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| Sunday, 24 October 2004 |
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Features |  |
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Sri Lanka has realized health goals Statement by Healthcare and Nutrition Minister Nimal Siripala de Silva, at the commemoration of the 10th anniversary of the International Conference on Population and Development (ICPD) United Nations General Assembly, Fifty-ninth session. At the outset I wish to state that Sri Lanka and the Government of Chandrika Bandaranaike Kumaratunga is fully committed to the implementation of the ICPD Programme of Action. In this regard, I wish to take this opportunity to highlight some of our achievements in the post ICPD period, the challenges we face and the way forward in meeting both the ICPD and Millennium Development Goals. During the past decade, Sri Lanka has continued to consolidate on the achievements in the population, development and reproductive health fields. This period has also seen an acceleration of population and socio-economic change. Sri Lanka was one of the countries to make an early transition to adopt the concept of reproductive health and formulate a comprehensive national policy on population and reproductive health. Based on it, an Action Plan has been developed to implement population and development and reproductive health activities in a broadbased and holistic manner. The concept of "Well Women's Clinics" was introduced in 1996 for screening of reproductive organ malignancies and certain other health conditions, and to provide counselling on reproductive health. In Sri Lanka, adolescents comprise about 17 per cent of the total population. Adolescence is a dynamic phase of development in the life of young people. It is a period often not very well understood by both adolescents themselves as well as by adults. This is particularly evident with regard to sexuality and reproductive health. The national reproductive health programme in Sri Lanka therefore provides opportunities for young people to have access to information, education and services in this regard. Although HIV prevalence is relatively low in Sri Lanka, the Government is concerned of the potential threat that it poses and places high priority on the prevention and control of HIV/AIDS and STIs. A policy on blood safety was developed in 1999. A comprehensive social support programme has been developed and supplemented with grant assistance from the World Bank and the Global Fund to prevent the spread of HIV among vulnerable groups. Life expectancy Sri Lanka's progress in the population and development field during the past decade has been significant. The rate of growth of population has declined from 1.5 per cent in the early 1990s to 1.1 per cent today. Life expectancy at birth for females and males is comparable to that of more development countries with 75.4 and 70.7 years respectively. Infant mortality rate has been reduced to 13 per thousand live births and the maternal mortality ratio is about 50 per 100,000 live births. Per capita income has continued to increase at a steady pace. Continued reliance on open economic policies with a human face and greater emphasis on human resource development, have enabled Sri Lanka to achieve an average economic growth rate of 5 per cent during the past decade, despite the armed conflict in the North and East of the country. The level of poverty has continued to decline due to overall economic growth and continued emphasis on the transfers of income to the poor through poverty alleviation programmes, free education and health services. Considerable progress has also been made in improving the level of education of the population. Literacy rates are equally high for both males and females with 91 and 88 per cent respectively. These impressive indicators place Sri Lanka in a unique position in relation to other countries at similar levels of per capita income. An economic benefit from slower rate of growth of population resulting from decline in fertility is the trend towards lower dependency ratios. The dependency ratio, which was 85.2 per cent in 1991 dropped to 46.4 in 2000. It is further expected to decline to about 45 per cent by 2010. Thus the demographic structure of Sri Lanka is well geared to accelerated social and economic development. Considerable progress has been made in improving gender equality and development. With regard to institutional development, Sri Lanka has had a Women's Bureau since 1978 even before CEDAW. The Government adopted the National Women's Charter in 1993. A separate Ministry of Women's Affairs was established in 1997. Gender focal points have been appointed in sectoral Ministries. Amendments to the Penal Code have been made to enhance punishment for rape and other forms of sexual abuse and violence. Trafficking of women and children has also been made a criminal offence. A Child Protection Authority has been established under H.E. the President to protect the rights of children, particularly with regard to sexual abuse and trafficking. A draft Bill on domestic violence is under consideration by the Cabinet of Ministers. A Bill on Women's Rights and Gender Policy is being formulated. Despite the considerable achievements during the post ICPD period, there are yet areas in Sri Lanka that need focused attention. Population ageing will assume important proportions in the coming decades, requiring demand for adequate healthcare and social support programmes. Migration Although the pace of urbanisation thus far has been relatively slow, it is expected to accelerate in the future. It is thus necessary to ensure the planned growth and development of cities. While it is necessary to promote the economic benefits of migration and urbanisation, attention needs to be focused on their adverse social and health effects. I wish to draw your attention to another important issue that confronts us, namely international migration. There are about 1.5 million migrant workers mainly females working outside the country. Some of them are exposed to health risks. In addition, migration of female workers has adversely affected the lives of families left behind and the workers themselves have been affected by poor working conditions. On the other hand, the "brain drain" resulting in large numbers of health and other professionals trained by the Government, emigrating, has placed detrimental pressures on our national health care system and other development activities. In spite of the progress made in the field of maternal health, still two thirds of maternal mortality and morbidity are due to preventable causes. Though maternal and child care services have reached the greater majority of the population, the quality of services needs improvement. The demand for better quality services by the people is the result of both rising incomes and educational levels of the population. Although the fertility rate is at replacement level, still significant fertility differentials exist between socio-economic groups and between geographic areas. The goals of ICPD Programme of Action require as a precondition, good governance and peace. In this regard, I wish to state that the impact of the armed conflict in the North and East of the country, for nearly two decades, which resulted in large numbers of internally displaced persons and constrained the provision of health and other reproductive health services, is gradually receding. There is no doubt that the benefits of the peace dividend would be widespread and positive. Population and development issues are very much inter-related. International developments that bring about "economic shocks" which causes adverse effects on developing countries in turn affect the implementation of population and reproductive health programmes. Therefore, I wish to emphasise that the international donor community should increase their contributions to enable developing countries to mitigate such external shocks, which are beyond our control so that population and reproductive health programmes, including poverty alleviation could be effectively implemented. Challenges We have realized that in order to consolidate the gains that Sri Lanka has achieved thus far, and to move forward to face emerging challenges in the coming years, broader and deeper partnerships between the Government, civil society and the international community are essential. I wish to state that Sri Lanka has effectively and efficiently utilized domestic and international resources in the realisation of their population and reproductive health goals. We are indeed grateful to the donor community and in particular to the United Nations Population Fund for the assistance extended to Sri Lanka to implement its programmes effectively. Such continued assistance will enable us to meet the ICPD and Millennium Goals during the given timeframe. |
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