Lanka Health and Ageing Study, working with the team in developing questionnaires, protocols, training field staff, monitoring data collection, data cleaning and analysis.
Owen O’Donnell
Swiss team member (Sri Lanka and Phillipines)
Owen O’Donnell is Professor of Applied Economics at Erasmus University Rotterdam and the University of Macedonia (on leave), a Senior Researcher at the University of Lausanne, and a Research Fellow of the Tinbergen Institute, Netspar and the CESR/Schaefer Center for the Study of Health Inequality. He has co-directed two European Union funded projects on equity in the finance and provision of health care in Asia (EQUITAP, HEFPA), is a co-author of Analyzing Health Equity Using Household Survey Data and has been a consultant to the World Bank, WHO and UNICEF. He is an Associate Editor of the Journal of Health Economics and Health Economics, and is co-organiser of the European Workshops on Econometrics and Health Economics. He obtained his doctorate from the University of York and has held visiting positions at the University of Lausanne and the University of Wisconsin-Madison, and a faculty appointment at the University of Kent.
Publications
2025
Rannan-Eliya, R.P., Wijemunige, N., Perera, B., Perera, P., Herath, H. M. M., Dissanayake, V. H. W., & SLHAS Collaborators. (2025). Hypertension diagnosis, awareness, treatment, and control in Sri Lankan adults: a nationally representative cross-sectional study. BMC Public Health, 25 (1). https://doi.org/10.1186/s12889-025-22659-7
2024
Zhou, B., Rayner, A. W., Gregg, E. W., Sheffer, K. E., Carrillo-Larco, R. M., Bennett, J. E., Shaw, J. E., Paciorek, C. J., Singleton, R. K., Pires, A. B., Stevens, G. A., Danaei, G., Lhoste, V. P., Phelps, N. H., Heap, R. A., Jain, L., De Brisis, Y. D., Galeazzi, A., Kengne, A. P., . . . Ezzati, M. (2024). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants. The Lancet, 404(10467), 2077–2093. https://doi.org/10.1016/s0140-6736(24)02317-1
Gunawardana, J. R. N. A., Viswakula, S. D., Rannan-Eliya, R. P., & Wijemunige, N. (2024). Machine learning approaches for asthma disease prediction among adults in Sri Lanka. Health Informatics Journal, 30(3), 14604582241283968. https://doi.org/10.1177/14604582241283968
Wijemunige, N., Gamage,A., Rannan-Eliya, R.P., & Kularatna, S. (2024). Population Norms and Disutility Catalog for Chronic Conditions in Sri Lanka. Value in Health Regional Issues, 45, 101033. https://doi.org/10.1016/j.vhri.2024.101033
Wijemunige, N., van Baal, P., Rannan-Eliya, R.P., & O’Donnell, O. (2024). Health outcomes and healthcare utilization associated with four undiagnosed chronic conditions: evidence from nationally representative survey data in Sri Lanka. BMC Global Public Health, 2, 45. https://doi.org/10.1186/s44263-024-00075-0
Wijemunige, N., Rannan-Eliya, R. P., Herath, H. M. M., & O’Donnell, O. (2024). The Prevalence and Epidemiological Features of Ischaemic Heart Disease in Sri Lanka. Global Heart, 19(1), 49. https://doi.org/10.5334/gh.1330
Deivanayagam, T. A., Ní Chobhthaigh, S., Devakumar, D., Patel, K., Rannan-Eliya, R. P. & SLHAS Collaborators. (2024). Mental health prevalence, healthcare use and access between 2018 and 2022 in Sri Lanka: an analysis of survey data . Global Health Research and Policy. Published online ahead of print May 22 2024. https://doi.org/10.3310/HJWA5078
Rannan-Eliya, R. P., Dissanayake, V. H., Perera, P., Perera, B., Herath, H. M. M., Wijemunige, N., Dalpatadu, S., Samarage, S., Gamage, A., Jayatissa, R., & Fernando, E. Y. (2024). Cohort Profile: The Sri Lanka Health and Ageing Study (SLHAS). International Journal of Epidemiology, 53(2). https://doi.org/10.1093/ije/dyae044
2023
Sasanka, B. E. U., Kumar, S., & Rannan-Eliya, R. P. (2023). Are Sinhala and Tamil PHQ-9 versions comparable across the Sri Lankan population? Psychometric equivalence of the SLHAS PHQ-9 form across translations and between demographic subgroups. Ceylon Medical Journal, 68(4), 174–183. https://doi.org/10.4038/cmj.v68i4.9946
Ukwaththage, B. E. S., Kumar, S., & Rannan-Eliya, R. (2023). Are Sinhala and Tamil PHQ-9 versions comparable across the Sri Lankan population? Psychometric equivalence across translations and between demographic subgroups.[Preprint]. https://www.doi.org/10.21203/rs.3.rs-2552791/v1
Rannan-Eliya, R. P., Wijemunige, N., Perera, P., Kapuge, Y., Gunawardana, N., Sigera, C., Jayatissa, R., Herath, H. M. M., Gamage, A., Weerawardena, N., Sivagnanam, I., Dalpatadu, S., Samarage, S., Samarakoon, U., Samaranayake, N., Pullenayegam, C., Perera, B., & Collaborators (2023). Prevalence of diabetes and pre-diabetes in Sri Lanka: A new global hotspot–estimates from the Sri Lanka Health and Ageing Survey 2018/2019. BMJ Open Diabetes Research & Care, 11(1). https://doi.org/10.1136/bmjdrc-2022-003160
Wijemunige, N., Rannan-Eliya, R. P., van Baal, P., & O’Donnell, O. (2023). Optimizing cardiovascular disease risk screening in a low-resource setting: cost-effectiveness of program modifications in Sri Lanka modelled with nationally representative survey data. BMC Public Health, 23, 1792. https://doi.org/10.1186/s12889-023-16640-5
2022
Wijemunige, N., Rannan-Eliya, R. P., Maurer, J. & O’Donnell, O. (2022). Cost-Effectiveness and Distributional Impact of Opportunistic Screening for People at High-Risk of Cardiovascular Disease in Sri Lanka: A Modelling Study. Global Heart, 17(1), 89. https://doi.org/10.5334/gh.1174
Rannan-Eliya, R. P., Wijemunige, N., Perera, P., Kapuge, Y., Gunawardana, N., Sigera, C., Herath, H. M. M., Perera, B., Gamage, A., Weerawardena, N., Sivagnanam, I., & SLHAS Collaborators. (2022). Prevalence and Associations of Hypertension in Sri Lankan Adults: Estimates from the SLHAS 2018–19 Survey Using JNC7 and ACC/AHA 2017 Guidelines. Global Heart, 17(1), 50. http://doi.org/10.5334/gh.1135
2018
Kämpfen, F., Wijemunige, N., & Evangelista, B. Jr. (2018). Aging, non-communicable diseases, and old-age disability in low- and middle-income countries: a challenge for global health. International Journal of Public Health, 63(9),1011‐1012. https://doi.org/10.1007/s00038-018-1137-z
PROJECT FUNDED BY
Inclusive social protection for chronic health problems 