he public health landscape in Sri Lanka is fast changing due to rapid urbanisation and because of the effects of globalisation.
Despite the 30-year civil war, our health outcomes, with limited resources are impressive with Sri Lanka placed 92nd out of 187 in the UN Human Development Index. This is not by accident but through prudent public investment in health and well-being of our people through free State education and free State health care.
We have a robust free health network with primary, secondary and tertiary care, where people are free to choose any facility they wish to attend. In addition, our preventive health care system has tackled maternal, reproductive, child and adolescent health care, immunisation where communicable diseases have been addressed and curbed effectively.
Primary, secondary and tertiary education is also free to all since 1938 resulting in a literacy rate of 91%.
The result is a high life expectancy of 74.9 years, infant mortality rate of 8.5 per 1000 live births and maternal mortality 32 per 100,000 live births in 2015.
High female literacy, women’s empowerment and willingness of the mother to access allopathic care for the family are the pivotal reasons for this impressive health outcome.
However, we are fast moving into an epidemic of “lifestyle illness” known as Non- Communicable Diseases or NCDs resulting in cardiovascular diseases, diabetes, cancer, chronic respiratory disease and addiction to tobacco and alcohol.
The common factor is that they are preventable.
It is in the hands of the individual who has to be empowered to co-operate through behavioural changes. Modern lifestyles of unhealthy diet coupled with sedentary and stressful lifestyles leading to overweight and obesity, are the main causes and risk factors.
Lifestyle modification from unhealthy to healthy to correct the risk factors need to be incorporated in early life in the “life circle” approach of preconception, conception, childhood and adult life.
It is frightening to note that these illnesses have increased morbidity, disability and mortality to account for 65% of all deaths in the country where 18% occur prematurely below 60 years of age.
Unfortunately, this is part of the global trend, when a country moves from a low-income to middle-income status.
The whole of Government and civil society approach is required to address and reverse these trends. We need an effective health promotion system to prevent control and treat NCDs.
-NCD Alliance Lanka