Sri Lanka’s Reproductive Health Care Best in South Asia, says New World Bank Report

Sri Lanka’s Reproductive Health Care Best in South Asia, says New World Bank Report

Sri Lanka outpaces Bangladesh, India, Nepal and Pakistan in achieving broad coverage of Reproductive Health Services, says a New World Bank report titled “Sparing Lives: Better Reproductive Health for Poor Women in South Asia,” released simultaneously today in South Asia.

The report takes a comparative look at Bangladesh, India, Nepal, Pakistan and Sri Lanka and the major risks faced by poor women – gender discrimination, early childbearing, poor nutrition, poor awareness of health, low access to quality health services and, ultimately, child loss and premature death.

On most indicators, Sri Lanka fares better than other South Asia countries. For example, the lifetime risk of dying during pregnancy for a woman in Sri Lanka is 1 in 430, which is significantly lower than in the rest of the region: in Bangladesh the lifetime risk is 1 in 59, in India 1 in 48, in Pakistan 1 in 31, and in Nepal 1 in 24. The average risk in these five South Asian countries (1 in 43) is almost a hundred times greater than that of a woman in the industrialized countries (1 in 4000).

Looking at pregnancy and delivery care, the report says differences in the region are greatest for institutional delivery – ranging from almost all births in Sri Lanka to less than 15 percent in Bangladesh and Nepal, and below 40 percent in Pakistan and India.

“Sri Lanka has achieved better reproductive health than the other countries in South Asia and this is not because it spends more per capita but because it uses resources more efficiently and equitably,” said Meera Chatterjee, World Bank Senior Social Development Specialist.

Poor women have substantially worse reproductive health than better-off women in all the five South Asian countries. The report says specific measures to improve poor women’s reproductive health are needed if the Millennium Development Goals (MDGs) related to maternal and child health are to be met.

The report calls for a substantial increase in the supply of reproductive health services for poor women, and for providing a complete package of essential reproductive health services in an integrated manner. Maternal and child health care, family planning, nutritional care, treatment of reproductive infections, referral, and all relevant information and counseling should be available through a ‘single window,’ the report says.

The report also looks at neonatal and infant mortality (deaths in the first month and year of life). Although immunization is an important strategy for infant and child health, only about half of all young children in the region are fully immunized. Deaths among children under-five need to be reduced to half or less of current levels to meet the MDGs.

“Sri Lanka can not be complacent about its reproductive health achievements,” said Naoko Ishii, World Bank Country Director for Sri Lanka. “It must continue to invest and maintain the momentum in its interventions in the health sector.”

All five countries have high levels of malnutrition, with over two-fifths of all children under-five in the region being malnourished. In Bangladesh, India and Nepal, 40-50 percent of children are under-nourished. In Sri Lanka the share is 22 percent. The levels are much higher among children of illiterate mothers – 52-55 percent in the first three countries, and 46 percent in Sri Lanka (based on 2000 Demographic and Health Survey data).

The report proposes decentralized action planning for improved reproductive health, involving a broad range of stakeholders in these processes, including poor women themselves, their institutions, local governments and health staff, thus increasing relevance and accountability. In addition the need is to target public resources more effectively at the poor, and in parallel, achieve universal coverage with essential health care. The health reforms that are critical to achieve these complementary goals are: enlarging and improving the pool of human resources; increasing the efficiency of spending; financing to reduce the cost burden on the poor; and increasing the responsibility and accountability of sub-national units.

To reach the MDGs, South Asian countries will also need to invest more in nutrition, girls’ education, water and sanitation, and transport, to name only those sectors with the most proximate bearing on reproductive health outcomes.

Credits:Dilinika Peiris,Colombo & Erik Nora Washington

More Information:http://go.worldbank.org/D8XSNBCUK0