Sri Lanka Human Development Report 2012.pdf

Galle, Matara, Vavuniya, Kurunegala and Anuradhapura,
and in urban areas. In Colombo and Kandy, this may be
the result of seriously ill infants dying while receiving care
in tertiary hospitals there. In some areas, the rate increased
from 2003 to 2007, including on estates, where it rose from
13.6 in 2003 to 16.9 in 2007. In Batticaloa, it increased
from 21.1 to 25.1 during the same period. Further studies
are needed to determine the reasons for these changes.
Maternal Mortality
For more than six decades, Sri Lanka achieved considerable
success in consistently reducing maternal mortality. It
began heavily investing in maternal and child health
Sustained, significant investment in health is an important
reason for a steep decline in the maternal mortality rate:
from 61 per 100,000 live births in 1995 to 39.3 per
100,000 in 2006, according to estimates by the Family
Health Bureau. Today, Sri Lanka has the lowest maternal
mortality rate in the SAARC region, although regional
disparities persist (Figure 3.3). Maternal mortality rates
are highest in war-affected districts such as Killinochchi,
Batticaloa, Ampara and Mullaitivu, and in Nuwara Eliya
and Monaragala, which have high levels of poverty. Half
of the population of Nuwara Eliya comprises the estate
population whose health care options have begun to
improve only recently.
Figure 3.3: Maternal Mortality Rate by District, 2006
Source: Institute of Policy Studies of Sri Lanka and United Nations Development Programme 2010.
in the 1940s, which produced positive dividends over
the years. The country now has a wide network of free
maternal care services integrated with child care services.
A well-trained cadre of Public Health Midwives provides
domiciliary care; 98 percent of births take place in public
health institutions; 65 and more than 98 percent of births
are attended by skilled health care personnel, 74 percent
of whom are medical doctors.
Communicable Diseases
Sri Lanka has nearly eradicated most vaccine-preventable
diseases, as well as leprosy, malaria and Japanese
encephalitis. Basic immunization coverage is close to 100
percent (see Figure 3.4). According to available data, by
12 months of age, almost 100 percent of infants have been
vaccinated against tuberculosis (the BCG vaccine),
Chapter 3 Bridging Human Development Gaps: Health 41