Back in the 1930s, Sri Lanka thought it would be a good idea to give everyone free access to health care. More than 75 years later, as the global health community bangs the drum for universal health coverage (UHC), Sri Lankans can be forgiven for letting out a yawn and wondering what all the fuss is about. But as shown by a workshop organized in Colombo last week to mark the first World UHC Day, the concept of universal health coverage (“all people receive the health services they need without suffering financial hardship”) does still have relevance here.
Start with the history. By 1960 Sri Lanka’s health indicators were already well above the curve for its income level, and it was close to having the best health outcomes in developing Asia. It started the MDG era in 1990 with a level of child mortality that was lower than where most Asian countries – including Vietnam, Philippines, Indonesia, and its South Asian neighbors India, Pakistan and Bangladesh – will finish it in 2015. Vaccination rates are above 99%. And all this was achieved without results-based financing, conditional cash transfers, or today’s other proposed silver bullet solutions for improving health.
It looked like an ordinary little drugstore. A reasonable supply of medication on the right, and man behind a small desk in the middle.
But what was on the desk was not ordinary: a netbook laptop and a fingerprint scanner. And on the left were boxes, all the same medication, with names written on them. “Try it,” Neema said. “Scan your finger.” I did and the screen turned yellow. “You have never been here yet” said Neema, “I cannot give you any medication.”
As the World Bank Group, we are dedicated to a world free of poverty. Poverty has many manifestations, of course, but few are sadder than child hunger and malnutrition. It is not just the heart-rending pangs of hunger or the susceptibility of a malnourished infant or child to ailments and diseases. The persistent effects are even more troubling. Poor nutrition impairs physical and mental development so that children benefit less from education and are less productive as adults. It leads to increased morbidity and mortality, causing output losses and increased spending on health and social support. Long ago William Blake wrote "some are born to endless night," poignantly capturing the tragedy of lives blighted by childhood deprivation.
If the extent of hungry children in the world – more than 350 million – is an inconvenient truth, their numbers in the South Asia region are acutely embarrassing.
The United Nations hosted the Millennium Development Goals (MDG) Summit in New York City last month, with the participation of over 120 global leaders from both developed countries and emerging markets. This year’s summit was an especially momentous occasion since it marks 10 years since the Goals were set into motion and begins the 5 year countdown to 2015 when the goals are to be met.
At the awards ceremony on September 19th, both Bangladesh and Nepal received MDG country awards for advancements towards the development goals in health indicators with India receiving a nomination for greatly increasing access to education.
We asked South Asia's Human Development Director, Michal Rutkowski about these achievements.
The National Solidarity Program (NSP) is a community-led reconstruction and rural infrastructure initiative. The program has made significant achievements in empowering communities, improving community relations, and increasing public faith in the system of government.
- South Asia
- Labor and Social Protection
- Social Development
- Law and Regulation
- Agriculture and Rural Development
- National Solidarity Program
- Irrigation and Rural Livelihoods
- International Development Association (IDA)
- Community Development Councils (CDCs)
|Photo Credit: (c) Chulie De Silva|
Reading the story today of Sri Lanka’s emergence as a success story in safer childbirth with a remarkable decline in maternal deaths, I mused about how I took for granted that childbirth would be safe when I had my children way back in the early 70’s. It was joy unlimited as I breezed through pregnancies always under the stern but very caring eye of my GP, Dr. Navaratnam. The news today that Sri Lanka should be held as an example for other South Asian countries makes me very grateful for the high quality of medical care that was available to us.
Presenting a paper at the Royal College of Obstetricians and Gynecologists, UK, South Asia Day, Dr Hemantha Senanayake, from the University of Colombo, said the “mortality ratio of Sri Lanka has declined dramatically as a direct result of the availability of midwives and trained assistance. “In 1960, the child mortality was 340 per 100,000; however, it was lowered to 43 per 100,000 live births in 2005.”