The many positive outcomes in health and nutrition in Sri Lanka include:
- almost universal immunization coverage
- vast reduction in under-five mortality
- increased breastfeeding and access to antenatal care
- improved quality and accessibility of water and sanitation facilities in communities and preschools.
However, gaps remain in quality health and nutrition for the youngest children.
Malnutrition remains a significant public health problem in Sri Lanka. Maternal anaemia, particularly during pregnancy, contributes greatly to maternal mortality, and morbidity, and negative birth outcomes, such as low birth weight. In Sri Lanka, almost one in six babies is born with low birth weight. These infants are at a disadvantage for growth, and physical and cognitive development. Despite relatively favourable indicators on complementary feeding, the prevalence of wasting is at critical levels (15.1%). Stunting (17%) also persists (Sri Lanka DHS 2016), particularly amongst low income populations. Two out of five children aged 6-23 months do not receive a minimal acceptable diet in terms of food diversity and meal frequency.
Under-five child mortality has declined in Sri Lanka but neonatal mortality remains a challenge. There are wide disparities in under-five and neonatal mortality rates, with higher rates recorded in the North, East and Central regions of Sri Lanka where many populations still live in poverty.
While water and sanitation services have improved (90% and 86% coverage respectively), only 40% of households have access to these services with water quality verification. This means that many people do not have access to services that meet minimum international standards. There is currently no data on water treatment for almost 60% of households and no assessment of WASH guidelines in pre-schools. Gaps in groundwater safety and in the disposal of human waste cause diarrhea and pose critical health implications for the vulnerable. These issues most severely affect the youngest children who are not physically equipped to fight infection and disease.
Community care givers and front-line service providers have a limited understanding of the importance of early stimulation. Additionally, weak policy and regulatory frameworks do not adequately support a multi-sectoral ECCD (Early Childhood Care and Development) approach.