Dear friends,
The Asian Human Rights Commission (AHRC) has received information that surveys conducted by State and UN Agencies have indicated an alarming rate of malnutrition among children, pregnant women and lactating mothers in Sri Lanka. The Demographic and Health Survey (DHS) conducted by the Health Ministry of Sri Lanka in 2010, A Nutrition and Food Security Assessment Survey issued by UNICEF and the World Food Program (WFP) on June 8 2010 and the National Health Bulletin issued by the Health Ministry of Sri Lanka in 2014, revealed statistics about the existing situation in the country. Underweight new-born children, stunted growth and small waist measurements of children shows the severity of the problem. On 1 April 2015 the Sri Lanka government started to provide a nutritional package for pregnant women worth Sri Lankan rupees 20 000 (US$ 148) divided by 10 months. The AHRC is of the opinion that this is not a proper approach to effectively address the problem. They noted Sri Lanka’s obligation to the UN-CESCR and put forward an alternative solution that could be adopted to implement comprehensive and collective measures to relieve the situation.
CASE NARRATIVE:
According to information received by the Asian Human Rights Commission (AHRC), the Sri Lankan government on 21 March 2015, started to provide a food allowance of Rs. 20,000 for pregnant women under the patronage of the President. This allowance was proposed in the new government’s interim budget under the Maternal Health Program.
All pregnant women, registered in government maternal clinics, who regularly attend clinics, will receive food and vitamins upon the recommendation of a doctor. Nutritious food will be provided during the last 6 months of pregnancy and for the first 4 months after delivery of a child. Coupons will be issued that can be redeemed at outlets of the Cooperative Wholesale Establishment or Sathosa.
Divisional Secretaries with the assistance of doctors and family health officials serving in the maternity clinics will implement the program under the supervision of the District Secretaries/Government Agents under a steering committee of the State Ministry of Children’s Affairs. Family health officers will monitor the program.
Malnutrition situation among children and women
Child Affairs State Minister, Rosy Senanayake, mentioned at a press conference held at the Information Department on 21 March 2015, that there are low birth weights of 16-18% in Sri Lanka.
An Island-wide survey was conducted in 2010 on the nutritional status of children and women in the country. The Ministry of Health conducted a Demographic and Health Survey (DHS) in 2010.
According to the reports, child malnutrition is considerably higher in the North and East Provinces reaching 46% out of a national average of 29 %. In the two provinces, the prevalence of malnutrition is significantly greater among boys-50%, than among girls-42%. This gender differential is in sharp contrast to the malnutrition pattern in the rest of the country, where rates are similar among boys and girls.
The age pattern of malnutrition shows that children who are underweight reach a peak in the age group 12-35 months, and then tapers off slightly to 36-59 months. This age limit is similar to the rest of the country.
The differences in malnutrition in urban and rural areas are small, varying by 1%. Lack of maternal education is strongly associated with the lower levels of malnutrition.
The prevalence of child malnutrition among uneducated mothers is 63%. As the education level of mothers rises, the prevalence of child malnutrition declines to 54% for primary school educated mothers, 42% among secondary school educated mothers and 36% among tertiary educated mothers. This pattern is consistent with evidence from the rest of the country which shows a favorable association between maternal education and child malnutrition.
The surveys reveal that acute malnutrition is rife among Sri Lankan children and women as a result of the country’s 30-year civil war and widespread poverty. Child malnutrition is more than 50% in some areas of the East and North, with the national average at a record of 29%.
In the Batticaloa, Trincomalee and Ampara districts in the eastern province, child malnutrition is 53, 45 and 44%, respectively. In the northern districts of Vavuniya and Jaffna it is 51% and 43%. The highest numbers of underweight children in these areas were in the 12-35 month age group, with a slight reduction in those aged 36 to 59 months. Malnutrition among girls is 42% and 50% for boys.
While the malnutrition figures are lower in other parts of Sri Lanka, the situation is nevertheless alarming. According to the 2006-07 Demographic and Health Survey, which excluded the northern and eastern parts of Sri Lanka, the national average of underweight infants was 17% and the figure has not improved.
The highest numbers of underweight infants were born to mothers in Sri Lanka’s plantation districts, with 31% of children from these areas born underweight. This is a 10% increase on the survey conducted in 2000, with the highest numbers recorded in the Nuwara Eliya and Badulla districts. For Nuwara Eliya the figure was 33.8%, and in Badulla 21.9%.
