Sri Lanka’s government is set to equip thousands of public health midwives with scooters under a major World Bank-backed initiative, enhancing maternal and community care in rural areas and boosting the island’s primary healthcare system.

Sri Lanka’s public health midwives have long been the backbone of the country’s renowned maternal and child healthcare system. Often traveling on foot or by public transport through challenging terrain, these dedicated professionals now stand to gain significant mobility support. In a major development announced in late 2025, the government approved the procurement of nearly 3,000 scooters specifically for public health midwives (PHMs) as part of a comprehensive fleet upgrade.

This initiative forms a key component of the Sri Lanka Primary Healthcare System Enhancing Project (PHSEP), financed by a USD 150 million World Bank agreement spanning 2024 to 2028. The project aims to strengthen community-level services, improve access to care, and build resilience against health emergencies, including those linked to climate change.

Scale of the Vehicle Procurement

The Cabinet of Ministers greenlit the purchase of over 4,000 vehicles and support equipment. The breakdown includes:

• 2,891 scooters for public health midwives
• 200 scooters for public health nurses
• 1,350 motorbikes for public health inspectors
• Additional scooters for laboratory services, clinical waste lorries, refrigerated trucks, double cabs, vans, and buses

This fleet will address a critical gap: the lack of reliable transport for field officers, which has hindered effective home-based care, supervision, disease surveillance, and timely medical supply distribution.

Health Minister Dr. Nalinda Jayatissa recently reinforced the government’s commitment during a certificate-awarding ceremony for newly trained administrative public health midwives. He assured that motorbikes (or scooters) for PHMs would be provided alongside a scheduled January salary hike, highlighting the vital role these workers play in Sri Lanka’s free healthcare system, which recently received international acclaim at the World Health Assembly.

The Unsung Heroes – Public Health Midwives in Sri Lanka

Public Health Midwives (PHMs) have been central to Sri Lanka’s impressive maternal health outcomes since the early 20th century. Operating at the grassroots level, PHMs provide antenatal care, conduct home visits, offer health education, support safe deliveries, and monitor child nutrition and immunization in both urban and remote rural communities.

Despite Sri Lanka’s strong track record in reducing maternal and infant mortality, challenges persist in reaching the most isolated areas, especially amid economic pressures and climate vulnerabilities. Many midwives currently rely on bicycles, public buses, or even walking long distances, which limits the number of households they can serve daily and delays emergency responses.

Equipping them with reliable two-wheelers will dramatically expand their reach. A single scooter can enable a midwife to visit dozens more families per week, facilitate faster referrals to clinics, and improve follow-up on high-risk pregnancies. This is particularly crucial for managing non-communicable diseases (NCDs) like diabetes and hypertension in pregnant women, as well as expanding elderly and palliative care services.

Broader Impact on Sri Lanka’s Health System

The vehicle procurement is not an isolated measure but part of a holistic strategy to reorganize and strengthen primary healthcare. The World Bank project seeks to enhance over 1,000 Primary Medical Care Institutions (PMCIs) nationwide, shifting more services away from overcrowded tertiary hospitals toward community-based facilities.

Key focus areas include:

• Prevention and management of NCDs
• Integration of mental health and geriatric care
• Improved laboratory and diagnostic services at the primary level
• Better data management and quality assurance
• Enhanced emergency preparedness

By providing transport not only to midwives but also to inspectors, nurses, and laboratory teams, the initiative creates a more coordinated and responsive health workforce. Clinical waste management vehicles and refrigerated trucks will further ensure safety and efficiency in the supply chain.

This investment comes at a pivotal time as Sri Lanka continues its economic recovery. Strengthening primary care is expected to reduce the burden on higher-level hospitals, lower overall healthcare costs, and contribute to better population health outcomes.

Challenges and Future Outlook

The announcement has been widely welcomed. Procurement processes are on to ensure that vehicles are fuel-efficient, suitable for Sri Lanka’s diverse terrains (from hilly central regions to coastal and northern areas), and supported by maintenance infrastructure. Training on safe riding and vehicle management for thousands of health workers will also be provided.

Proponents argue that the long-term returns – in lives saved, healthier communities, and reduced hospital admissions – far outweigh the costs. The project aligns with Sri Lanka’s National Health Policy and Vision for a more resilient, people-centred health and care system.

As scooters and motorbikes hit the roads in the coming months and years, they will carry more than just health workers – they will transport hope, expertise, and care to the doorsteps of countless Sri Lankan families.