Sri Lanka Human Development Report 2012.pdf

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Box 3.2 .....Continued What has been done so far Sri Lanka has taken initiatives to stop violence against women, such as the Domestic Violence Act of 2005. It has ratified all key international mechanisms on human rights, including four major instruments relevant to rape and other forms of gender-based violence. Following the passage of the Domestic Violence Act, the Forum against Gender-Based Violence was set up. Programmes help raise awareness among women and extend assistance through both government and non-governmental organizations. One-stop crisis centers are in place in government hospitals, and there are women’s desks at police stations. 1 United States Agency for International Development 2009b. 2 World Health Organization 2005. 3 Department of Census and Statistics of Sri Lanka 2011e. Health Care Services Decades of health investment have enabled Sri Lanka to achieve commendable health outcomes. Today, public health care is provided free of charge at government hospitals and dispensaries to all citizens, although the supply is unable to meet the demand. While the public health sector serves nearly 60 percent of the population, out-of-pocket health expenditure is very high, as will be discussed later in this chapter. 79 Responsibility for the public health service devolved from the central Government to the provincial councils with Provincial Council Act No. 42 of 1987. As a result, apart from the Health Ministry at the national level, there are nine provincial ministries of health. The Ministry of Indigenous Medicine promotes ayurvedic medicine. Compared to the public sector, the role of the private sector in health care is smaller, but has increased over time. Only 46 private hospitals operated in 1990; by 2000, their number grew to 65, and by 2008 to 90. 80 Private hospitals are largely concentrated in the Western Province, which in 2008 had 60 percent of them and 75 percent of all private hospital beds. 81 Health Facilities Access to health care is a complex process, encompassing service availability, the adequate supply of services and the opportunity to obtain health care. 82 The extent to which a population gains access depends on a variety of financial, organizational, social and cultural factors. 83 According to the Ministry of Health, by the end of 2007, Sri Lanka had 608 hospitals and 68,694 patient beds, including maternity homes and central dispensaries, and 72 government medical institutes, including teaching, provincial and base hospitals. 84 There were 62 ayurvedic hospitals and 208 central ayurvedic dispensaries, with 1,424 physicians serving public ayurvedic hospitals. 85 The number of government hospitals increased from 558 in 2000 to 615 in 2007. On average, a free Western-type government health care service can be found within 4.8 kilometres of any home. 86 In 2011, 11,023 medical officers and 31,466 nurses worked in the public hospital system. The number of medical officers and nurses per 100,000 people increased from 41.1 to 55.1, and 76 to 157.3, respectively, from 2000 to 2007. 87 This enormous health infrastructure is not equitably distributed. There are fewer government hospitals in the Northern and Eastern provinces (i.e. Jaffna, Killinochchi, Mannar, Vavuniya, Mullaitivu, Batticaloa, Ampara and Trincomalee), although the situation improved markedly from 2000 to 2007 (Figure 3.7). Chapter 3 Bridging Human Development Gaps: Health 47
Figure 3.7: Distribution of Government Hospitals, 2000-2007 Source: Ministry of Health 2007. Human and Physical Resources Access to health facilities alone does not ensure good health care. Facilities need to be adequately staffed, and require a regular supply of at least essential medicines and equipment. Nationally, Sri Lanka’s health workforce and infrastructure indicators are mostly comparable to those of Sri Lanka does well in terms of physician density compared to the poorer South Asian countries, such as Bangladesh and Nepal. This is also true in comparison to some more advanced economies such as Thailand and Indonesia (Table 3.4). However, Sri Lanka’s statistics appear low in comparison to most other Asian countries. For example, Table 3.3: Health Workforce and Infrastructure sri Lanka South-East Asia Global Physicians per 10,000 people, 2000-2010 4.9 5.4 14.0 Nursing and midwifery personnel per 10,000 people, 2000-2010 19.3 13.3 29.7 Dentistry personnel per 10,000 people, 2000-2010 0.8 0.7 3.0 Pharmaceutical personnel per 10,000 people, 2000-2010 0.4 3.8 4.1 Hospital beds per 10,000 people, 2000-2009 31 11 29 Radiotherapy units per 1,000,000 people, 2010 0.6 0.3 1.8 Source: World Health Organization 2011. South-East Asia, but they lag behind corresponding global figures, perhaps with the exception of pharmaceutical personnel (Table 3.3). the number of midwives and nurses is low compared to more advanced economies: 19.3 per 10,000 people in Sri Lanka compared to 27.3 in Malaysia. Performance is better in terms of the number of hospital beds: 31 per 10,000 people compared to 18 per 10,000 in Malaysia. 48 sri lanka Human Development report 2012
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SriLankaHumanDevelopmentReport 2012
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Sri Lanka Human Development Report
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Acknowledgements This report would
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sri lanka Human Development report
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Access to water 89 Accessibility to
Page 11 and 12: Figure 1.1: Share of GDP by Provinc
Page 13 and 14: Table 2.1 Table 2.2: Table 2.3: Tab
Page 15 and 16: CHAPTER 1 Why Revisit Regional Dime
Page 17 and 18: spreading its fruits more equitably
Page 19 and 20: Negotiations are still ongoing to f
