SriLanka

2. TRENDS IN SOCIOECONOMIC DEVELOPMENT

2.1       Economic trends

The economy has witnessed a moderately high growth since 1989/1991. The annual growth rate of the GNP increased from 4.6 percent in 1991 to 5.9 percent in 1995. The GNP per capita increased from US $ 345 in 1989 to US $ 856 in 2000 and to US $ 1000 in 2004.

The Sri Lanka’s Gross Domestic Product (GDP) in 1945 was 2.66 billion rupees (nominal) and it rose to 13.71 billion rupees in 1970 and it continued to rise and showed a figure of 64.59 in 1980. The GDP in 1990 was 290.6 and rose to 1255.5 billion rupees in the year 2000.  The GDP in 2003 was 1822.09 billion rupees. The GDP per capita increased from US $ 899 in 2000 to US $ 947 in 2003 (Economic and Social Statistics of Sri Lanka, 2004, Central Bank of Sri Lanka).

This moderately high growth rate was supported by continuity in reforms towards a market-oriented environment, a strong export performance, and an improvement in primary commodity prices. Economic growth in 1995 was spearheaded by the manufacturing sector, while other major contributory sectors were trade, agriculture, transport, communication and financial services.

Some Macro-economic indicators 1981-2001

Source: Economic and Social Statistics of Sri Lanka, 2004, Central Bank of Sri Lanka

Human Development Index (HDI)

Sri Lanka has not performed well in the area of Human Development, as HDI value is 0.755, ranking 93^rd among 177 countries in 2004.  However, Human Development Index value has increased from 0.613 in 1975 to 0.755 in 2004.

Gender Development Index (GDI)

Sri Lanka has not performed well in the area of Gender Development, GDI value was 0.748, ranking it 69^th among 177 countries in 2004, though it is better than HDI (Human Development Report, 2006).

Unemployment

The unemployment rate in 2003 was around 8.4 percent as against 13.8 percent in 1991. Increased foreign employment contributed to easing the labour market pressure. Women have entered the labour force at a faster rate than men, but taken on lower pay and less prestigious jobs. Infrastructural deficiency has been a serious impediment and the government has accepted in principle the need for wider private sector participation. The public sector health services are almost fully financed by the government, with the services available free of direct cost to the consumer.

The unemployment rate for female is still high though the rate shows a downward trend.  In 1991 the unemployment rates for males and females were 10.1 and 23.0 percent, respectively whereas the corresponding rates in 2003 were 6.0 and 13.2 percent, respectively.

Labour force

In Sri Lanka, labour force participation rate has been fluctuating during 1991-2003, at 50 percent, which was 49.8 percent in 1991 and 48.9 percent in 2003. The female participation rate has declined from 35 percent in 1991 to 31.4 percent in 2003 whereas male participation rate has increased from 64.8 percent in 1991 to 67.2 percent in 2003 (Report on Employment and Unemployment in Sri Lanka, Department of Census and Statistics).

In Sri Lanka, around 7.6 percent population was spending below US $ 1 per day as per survey conducted in 1999-2000 (World Development Indicators, 2005).

Poverty

There has been steady decline in poverty in Sri Lanka, as 26.1 percent of population were below poverty line in 1990-91 whereas 22.7 percent population was suffering with extreme poverty in 2002. Urban poverty has declined at fast pace from 16.3 percent in 1990-91 to 7.9 percent in 2002, whereas rural poverty has declined at slow pace - from 29.4 percent in 1990-91 to 24.7 percent in 2003 (Statistical Pocket Book - 2004, Department of Census and Statistics, Sri Lanka).

Related Links

Ministry of Finance

National Accounts

World Bank

HDI

UNESCAP

2.2 Demographic trends

The last census in 1981 recorded a population of 14.85 million. The population in 2005 was estimated to be 19.67 million. The annual population growth rate in 2004 was 1.2 percent. The Total Fertility Rate in 2000 was 1.9.

The population is projected to stabilize at 23 million by the year 2036 with an annual growth rate of 0.3 percent. The population growth rate is declining, although the absolute population will continue to increase at over 0.2 million a year until 2006.