These figures are not accidental. Estate workers are among the lowest paid workers in Sri Lanka. According to official statistics, poverty among plantation workers increased 56% between 1991 and 2006.
Diarrhea, acute respiratory infections, malaria and other diseases causing fever are widespread among children under the age of five throughout Sri Lanka. The prevalence of fever among children between 6-11 months is 22.8%, and among children 12-23 months is 21.5%
A Nutrition and Food Security Assessment Survey issued by UNICEF and the World Food Program (WFP) on 8 June 2010 confirmed the same general trends. The survey was carried out in nine districts—rural, estate and urban—among those considered the most economically vulnerable.
It was revealed that households spent 37.9% of their monthly income on food and 43.6% on work related expenses, with nearly a third of households forced to borrow money for their purchases. According to the survey, 32% of the households “did not have enough food” at least once during the previous 12 months. The figure was 55.9% in the estate sector.
The UNICEF-WFP report reveals that 39.1% of households had a monthly income of less than 9,000 Sri Lankan rupees ($US79). Almost 60% of the Jaffna district households were in the lowest income category, 55% in Badulla and 51.7% in Ratnapura. It found that 0.5% of the households were “severely food insecure”, 11.8% “moderately food insecure” and 87.6% “food secure”.
The prevalence of anemia was 16.2% among pregnant women, 19.6% among lactating mothers and 21.7% among non-pregnant and non-lactating women. Almost 20% of Sri Lankan children in the 0-59 month age group were stunted, 11.7 wasted and 21.6 percent underweight. Stunting in the Nuwara Eliya, Badulla and Ratnapura districts was 40.9%, 23.9% and 21.6% respectively. The Colombo district figure was 17.4%.
The UNICEF-WFP report concluded that a high percentage of households were living on “borrowed food and reduced meals as a coping strategy,” and the prevalence of anemia among women and malnutrition among pre-school children, were serious public health issues. The government, however, has no solutions for these acute problems.
Several Sri Lankan State agencies, UN agencies and various corporations, engaged in campaigns from 2010 to 2015, focusing on “eradicating child malnutrition” have not been able to overcome the problem. They were not successful in addressing the situation fully.
Economic policies of consecutive governments were not well planned. Social welfare spending, especially for education and health, was increased in the last decade. Local food production was increased. A government effort on strengthening the livelihood of the population has failed. The unequal distribution of wealth remains. As a result, poverty and acute health problems face the Sri Lankan masses.
The Asian Human Rights Commission recommends the following short and long term measures be adopted and implemented by the State of Sri Lanka.
a) Immediately conduct a Demographic Household Survey on malnutrition among children, pregnant women and lactating mothers, to clarify the present situation.
b) Identify essential foods items and arrange necessary budgetary relief for those items.
c). Establish a pricing policy for essential foods throughout the country.
d). Implement monitoring by the officers of the Consumer Affairs Authority (CAA).
e). Research ad-hoc specimens of essential food items to inspect the quality, nutritional values, and the hygienic condition of the food items.
f). Wave custom duties on essential food items from abroad.
g). Strengthen co-operative networks throughout the country, enabling rural and suburban communities to buy essential food items.
h). Strengthen the work of Medical Officers of Health (MOH) throughout the country and the routine follow-up on households to check the nutritional levels of children and women.
i). Simplify the taxation policy of the country.
j). Reduce the dependency of the government’s revenue on Value Added Taxation (VAT) and increase the ratio of government’s revenue, through income tax. According to the Central Bank’s Report for 2013, the government has weighted 88% of their revenue on VAT.
k). An agreed time frame for the alleviation of malnutrition among children and women.
SUGGESTED ACTION:
Kindly send a letter to the authorities listed below expressing your concern about the malnutrition among children, pregnant women and lactating mothers in Sri Lanka. Request an immediate investigation into the situation, taking into consideration short term and long term collective measures to address the question.
Please note that the AHRC has also written a separate letter to the UN Special Rapporteur on the right of everyone to enjoy the highest attainable standard of physical and mental health.
To support this case, please click here: SEND APPEAL LETTER
SAMPLE LETTER
Dear ………………..,
SRI LANKA: Serious malnutrition among children, pregnant women and lactating mothers
Name of the victim: Children, pregnant women and lactating mothers
Alleged perpetrator: Ministry of Sri Lanka and other responsible government agencies
Date of incident: Year 2015
Place of incident: Island wide in Sri Lanka
I am writing to express my serious concern over the situation of serious malnutrition among children, pregnant women and lactating mothers in Sri Lanka.
