Sri Lanka Human Development Report 2012.pdf

Both Nuwara Eliya and Badulla have high proportions
of their population living on estates, where poverty rates
are high. Nearly half of all women of reproductive age on
the estates do not have even a primary education, and 30
percent of women are malnourished. 60 Most districts with
high levels of child malnutrition in 2009 had relatively low
female educational outcomes. 61
Several government initiatives are in place to arrest
malnutrition. Some, such as the Threeposha supplementary
feeding programme, have been operating for a long time.
Yet improvements have been limited, due partly to the fact
that raising nutrition levels requires concerted efforts on
many different fronts (Box 3.1). Frequent infections and
hard labour, for example, can also cause malnutrition, but
are unlikely to be addressed by feeding programmes. More
recent malnutrition initiatives are more intersectoral and
likely to have a greater impact. They follow the National
Nutrition Policy and Strategic Plan of 2010, which seeks
to bring together many different stakeholders to address
malnutrition. 62
Box 3.1
The Influence of Socioeconomic Factors on Child Nutrition
There are considerable disparities in child nutrition across
socioeconomic groups that favour the better-off in Sri Lanka.
A child belonging to the ‘poorest’ socioeconomic quintile is
three times more likely to be underweight than a child in the
richest quintile. The prevalence of maternal malnutrition and
low birth weight babies is four times higher among the lowest
socioeconomic group compared to the highest. Babies
with a low birth weight are twice as likely to be underweight
children as babies with normal birth weight. A mother’s
nutritional status and education have strong impacts on a
child’s nutrition and birth weight. A malnourished mother
may, for example, be less successful at breastfeeding and
caring practices that are vitally important for a child’s health
and proper growth. 1 A child whose mother is educated below
primary level is twice as likely to be underweight as a child
with a mother who has completed senior secondary level
education. Poor education reduces the ability of mothers to
benefit from awareness programmes about family health
and hygiene, among other effects.
Prevalence of Underweight Children and Underweight Babies by Mothers’
Socioeconomic Characteristics
Sources: 1 Jayawardena forthcoming and Smith et al. 2003.
Chapter 3 Bridging Human Development Gaps: Health 39