The median age of the population is also projected to increase from 23 years in 1998 to 40 years in 2025. The population age structure of the country is also changing with base of the population pyramid contracting. In 2001, total population of Sri Lanka was 18,732,000 of under 15 years of age was 4,987,000, the population between 15 and 59 years was 11,995,000, and the population over 60 years was 1,750,000.

Sri Lanka has passed through the classical phases of demographic transition to reach the third phase of a declining birth rate as it has stabilized at 19 per 1000 population during 2000-2004 and showed a relatively stable low death rate at 6 per thousand population during the same period (Statistical Pocket Book – 2004, Department of Census and Statistic, Colombo, Sri Lanka).

Note: Values of CBR for the years 1998-2003 are provisional.

Source: Statistical Pocket Book – 2004, Department of Census and Statistic, Colombo, Sri Lanka

Note: Values of CDR for the years 1998-2003 are provisional.

Source: Statistical Pocket Book – 2004, Department of Census and Statistic, Colombo, Sri Lanka.

The base of the population pyramid is contracting. In 2004, the population over 60 years was 11, the population under 15 years was 25 percent and the population aged 15-59 years was 64 percent.

Life expectancy at birth

Life expectancy at birth increased from 43 years in 1946, to 70 in 1981, 72 in 1991 and 73 in 1996. The life expectancy in 2001 for males was 70.7 years; for females, it was 75.4 years. The rapid increase in the average life span, together with the widening of the gap between male and female longevity, reflects a dramatic improvement in the survival of those groups that were most vulnerable and exposed to high risk of mortality, namely, infants and children in the age group 1-4 and women of the child bearing age (Department of Health Services, Ministry of Health, Annual Health Bulletin 2002). 

Infant Mortality Rate (IMR)

In 1935, a very high IMR (263) was recorded. A decline in the IMR is observed after 1946. It continued to decline during the past few decades, and in 1997 it remained at 16.3. In Sri Lanka, infant mortality rate has declined from 17.7 per 1000 live births in 1991 to 11.2 in 2003 (Statistical Pocket Book – 2004, Department of Census and Statistic, Colombo, Sri Lanka).        

The trend in IMR over the periods is shown in figure below:

Note: Values of IMR for the years 1998-2003 are provisional.

Source: Statistical Pocket Book – 2004, Department of Census and Statistic, Colombo, Sri Lanka.

The urban population was reported 21.5 percent in 1981 and 15 percent in 2001. It is expected to rise to 41.9 percent in 2030.

Related Links

MoH Srilanka

Vital Statistics- MoH Srilanka

World Health Report

2.3       Social trends

Education is one of the measures of social and economic development of the population. With the intention of providing education to every citizen of the country, the government of Sri Lanka introduced free education to every citizen of the country from grade one to university education in 1946. As a result of this action a notable progress was achieved in the literacy rate of the population. The gradual narrowing of the gender inequality in education is also a significant achievement.

The national literacy rate increased steadily within short period from 57.8 percent in 1946 to 87.2 percent in 1981. The female literacy rate increased at a greater speed reducing the gap between the rates of entry for males and females into the labour force at all levels. The national literacy rate in 1994 was 90.1 percent while rates for males and females were 92.5 percent and 87.9 percent respectively. By the year 2001, adult literacy rate (age of 15-24 years) has reached 95.6 percent, with 95 percent for male and 96 percent for female (Draft Report on Millennium Development Goals: Sri Lanka’s Progress, September 2004).

In Sri Lanka, Gross Enrolment Ratio (GNR) in primary education has increased from 109 percent in 1998-99 to 112 percent in 2002-03 for both sexes. Male and female GNR in primary education has increased from 111 percent and 108 percent respectively to 113 percent and 112 percent during same period.  Similarly, in secondary education there is very nominal increase from 86 percent in 2002-03, for both sexes, to 87 percent in 2003-04. In case of male and female, there is no increase as it has stabilized at 84 percent and 89 percent respectively during same period (UNESCO).

