Revisiting the History: A Century of Public Health Nursing in Sri Lanka: A Scoping Review

Background Globally, public health nursing is an integral part of the community healthcare system, and it focuses mainly on disease prevention and health promotion. This study aims to systematically examine the evolution, roles, and discontinuities in public health nursing in Sri Lanka, highlighting historical milestones, training changes, and broader contributions to improving the community health of Sri Lanka. Methods/data sources: A scoping review was conducted via electronic databases (PubMed, Web of Science, EMBASE, MEDLINE, and Lens.org), supplemented by gray literature and manual searches in national archives, government reports, historical records, and local journals. Sources in English and Sinhala were included, and the data were synthesized thematically across identified historical periods. Results Based on our findings, we classified the history of public health nursing in Sri Lanka into four distinct eras: the Colonial Era, the Post-Colonial Era, the No-PHN Era, and the Re-establishment Era. This review traced how public health nurses were progressively involved in maternal and child health, control of communicable disease, and school health in the early decades, supported by progressively improved recruitment and training programs. It also revealed a prolonged interruption in public health nurse services in the 1980s, but with limited documentation and records for this discontinuation. In recent years, they have been reintroduced to reflect newly emerging health needs of the country, with a widened role that consists of palliative care, geriatric care, and prevention of noncommunicable diseases. Throughout the review, a lack of consistent documentation and visibility in published work and official records in the public health system of the country could be observed. Conclusions The evolution of public health nursing in Sri Lanka reflects the changes that have occurred in the health goals of the country over the past century. Since the beginning, public health nurses have shown their value and essential service through providing maternal and child health care and more contemporary services, including NCD prevention, palliative, and elderly care. Although this position was discontinued in the 1980s, resulting in clear gaps in service, its re-establishment could have redefined the role and responsibilities of public health nurses in Sri Lanka.