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Sri
Lanka has made remarkable progress in the
last few decades in lowering infant, child and maternal mortality. This is
attributed to a number of factors that have had a mutually beneficial effect
which included, high political
commitment to health, provision of free health care, a well-developed health
infrastructure, implementation of evidence based intervention, free
education, subsidized food schemes and other socio economic welfare measures.
However, wide disparities in mortality rates exist between geographic regions
as well as population groups. The Infant Mortality Rate (IMR) and Neonatal
Mortality Rate (NNMR) have been stagnant over the past decade.
Much has been achieved in maternal health, but the quality
of care, both at institutional level and in the field, needs improvement.
Pre-conception needs which are coming into focus, has to be addressed
preferably through existing programmes such as
school health and adolescent / youth health programmes.
Antenatal care though having a broad coverage needs to be rationalised
to avoid duplication of services as well as to improve some quality aspects
of the services. In particular, improvements in intrapartum
care need special focus on many service issues, which would improve the
outcome of labour and impact on the health of the
mother and the neonate. Coverage and quality of services for postpartum care
were also addressed during the review process.
Newborn care in the country’s health system needs much
improvement. Unlike for maternal health that has a national focal point in
the FHB, there is none with regard to neonatal services.
WHO Country Cooperation
Strategy focuses on:
Strengthen the existing Maternal, Perinatal,
Newborn, Child, Adolescent , and Reproductive Health program by
supporting the addition of new evidence based interventions and
approaches, through effective policies and
strategies. Emphasis will be more focused on perinatal
care, newborn care, and vulnerable groups such as adolescent’s, children with
special needs, through continuum of care through out the lifecycle plus
nutrition issues and economic evaluation of interventions.
WHO in Sri Lanka has
focused its technical support to the government in following areas:
1. Development
of the capacity of programme managers strategic
planning in the programme areas.
2. Development
of a National strategic Plan on Maternal and new born Health.
3. Quality
of ANC to be improved & evidence based ANC intervention to be introduced
in to the health system with redesigning the existing maternal care package.
4. Intra
partum care to be improved with main steaming of near miss enquiry into
existing surveillance system and developing and implementing treatment
guidelines.
5. National
strategies, standards and guides on New born care to be developed and expanded
6. MNC
/ RH programs to be monitored and evaluated by using the performance
appraisal tools and Monitoring of MDG 4 and 5 to be continued and
mainstreamed with newly developed indicators.
7. Mainstreaming
of health package developed for newly married couples to address the
reproductive health need of the women.
8. Support
to conduct operational research on RH/CAH
9. Development
of comprehensive evidence based strategic plan for children with special needs
and planning and implementation of community based program for developmental,
behavioral & emotional disorders in 2 pilot districts.
10. Capacity
building of central & peripheral staff on Adolescent health including
life skills Adolescent Friendly Health Service package developed &
implemented in schools.
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