Boosting access to critical healthcare for children living in remote areas through outreach clinics

It’s a bustling Tuesday morning at the Mahaoya Base Hospital, Ampara in Sri Lanka’s Eastern Province where over 15 families have gathered at the local outreach clinic to receive healthcare for their malnourished children.

Nestled amidst a dense jungle, this clinic serves as a lifeline for a 20,000 community of farmers, including indigenous persons, to access healthcare and nutrition for their children who are suffering from Severe Acute Malnutrition (SAM).

“These special outreach clinics provide communities with critical paediatric care since the two main hospitals are located over 60km away,” explains Dr. Wickramasinghe (38), the District Medical Officer of the Mahaoya Base Hospital.

At the clinic, Ms. Mallika Rathnayake (28) is waiting in line with her 4-year-old daughter, Sathsarani, for a growth monitoring check-up, hoping for some improvement. Last November, Sathsarani was identified with SAM and has been since receiving the much-needed care at the clinic.

Mallika, and many of the farmers in the area, are impacted by factors beyond their control such as droughts, elephant encroachment of their crops, and the added burden of the economic crisis, making it a challenge for them to provide for their children.

Due to the limited availability and affordability of public transport, Mallika is often left with little choice, but to walk 20 km on foot in order to reach the town. Occasionally, she would rely on a lift from kind-hearted strangers. The financial burden of hiring a three-wheeler, costing around Rs. 1,500 (USD 4.6), is a luxury she cannot afford.

“We often travel by foot to save money to support our children’s needs,” Mallika explains. “It pains me to know that my child is severely malnourished. I cannot explain my sadness.”

“We somehow try to save enough money to feed our children, but it is very difficult to manage amidst the rising cost of living."

Like most parents, despite her limitations, Mallika is eager to see her child’s growth and development. Fortunately, through the outreach clinic, and the monetary incentives provided to cover transport and the day’s expenses, she was able to take her daughter to the clinic to receive the proper paediatric care.

Sathsarani started receiving BP-100 Ready-to-Use Therapeutic Food (RUTF) last December as treatment for SAM. “My daughter has now gained weight and is progressing,” says Mallika. “But she is still the smallest -in weight and height, in her pre-school class even though she is the oldest.”

“Unlike the regular health clinics, this clinic is dedicated for children identified with SAM. Paediatric care, provision of therapeutic food, and advice on nutrition, are provided here,” explains Dr. Wickramasinghe. “We promote this facility through our healthcare network as it is important that parents bring their children to the clinic to receive proper care and support to overcome malnutrition. Funding to cover transportation to the clinic and back ensures regular attendance.”

In October 2022, over 18,000 children in Sri Lanka were identified with SAM and in November 2022, nutrition treatment services were scaled up by UNICEF with the funding assistance from the Department of Foreign Affairs and Trade, Australia (DFAT) and United States Agency for International Development (USAID). Outreach clinics have been set up across the country and over 10,000 SAM children are enrolled at these clinics and are being treated with therapeutic food and paediatric care. UNICEF is working with key partners in the Government and civil society organizations (CSO) to ensure the delivery of this programme.