Child survival & development in early childhood

Building a strong foundation for a child’s future wellbeing and learning.

Father carrying his baby

The Challenge

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.

The Solution

UNICEF is working to ensure that children in early childhood are given the best possible foundation to survive and thrive in the future. We pursue an integrated approach to:

  1. Reduce neonatal mortality and morbidity;
  2. Address maternal and childhood malnutrition;
  3. Increase access to comprehensive quality early learning, care and development services;
  4. Support efforts to create and sustain urgency for national action on early identification of disabilities
  5. Improve child-friendly WASH and capacity of relevant duty bearers
  6. Provide intervention services, focusing on the most deprived children and their families.

These efforts are supported by improved data management on nutrition, health and WASH at the national and district levels so that future interventions are data-driven and relevant to ground realities. UNICEF will use this information to work with government partners and improve coordination and distribution of services to realize a more holistic child survival system across Sri Lanka. The goal is to adapt healthcare, WASH and nutrition services to international standards that is equally accessible to all.

UNICEF is committed to working with all stakeholders to drive continued progress.

UNICEF is working with its partners to impart knowledge to pregnant mothers, parents and caregivers on nutrition, breastfeeding, complementary feeding, sanitation and hygiene, early stimulation and psychosocial development.

UNICEF also advocates for improved child-friendly WASH infrastructure in pre-schools and communities. We are pushing for grassroots education and empowerment for the planning, budgeting, monitoring and practice of healthy WASH behaviors in society. This advocacy and capacity-building will be conducted in partnership with centers of excellence, academic institutions, private sector organizations and other stakeholders to uplift the standard of health and nutrition across the country.

Children with disabilities will be looked at with special concern, and a concerted effort will be made to provide broadly accessible services that address the specific needs of this vulnerable segment.


Everything we do at UNICEF, from planning to execution, is grounded in empirical data, independent evaluation, rigorous research and thoughtful analysis. This information is gathered with the help of our own staff and the help of our network of partners in communities around the country.

UNICEF supports research and uses it to inform every decision we make. We rely on hard evidence to assess any situation on the ground, and we use these findings to drive programs, policies and initiatives.

If you would like to learn more about child survival and development in early childhood, please have a look at the resources below.

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