Assessing Public Financing for Nutrition in Sri Lanka
For decades, Sri Lanka’s health system has been known globally as one of the best performing in the world, having achieved ‘good health at low cost’. Life expectancy at birth, which stood at 75 years as of 2016, was higher than the South Asian average of 69 years. In terms of maternal and child health (MCH) indicators, Sri Lanka’s neonatal, infant, and under-five mortality rates in 2018 were 6.5, 9.1, and 10.6 per 1,000 live births (LB), respectively, and the maternal mortality ratio was 39.3 per 100,000 LB in 2017. Nonetheless, issues remain.
Undernutrition is one such unfinished agenda that has not improved over the last decade. Stunting rate, which reflects chronic undernutrition in early life, remained unchanged at 17.3 percent between 2006 and 2016, neither did the rate of wasting change significantly. Particularly, the current wasting rate of 15.1 percent among children under five is considered ‘very high’ in the World Health Organization (WHO) benchmark. Undernutrition is the single dominant risk factor of burden of disease for children under five in Sri Lanka. In addition, there is a growing concern over the threat of noncommunicable diseases (NCDs). The share of NCDs in aggregate disability-adjusted life years (DALYs) increased from 53 percent in 1990 to 77 percent in 2017, and the total DALYs from NCDs have increased by 36 percent. It is well regarded that overweight and obesity are critical risk factors for NCDs, and hence the country is in the midst of double burden of malnutrition.