C ommo nwe a l t h memb e r c o u n t r i e s immunisation to 100 per cent when the 2015 data is analysed. In 2013 under-five mortality stood at ten deaths per 1,000 live births and measles immunisation at 99 per cent. Considering that Sri Lanka’s under-five mortality rate has been consistently falling since 1990 and measles immunisation is nearing 100 per cent, Sri Lanka has a good chance of achieving its MDG 4 targets when the 2015 data is analysed. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. For Sri Lanka, maternal mortality should fall to 29 deaths per 100,000 live births. In 2013 Sri Lanka had an adjusted maternal mortality rate of 29 deaths per 100,000 live births (this figure was estimated at 35 deaths per 100,000 by UN agencies/World Bank in 2010). Considering the figure reported by the country, it has already met the maternal-mortality target. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In 2013 this figure stood at 99 per cent, so this target has virtually been achieved. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. Sri Lanka is a low prevalence country for HIV/AIDS. In the period 2010–11 there was a significant decrease in the number of reported cases of malaria, from 632 to 124. Estimated TB mortality (when mortality data excludes cases comorbid with HIV) fell slightly in the period 1990–2010, though estimated incidence has remained unchanged. With continued progress, Sri Lanka may achieve the targets set by this goal when the 2015 data is analysed. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Only two-fifths of health care in Sri Lanka (40 per cent) was government funded in 2012. The remaining 60 per cent was paid for by patients or funded by other non-governmental entities, such as private insurers, charities or employers. Total health expenditure constituted 3.1 per cent of GDP in 2012. Expenditure by the government amounts to US$35 per capita. In recent years the government of Sri Lanka has taken significant steps towards improving government-funded health care in the country. Sri Lanka has an extensive network of public health units and hospitals spread across the island, and the majority of hospitals are well staffed and equipped to meet the general health demands of the community. Public health services are provided free of charge to citizens of Sri Lanka. However, in 2013 the World Health Organization reported that there is still a need for the reform of the primary health care model. It was suggested that, while hospitals in general are well equipped in terms of staff and 272 Commonwealth Health Partnerships 2015 equipment, the importance of public health needs revitalising. The health system of the northern and eastern provinces was severely affected by years of conflict in the country and is in dire need of attention. Sri Lanka was not an original signatory to the International Covenant on Economic, Social and Cultural Rights, but acceded to it in 1980 and has written the covenant into law. It includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination. Care of the elderly: Around 1.8 million people in Sri Lanka are over the age of 65 – eight per cent of the total population (2013). At the age of 60 a person in Sri Lanka can be expected to live for an additional 20 years, on average (2013). Overall, public pension spending is equivalent to two per cent of the country’s total economic output (2007). Population over 65 8% The population of Sri Lanka, in running with the population in the rest of South Asia, is rapidly increasing. Where in the past elderly members of society would have been cared for by their close relatives and neighbouring community, the societal structure of Sri Lanka has now begun to move away from these traditional practices. In recent years, the government has started to expand its duty to protect the rights of the elderly and promote social welfare services. Consequently, in 2000 the Ministry of Social Services, Welfare and Livestock Development established the National Council for Elders and National Secretariat for Elders under the Protection of Elders Rights Act. There are a number of private elderly care providers present on the island, including Cinnamon Care Services and the Royal Nursing Home. Further information Ministry of Health: www.health.gov.lk Commonwealth Health Online: www.commonwealthhealth.org/health/asia/sri_lanka
Commonwealth Health Partnerships 2015
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