SriLanka

7. TRENDS IN HEALTH STATUS

7.1 Life expectancy

Source- Department of census and statistics

Life expectancy at birth increased from 43 years in 1946, to 70 in 1981 and to 73 in 1996 (estimated). 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 age groups that were most vulnerable and exposed to high risk of mortality, namely infant and children in the age group 1-4 and women of the child bearing age.

In Sri Lanka, Healthy Life Expectancy at birth was estimated to be 61.6 years with 59.2 years for male and 64 years for female in 2002 (as per World Health Report 2004).

Related Links

Life Expectancy – WHO/HQ

WHO/HQ

7.2 Mortality

Trends in Infant Mortality Rate

The IMR also shows a similar trend in decline as the MMR. In 1935, a very high IMR (263/1000 Live Births) was recorded. A decline in IMR is observed after 1946. The IMR in 2003 is reported to be 11.2 (provisional) per 1000 live births (Statistical Pocket Book - 2004, Department of Census and Statistics, Colombo, Sri Lanka). 

Few districts with large hospitals report (in comparison) a high IMR because of the earlier stated problem in death registration. District of Anuradhapura reported the highest IMR during the year 2001. During this period, the Anuradhapura hospital served as a referral centre to several neighbouring districts including those from the war affected Northern Province. 

Trends in Under-5 mortality Rate

In Sri Lanka, Under-5 mortality rate per 1000 live births was 16 in 2000 (Millennium Development Goals Country Report 2005: Sri Lanka).

Trends in Maternal Mortality Ratio

MMR has been very high in the past, fluctuating between 265 in 1935 and 155 in 1946 per 10 000 live births. A dramatic decline was observed in the post war period. The most recent MMR released by the Registrar General’s Department is 2.3 per 10 000 live births. According to hospital records (Government Institutions only), MMR is 3.9 for the year. The maternal mortality reported by Family Health Bureau after reviewing all maternal deaths was 46 per 100,000 live births. In this calculation, the Maternal Deaths have been allocated to the district of residence of the pregnant mother, overcoming the issue of death registration. The Millennium Development Goals Report 2005, Sri Lanka, reports a maternal mortality ratio of 47 per 100,000 live births in 2001.

A wide range of district disparity exists in MMR. The highest MMR is reported for the district of Nuwara Eliya in the year 2001 according the Family Health Bureau.

The mortality pattern in Sri Lanka is in a transitional stage. It appears to be changing from a pattern seen in developing countries to a pattern in developed countries. The trends in mortality indicate a decrease in deaths resulting from infectious and parasitic diseases, diseases of the nervous system and sense organs and of the respiratory system, whereas a substantial increase in the death rates associated with diseases of the circulatory system, injury and poisoning is evident.

Perinatal disorders were the leading cause of death during infancy. Premature deliveries was the main contributory factor. Diseases of the respiratory system, excluding diseases of the upper respiratory tract, ranked within the first five leading causes of death in all age groups, except for 15-24 and 25-49 years. Similarly, diseases of the pulmonary circulation and other forms of heart diseases were among the five leading causes of death in all age groups, except the 15-24 year age group.

Symptoms and signs of ill defined conditions were an important cause of mortality in all age groups.

It is significant that external causes of injury and poisoning are the leading cause of death in all ages, except in infancy and above 50 years of age. Homicide and injury purposely inflicted by other persons was the leading cause of death in the age groups of 15-24 and 25-49 years, respectively.

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Statistics WHO/HQ

7.3 Morbidity

Overall morbidity, based on in-patient and out-patient records, has shown a decrease. However, this decline has been due solely to a drop in out-patient attendance, while in-patient care has increased. The latter may be due to wider service provisions for curative care and the increasing proportion of the elderly. Remarkable achievements have been made in the reduction of mortality in respect of the EPI-target diseases. All other communicable diseases have also shown a decline since 1991, but non-communicable diseases have shown a two-fold increase during the past two decades. Injuries and poisoning have increased since early 1990s. The trends in hospital morbidity and mortality are given in table below:

7.4 Disability

In Sri Lanka, total disability rate was 162.9 per 10,000 population in 2001. It was 189.9 for males and 136.4 for females. The prevalence of blindness was 41 per 10,000 persons (42.5 for males and 39.5 for females). The disability rate due to hearing/speaking was 43.5 per 10,000 persons (48.6 for males and 38.4 for females). Highest disability rates, in seeing of 70.1 and hearing/speaking of 62.6 per 10,000 persons, have been reported for Hambanthota district (Report on Disability Statistics of Sri Lanka, 2004).

Related Links

Disability and Rehabilitation WHO/SEARO

Disability and Rehabilitation- WHO/HQ