Navigating turbulent waters: resilience and recovery of a tertiary care hospital in Sri Lanka during economic crisis through situational leadership

Sep 29, 2026

Sri Lanka’s worst economic crisis since April 2022 severely affected a tertiary care hospital (THS), disrupting care delivery through medical supply shortages, limited funding, staff transportation problems from nationwide fuel shortage, reagent scarcity, human-resource strain from staff outmigration, and absence of a business continuity plan. This perspective article explains the crisis impact and outlines administrative recovery using a leadership approach akin to situational leadership. THS applied directing, coaching, supporting, and delegating to prioritize resources, guide immediate actions, strengthen communication, and implement emotional support, emphasizing delegation, empowerment, and teamwork while recommending formal continuity planning and larger-hospital stock buffers.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Abstract

Introduction

Leadership in the Mirror 1National Hospital Galle, Ministry of Health, Colombo, Sri Lanka 2Base Hospital Panadura, Ministry of Health, Colombo, Sri Lanka Correspondence to Dr Ranga Sabhapathige; [rangasabhapathige@gmail.com](rangasabhapathige@gmail.com) Received 10 June 2024 Accepted 11 July 2025 © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. To cite: Sabhapathige R, Deerasinghe D. BMJ Leader Published Online First: [please include Day Month Year] . doi:10 . 1136/ leader-2024-001082 Navigating turbulent waters: resilience and recovery of a tertiary care hospital in Sri Lanka during economic crisis through situational leadership Ranga Sabhapathige , 1 Dilrukshi Deerasinghe 2 ABSTRACT Sri Lanka has been going through its worst economic crisis ever since April 2022. The economic crisis had a significant impact on a tertiary care hospital in Sri Lanka (THS), and the main challenges faced included a severe shortage of medical supplies, a lack of funding, staff transportation issues due to a nationwide fuel shortage, a shortage of reagents, human resource issues due to the outmigration of hospital staff and a lack of a business continuity plan in place. This perspective article aimed to describe how the economic crisis affected a THS in Sri Lanka and how the hospital’s administration overcame it by employing a leadership style similar to situational leadership. THS implemented situational leadership style, directing, coaching, supporting and delegating to effectively address the above challenges. The directing style strategies such as withholding renovation projects, purchasing drugs locally, hiring consultants, providing extra duty payments and prioritising resources were employed to guide the team through immediate challenges. The establishment of a crisis management committee served as a coaching approach. Enhancing communication among workers and implementing emotional support initiatives were key aspects of our supportive leadership, creating a positive work environment. We emphasised delegation, empowerment and teamwork, encouraging team members to take ownership of their roles and collaborate effectively. It is recommended that a business continuity plan to manage hospitals during an economic crisis be included. Medical supplies should be buffered in a larger hospital like THS for a minimum of 6 months. The government ought to enact new legislation and require applicants to sign bonds in order to retain healthcare professionals in the nation. INTRODUCTION Sri Lanka’s health system has been recognised as a low-cost model, high impact, on a global scale, and citizens of Sri Lanka enjoy free access to healthcare through a well-defined preventative and curative sector. Curative services are provided by a network of tertiary and secondary care facilities, divisional hospitals (outpatient and inpatient treatment) and primary medical care units (outpatient care).1 Approximately 95% of inpatient treatment and 50% of outpatient care are provided by the public sector. Through health units, the medical officer of health and his team provide preventive care to the entire island2. Since April 2022, Sri Lanka has been experiencing the most severe economic crisis in its history. All foreign reserves have been depleted as a result of debt payments, and there is no foreign reserve to buy fuel, necessities or medications. There were fuel queues all around the country, and individuals had to wait for several days to fill up their automobiles. Power outages were widespread across the country, lasting up to 12–16 hours at times.3 Finally, the central bank of Sri Lanka announced that the country was bankrupt and that it was not possible to pay all types of loans. Hospitals encountered many challenges as a result of such problems, and managing the hospitals in Sri Lanka was extremely difficult.4 THS is the third-lar

FAQs

What main challenges did the tertiary care hospital face during Sri Lanka’s economic crisis?

The article describes shortages of medical supplies and reagents, limited funding, staff transportation issues due to fuel shortages, human-resource problems from staff outmigration, and no business continuity plan.

How did the hospital administration respond using situational leadership?

It used a mix of directing, coaching, supporting, and delegating—prioritizing resources, withholding certain renovation projects, purchasing drugs locally, hiring consultants, and adding extra duty payments to address immediate problems.

What recommendations does the article make for managing hospitals during future economic crises?

It recommends including a business continuity plan, buffering medical supplies for at least 6 months at large hospitals, and enacting legislation that uses bonds to retain healthcare professionals.

Sep 29, 2026

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