Establishing a novel partnership model to deploy health services for children with autism in a low-resource setting - experience from Sri Lanka

Abstract

Sri Lanka is representative of challenges faced by low-income and middle-income countries, including the rise in the prevalence of autism and the lack of sufficient autism-specific services in the state sectors. The experience in establishing a Center to provide services for children with autism in Northern Sri Lanka is described. Funding and resourcing were accessed through an innovative partnership-based public/non-governmental organisation/charity model, where service-based outcomes were the main objectives. This model, incorporating state institutions, local and international charity organisations, and volunteers, devised a bespoke approach to care provision using the available resources under the clinical supervision of a consultant psychiatrist and the administrative purview of the Regional Director of Health Services. The evolution of this Center into a Learning Health System is described, reflecting how a minimalistic partnership approach focused on the integration of existing organisations and services could be a feasible model for the delivery of high-quality healthcare in low-resource settings.

Keywords: Autism; Low resource setting; Sri Lanka; Viewpoint.

Fig. 1

The organisational structure of the Autism Center. IMHO, International Medical Health Organization; MHS, Mental Health Society; MNT, “Manitha Neyam” Trust; RDHS, Regional Directorate of Health Services.

Fig. 2

Care pathway for autism followed at the Autism Center. ABLLS, Assessment of Basic Language and Learning Skills; CARS, Childhood Autism Rating Scale; EIBI, Early Intensive Behavioral Intervention; OT, Occupational Therapy; SALT, Speech and Language Therapy; TONI-4, Test of Nonverbal Intelligence - Fourth edition.