The Sri Lankan government on 21 March 2015, started to provide a food allowance of Rs. 20,000 for pregnant women under the patronage of the President. This allowance was proposed in the new government’s interim budget under the Maternal Health Program.
All pregnant women, registered in government maternal clinics, who regularly attend clinics, will receive food and vitamins upon the recommendation of a doctor. Nutritious food will be provided during the last 6 months of pregnancy and for the first 4 months after delivery of a child. Coupons will be issued that can be redeemed at outlets of the Cooperative Wholesale Establishment or Sathosa.
Divisional Secretaries with the assistance of doctors and family health officials serving in the maternity clinics will implement the program under the supervision of the District Secretaries/Government Agents under a steering committee of the State Ministry of Children’s Affairs. Family health officers will monitor the program.
Malnutrition situation among children and women
Child Affairs State Minister, Rosy Senanayake, mentioned at a press conference held at the Information Department on 21 March 2015, that there are low birth weights of 16-18% in Sri Lanka.
An Island-wide survey was conducted in 2010 on the nutritional status of children and women in the country. The Ministry of Health conducted a Demographic and Health Survey (DHS) in 2010.
According to the reports, child malnutrition is considerably higher in the North and East Provinces reaching 46% out of a national average of 29 %. In the two provinces, the prevalence of malnutrition is significantly greater among boys-50%, than among girls-42%. This gender differential is in sharp contrast to the malnutrition pattern in the rest of the country, where rates are similar among boys and girls.
The age pattern of malnutrition shows that children who are underweight reach a peak in the age group 12-35 months, and then tapers off slightly to 36-59 months. This age limit is similar to the rest of the country.
The differences in malnutrition in urban and rural areas are small, varying by 1%. Lack of maternal education is strongly associated with the lower levels of malnutrition.
The prevalence of child malnutrition among uneducated mothers is 63%. As the education level of mothers rises, the prevalence of child malnutrition declines to 54% for primary school educated mothers, 42% among secondary school educated mothers and 36% among tertiary educated mothers. This pattern is consistent with evidence from the rest of the country which shows a favorable association between maternal education and child malnutrition.
The surveys reveal that acute malnutrition is rife among Sri Lankan children and women as a result of the country’s 30-year civil war and widespread poverty. Child malnutrition is more than 50% in some areas of the East and North, with the national average at a record of 29%.
In the Batticaloa, Trincomalee and Ampara districts in the eastern province, child malnutrition is 53, 45 and 44%, respectively. In the northern districts of Vavuniya and Jaffna it is 51% and 43%. The highest numbers of underweight children in these areas were in the 12-35 month age group, with a slight reduction in those aged 36 to 59 months. Malnutrition among girls is 42% and 50% for boys.
While the malnutrition figures are lower in other parts of Sri Lanka, the situation is nevertheless alarming. According to the 2006-07 Demographic and Health Survey, which excluded the northern and eastern parts of Sri Lanka, the national average of underweight infants was 17% and the figure has not improved.
The highest numbers of underweight infants were born to mothers in Sri Lanka’s plantation districts, with 31% of children from these areas born underweight. This is a 10% increase on the survey conducted in 2000, with the highest numbers recorded in the Nuwara Eliya and Badulla districts. For Nuwara Eliya the figure was 33.8%, and in Badulla 21.9%.
These figures are not accidental. Estate workers are among the lowest paid workers in Sri Lanka. According to official statistics, poverty among plantation workers increased 56% between 1991 and 2006.
Diarrhea, acute respiratory infections, malaria and other diseases causing fever are widespread among children under the age of five throughout Sri Lanka. The prevalence of fever among children between 6-11 months is 22.8%, and among children 12-23 months is 21.5%
A Nutrition and Food Security Assessment Survey issued by UNICEF and the World Food Program (WFP) on 8 June 2010 confirmed the same general trends. The survey was carried out in nine districts—rural, estate and urban—among those considered the most economically vulnerable.
It was revealed that households spent 37.9% of their monthly income on food and 43.6% on work related expenses, with nearly a third of households forced to borrow money for their purchases. According to the survey, 32% of the households “did not have enough food” at least once during the previous 12 months. The figure was 55.9% in the estate sector.
The UNICEF-WFP report reveals that 39.1% of households had a monthly income of less than 9,000 Sri Lankan rupees ($US79). Almost 60% of the Jaffna district households were in the lowest income category, 55% in Badulla and 51.7% in Ratnapura. It found that 0.5% of the households were “severely food insecure”, 11.8% “moderately food insecure” and 87.6% “food secure”.