The rate of females continuing their education into the secondary level in Sri Lanka is high compared to most of the developing countries. The number of educated females for hundred males in 1988 was 93 at the primary level, while at the secondary level it was 106. Education gap between males and females has reduced very fast. 

In Sri Lanka, total number of schools (Government and others) is reported as 10,475 in 2003. Universities are 13 and technical colleges are 36 as per 2003 data (Statistical Pocket Book -2004, Department of Census and Statistic, Colombo, Sri Lanka).

Despite the increasing numbers of specific categories of human resources in the health sector, the past years have witnessed many problems and challenges. One of the recurrent constraints for improving the effectiveness of human resource policy and planning in the health sector is the lack of a comprehensive human resource strategy and lack of coordination among all units concerned in the Ministry of Health and Ministry of Education.

The current major problems are imbalance in production of staff, geographic inequity in distribution, and a gap between expected job performance and training.

Related Links

Statistics, Home

Social Status

Mo E

UNESCO

World Bank

2.4 Food supply and nutritional status.

Intrauterine growth period is the first stage of growth and development of a human where linear growth velocity is highest and adequate nutrition is of great importance. The initial nutrition status of the newborn is indicated by the birth weight. At present, the national average for newborns weighing less than 2500 g is 17.2 percent.

It is well documented that adequate growth and development in the five-year age group, and particularly those less than three years of age, is vital to attain the full genetic potential of growth and development of the child. Under-nutrition in this group has a long-term consequence on the growth and development of the child.

Three anthropometric measures have been used to ascertain the level of nutrition among the children in the country. Heights for age, weight for height, and weight for age were the three indicators used to obtain the extent of stunting, wasting and under-weight among the children. The DHS 2000 reports national percentage for stunting as 14 percent, with highest percentage reported in estate sector (33.5 percent). Information on obese children in Sri Lanka is scarce and incidence is still much lower than that of under-nutrition.

Prevalence of under-nutrition by sectors (percent)

Source: DHS 1987, 1993, 2000

Sri Lanka has three micronutrient deficiencies that have been identified as public health problems, namely, iron, vitamin A and iodine. They are also known as “hidden hunger” as many deficiencies are unnoticed by the individual until symptoms become a hindrance. The latest survey information is only available in terms of iron deficiency anaemia conducted in 1994 by the Ministry of Planning and Implementation, and by the Medical Research Institute in 2001. Vitamin A deficiency Survey was conducted by the Medical Research Institute in 1995/96. The last Iodine deficiency Survey was conducted in 1986 and this has not yet been updated.

Prevalence of Iron deficiency is more acute among the under-two years old children than the older age group; but as for vitamin A, there is no significant difference with age. Overall 35 percent of the under-five years old children are vitamin A deficient, and 30 percent are anaemic.

Micronutrient deficiency by age groups

Sources: 1995/96 – Vitamin A status Survey, MRI (1996); Mudalige & Nestal: 2001; Anaemia Survey, MRI

Seventy percent of the population live in areas where iodine deficiency exists and some areas (districts) have shown goitre prevalence among school children of 5-18 years as high as 25-30 percent. In response, the government has initiated a programme for the universal iodization of salt.

Poor maternal nutrition and health during pregnancy is mainly due to inadequate diet, low in energy, protein and micronutrients, infections and inadequate rest. Another contributory factor is food taboos and beliefs that prevent certain nutritious food being consumed. The average weight gain during pregnancy is 7.5 kg compared to the acceptable minimum of 9.5 kg. Further, 36 percent pregnant women are found to be anaemic. According to international studies in developing countries, low weight gain in pregnancy may account for 18.5 percent of Intra-Uterine Growth Retardation (IUGR).

Breast feeding promotion programme which is being carried out through home visits at clinics and at hospitals have not achieved the desired objectives. Lactational management programme is being conducted by the Family Health Bureau (FHB) for their peripheral staff who are expected to implement breast-feeding promotion activities at the periphery. Certain hospitals were declared as “Baby Friendly Hospitals” to actively promote exclusive breastfeeding.  The Sri Lanka Breast Feeding Code, which was brought into effect from 1983 as a legal and ethical instrument, has been effective in regulating the sale of breast milk substitutes and related products.

