The most striking feature of the distribution of health care facilities in the island of Sri Lanka is the marked concentration of state sector hospitals and key health personnel in the densely populated Colombo Metropolitan Region. Urban bias is evident in the lack of higher grade hospitals in peripheral areas. Lower grades of hospitals located predominantly in the underserved areas are underfunded and are being by-passed by the majority of potential patients. The highest priority is now being accorded by the state to providing health care facilities to underserved areas and to underserved and vulnerable populations in order to reduce existing disparities. This is reflected in improving health conditions in the peripheral areas developed under the Mahaweli Development Programme, the Matara Integrated Rural Development Project and in the rural estate sector.