The prevalence of anemia was 16.2% among pregnant women, 19.6% among lactating mothers and 21.7% among non-pregnant and non-lactating women. Almost 20% of Sri Lankan children in the 0-59 month age group were stunted, 11.7 wasted and 21.6 percent underweight. Stunting in the Nuwara Eliya, Badulla and Ratnapura districts was 40.9%, 23.9% and 21.6% respectively. The Colombo district figure was 17.4%.
The UNICEF-WFP report concluded that a high percentage of households were living on “borrowed food and reduced meals as a coping strategy,” and the prevalence of anemia among women and malnutrition among pre-school children, were serious public health issues. The government, however, has no solutions for these acute problems.
Several Sri Lankan State agencies, UN agencies and various corporations, engaged in campaigns from 2010 to 2015, focusing on “eradicating child malnutrition” have not been able to overcome the problem. They were not successful in addressing the situation fully.
Economic policies of consecutive governments were not well planned. Social welfare spending, especially for education and health, was increased in the last decade. Local food production was increased. A government effort on strengthening the livelihood of the population has failed. The unequal distribution of wealth remains. As a result, poverty and acute health problems face the Sri Lankan masses.
The Asian Human Rights Commission recommends the following short and long term measures be adopted and implemented by the State of Sri Lanka.
a) Immediately conduct a Demographic Household Survey on malnutrition among children, pregnant women and lactating mothers, to clarify the present situation.
b) Identify essential foods items and arrange necessary budgetary relief for those items.
c). Establish a pricing policy for essential foods throughout the country.
d). Implement monitoring by the officers of the Consumer Affairs Authority (CAA).
e). Research ad-hoc specimens of essential food items to inspect the quality, nutritional values, and the hygienic condition of the food items.
f). Wave custom duties on essential food items from abroad.
g). Strengthen co-operative networks throughout the country, enabling rural and suburban communities to buy essential food items.
h). Strengthen the work of Medical Officers of Health (MOH) throughout the country and the routine follow-up on households to check the nutritional levels of children and women.
i). Simplify the taxation policy of the country.
j). Reduce the dependency of the government’s revenue on Value Added Taxation (VAT) and increase the ratio of government’s revenue, through income tax. According to the Central Bank’s Report for 2013, the government has weighted 88% of their revenue on VAT.
k). An agreed time frame for the alleviation of malnutrition among children and women.
I request your urgent intervention to ensure that the authorities listed below instigate an immediate investigation into the question of malnutrition and take collective measures to address the problem.
Yours sincerely,
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PLEASE SEND YOUR LETTERS TO:
1. Dr. Rajasthan Senarathna,
Minister of Health and Indigenous Medicine
Ministry of Health and Indigenous Medicine
No: 385, Ven. Baddegama Wimalawansa Thero Mawatha
Colombo 10
SRI LANKA
Tel: + 94 11 2685663/ + 94 11 2694132
Fax: + 94 11 2694227
E-mail: minister@health.gov.lk
2. Secretary
Ministry of Health Indigenous Medicine
No: 385, Ven. Baddegama Wimalawansa Thero Mawatha
Colombo 10
SRI LANKA
Tel: + 94 11 2698511/+ 94 11 2698517
Fax: + 94 11 2692913
Email: secretary@health.gov.lk / secretary.health.sl@gmail.com
3. Director General of Health Services
Ministry of Health and Indigenous Medicine
No: 385, Ven. Baddegama Wimalawansa Thero Mawatha
Colombo 10
SRI LANKA
Tel: + 94 11 2694860
Fax: + 94 11 2693869
Email: dghs@health.gov.lk
4. Mr. N.K. Illangakoon
Inspector General of Police
New Secretariat
Colombo 1
SRI LANKA
Fax: +94 11 2 440440
Email: com@police.lk
5. Mr. Yuvanjana Wijayatilake
Attorney General
Attorney General’s Department
Colombo 12
SRI LANKA
Fax: +94 11 2 436421
E-mail: ag@attorneygeneral.gov.lk
6. Secretary,
Human Rights Commission of Sri Lanka
No 108 Barnes Place
Colombo 07
SRI LANKA
Tel: +94 11 2 694 925 / 673 806
Fax: +94 11 2 694 924 / 696 470
Email: sechrc@sltnet.lk
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Thank you.
Urgent Appeals Programme
Asian Human Rights Commission (ua@ahrc.asia)