Related Links

Nutrition Unit- Srilanka

Food Control

Nutrition – Srilanka

Nutrition – WHO/SEARO

Nutrition – WHO/HQ 

2.5       Lifestyle and Risk Factors

Urbanization and changes in life styles carry a set of issues that affect the health and nutritional welfare of the communities. The incidence of over-nutrition and diet related degenerative diseases such as obesity, hypertension, diabetes, coronary heart disease and stroke are on the increase. The factors which are thought to be responsible are the changing food habits and preferences; stressful life styles, time constraints and lower physical activities; switching over to fast and convenient foods; and relatively high price of fruits and vegetables. Negative effects that arise from a more sedentary life style are associated with lowered physical activity; issues related to time allocation; tendency to consume more convenient foods; and preference to settle for less strenuous recreational activities. The occupational types have also changed over the last decade where heavy work activities such as labour in agriculture, forestry and fishing have declined. A shift in the labour force towards more sedentary type jobs has increased, while a decrease in manual jobs is apparent.

Alcohol

The per capita alcohol consumption in Sri Lanka

Per capita alcohol consumption of Sri Lanka for the period of 1981 to 2001 is given below.

* Other = Whiskey, Wine, Brandy, Gin, Rum, Vodka, Toddy

According to the chart, the per capita alcohol consumption in litres in Sri Lanka shows a very rapid increase during 1990s. The per capita alcohol consumption in 1981 was 1.88 L, while it increased to 2.88 L in 1990. The consumption has gone up to 6.68 litres in 2001. The consumption of Beer has increased very rapidly during the period and it has mainly contributed to the rise in total consumption.

Related Links

Alcohol WHO/HQ

Tobacco

Among the males over 15 years, 58 percent are calculated to be smokers.

Integrated approaches to alcohol, tobacco and drug prevention programmes have proved viable, with necessary impetus being given by non-governmental organizations that play the role of catalyst in motivating organizations and institutions to integrate tobacco and drug prevention programmes into their own activities.

Related Links

Tobacco – WHO/SEARO

Tobacco WHO/HQ

Policies and programmes related to physical activity and health-behavioural changes

The determinants for behavioural and lifestyle changes are multi-factorial. They are multi-faceted and are densely interwoven to the social fabric that has been enriched by ideas, norms, values and beliefs of people. The effort needed to achieve a positive behavioural change in selected population risk groups needs to be equally shared by civil, non-governmental and other governmental organizations as well. In selected areas, the programme will work with relevant government departments aiming to achieve healthy public policies and interventions in all sectors. Similarly, the community groups and other non-governmental organizations too will be encouraged to participate in these activities.

The Ministry of Health will lead in planning and sponsoring a major national behaviour change communication programme and set off activities aimed at healthy life style changes in targeted population groups. It will be carried out through inter-sectoral and multi-sectoral collaboration with relevant departments and agencies. The objective will be to reduce preventable risk factors and the main stakeholders are the people themselves. The ministry of health in collaboration with other partners will identify the target group and the needed lifestyle changes based on evidence of epidemiology, treatment cost and effectiveness factors. These will include optimising health, productivity and educational performance and ageing through nutrition, exercise, relaxation and sleep, through avoidance of tobacco, alcohol intake, substance abuse, unsafe sex, and observance of road safety including seatbelt use. Behavioural change advertising and lobbying companies will be contracted to design, pre-test, implement and manage these programmes.

Related Links

Substance Abuse – WHO/SEARO

Trends in abortion rates

As in many other countries, in Sri Lanka too, a significantly large number of women in reproductive ages are faced with unwanted pregnancies, and an increasingly large proportion of them use abortion to prevent births. In spite of it being widely practised, abortion largely remains a taboo subject because of its legal, religious and cultural implications. Legally induced abortion is not permitted by law except in the case of threat to mother’s life.

Only a very limited number of research investigations have been conducted in Sri Lanka on any aspect of the abortion issues up to now. No precious statistics could be collected from private practitioners and private hospitals about their services related to induced abortion. The estimated incidence of induced abortions in Sri Lanka is thought to be between 150,000 and 175,000.