Page 21 and 22: Box 1.1 A Selected Summary of Damag
Page 23 and 24: Other Vulnerable Groups A number of
Page 25 and 26: education financing and the distrib
Page 27 and 28: CHAPTER 2 Patterns of Human Develop
Page 29 and 30: population. It accounts for inequal
Page 31 and 32: Regional Variations in the Human De
Page 33 and 34: Map 2.1: Human Development Index 20
Page 35 and 36: Gender Inequality Index Among distr
Page 37 and 38: Comparing Districts Across Indices
Page 39 and 40: 14.5 percent in 2009-2010. As seen
Page 41 and 42: Economic Growth and Inequality Alth
Page 43 and 44: The poverty gap index, which measur
Page 45 and 46: half the headcount index. For the e
Page 47 and 48: What are the factors that push peop
Page 49 and 50: lowest incidence of both income and
Page 51 and 52: CHAPTER 3 Bridging Human Developmen
Page 53 and 54: disability of the heads of poor hou
Page 55 and 56: Infant Mortality and Under-five Mor
Page 57 and 58: and given three doses each of polio
Page 59 and 60: as the absence of illness, but also
Page 61: Box 3.2: Gender-based Violence The
Page 65 and 66: Figure 3.10: Medical Officers per 1
Page 67 and 68: While access to public health care
Page 69 and 70: Data on access in the Northern and
Page 71 and 72: People in Conflict-affected Areas F
Page 75 and 76: Levels)—mark the end of the senio
Page 77 and 78: Funding Education Public investment
Page 79 and 80: Figure 4.2: Distribution of Out-of-
Page 81 and 82: Male children are generally less li
Page 83 and 84: Deficits in information technology
Page 85 and 86: supports displaced children who ret
Page 87 and 88: Educational Performance: Senior Sec
Page 89 and 90: Building a Knowledge Economy Sri La
Page 91 and 92: Figure 4.10: Distribution of Univer
Page 93 and 94: offered by private institutions. 18
Page 97 and 98: twice the rate for the economy as a
Page 99 and 100: across geographic locations and by
Page 101 and 102: Box 5.1 Programmes to Improve Infra
Page 103 and 104: Figure 5.5: Extent (Ac) of Agricult
Page 105 and 106: towards constructing multipurpose r
Page 107 and 108: The length of national, provincial
Page 109 and 110: performs better in terms of mobile
Page 111 and 112: Technological advancements and tran
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Figure 5.12: Number of Fishers and
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CHAPTER 6 Bridging Governance Gaps:
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Figure 6.1: Sri Lanka’s Tax Reven
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When taxation becomes more visible,
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Table 6.2: The CPI: Comparing Count
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While the objective is laudable, it
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There has been progress on some ind
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to collect their own revenue throug
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the public sector in policy reform
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Table 6.6: Women in Elected Politic
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CHAPTER 7 Building on Peace, Progre
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This is a considerable task, but it
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The Ministry of Health in associati
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nationally and locally. The decline
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Notes sri lanka Human Development r
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54 World Health Organization 2001.
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amount equivalent to 8 percent of G
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Bibliography sri lanka Human Develo
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———. 2009e. Statistics databa
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Draft-13%2006%202010.pdf]. Last acc
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———. 2008c. Land Reforms in S
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Table A2: Human Development Index a
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Table A4: Income Poverty, Multidime
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Table A6: Income Poverty and Measur
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Table A8: Demography, Land and Hous
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Table A10: Infant Mortality, Under-
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Table A12: Maternal Nutrition, Tota
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Table A14: Health Awareness Percent
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Table A16: Primary Gross Enrolment
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Table A18: Government Schools and S
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Table A20: Labour Force Labour forc
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Table A22: Unemployed Population Un
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Table A24: Household Possessions Co
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Table A26: Average Distance and Tim
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Technical Note sri lanka Human Deve
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HDI= (I Life Expectancy ) 1 / 3 ×
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where MMR=maternal mortality rate;
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Multidimensional poverty headcount(
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Figure T.2: Intensity of Poverty an
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of the total deprivations of poor p
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178 sri lanka Human Development rep
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