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COUNTRY PRESENTATION OF

SRI LANKA

ADMI- Ehwa Institute for Development


and Human Security Policy Workshop:
Gender Dimension in Health and
Sustainable Development Goals
Dr. Kaushalya Kasturiaratchi (MBBS, MSc, MD)
Consultant Community Physician
Family Health Bureau
Ministry of Health, Sri Lanka
The views expressed in this presentation are the views of the author and do not necessarily reflect the views or policies of the Asian Development Bank
Institute (ADBI), the Asian Development Bank (ADB), its Board of Directors, or the governments they represent. ADBI does not guarantee the accuracy
of the data included in this paper and accepts no responsibility for any consequences of their use. Terminology used may not necessarily be consistent
with ADB official terms.
Country Profile of
Sri Lanka

Democratic Socialist Republic of Sri Lanka

• Island in the Indian Ocean, southeast of the Indian subcontinent


• Area: 65,610 sq. km
• Population: 21.44 million (2017)
• A Lower Middle Income Country
• Annual GDP: 87,357 M $ (2017)
• GDP per Capita: 4,074 $ (2017)
• Human Development Index: 0.770 ( ranked 76th )
Women’s Sexual and Reproductive Health in Sri Lanka
• Life expectancy (female): 79.6 years
• Female literacy rate: 91.71 %
• Institutional deliveries: 99.9%
• Maternal mortality ratio: 39/100, 000 live births (2017)
• Infant mortality rate: 9.1/ 1000 live births (2018)
• Teenage pregnancy : 4.4% of all pregnancies (2018)
• Prevalence of eligible families using modern contraceptive methods:
58.4%
• Prevalence of eligible families using any contraceptive methods:
67.7%
% of Teenage pregnancies
9

8 7.7

7 6.7
6.5 6.5
6.1 6
6
5.3 5.2
4.9 4.8
5 4.6
4.4

0
2005 2007 2009 2011 2013 2015 2017 2019
Story behind the success
• Free Education Policy (1945), Free Health Policy
(1952)

• Unique community based Public Health System


(1926) to address Reproductive, Maternal, Newborn,
Child, Adolescent, Youth Health including including
Family Planning, Gender and Women’s Health

• Public health performances are rigorously monitored


through a strong surveillance system at central level
Women’s Sexual and Reproductive Health- Sri Lanka cont...
Rights and Policy Context
• 1965 -Government accepted family planning as a national policy
• 1978-Article 12 of constitution of Sri Lanka provides for equality for men and
women and emphasis non discrimination, based on sex
• 1978-Establishment of Women’s Bureau
• Country has ratified key international conventions, which embed gender equity in
to state policy
- UN Convention on the Elimination of all forms of Discrimination Against Women
(1981)
- UN Convention on the rights of the child
• 1993- Sri Lanka Women’s Charter-(principal policy statement of the government on
women’s rights) launched
• 1994- National Committee on Women (to monitor the provisions in the Women’s
Charter)
Women’s Sexual and Reproductive Health-
Sri Lanka cont.…
National Level Policies and Strategies
• 1996- 2015 National Health Policy [ National Health Policy 2016- 2025]
• 1998- The Population and Reproductive Health Policy was approved by
the Cabinet of Ministers
• 2005- National Mental Health Policy
• National Action Plan for the Protection and Promotion of Human Rights
(2011-2016), (2017-2021)
• Policy Framework and National Plan of Action developed to address
Sexual and Gender-based Violence in Sri Lanka (2016- 2020) with 9
ministries
• National Plan of Action on Health Sector Response to Gender Based
Violence in Sri Lanka (2017- 2021)
Women’s Sexual and Reproductive Health-
Sri Lanka cont…
Legal Context
• The Marriage Registration Act No. 18 (1995) recognizes 18 years as the
minimum age at marriage
• Under the Common Law, age for giving consent for sexual act for both
male and female has been identified as 16 years
• Sexual intercourse with a girl under 16 is punishable offence under the
Criminal Law
• Provisions of the Penal Code addresses the Gender Based Violence
• Prevention of Domestic Violence Act is enacted since 2005
Partnership and Resource Mobilization to achieve
Women’s Sexual and Reproductive Health in Sri Lanka
• Nine Ministries working together – Child affairs, Health, Education,
Economic Development and Employment, Justice and Law, Foreign
employment, Empowerment and prevention and Disaster management
• World Health Organization
• UN Agencies (E.g. UNFPA, UNICEF)
• INGOs and NGOs
• Bi-lateral and Multi-lateral development partners (E.g. World Bank, ADB)
Health Sector
Response to
Gender Based
Violence in
Sri Lanka
1. PREVENTION

RESPONDING TO
GENDER BASED
VIOLENCE

2. PREVENTION
3. RESPONSE
AND RESPONSE

FHB 13
Prevention of GBV

• Package for Newly Married Couples on sexuality, STIs, FP,


Nutrition of the female, prevention of GBV, marital harmony
• Package for migrant workers and their families
• Creating public awareness on GBV
• Prevention programmes through public health care providers
• Prevention of female genital mutilation in Sri Lanka

FHB 14
CAPACITY BUILDING AND
PREVENTION &
EMPOWERING HEALTH CARE
WORKERS
RESPONSE
CAPACITY BUILDING OF ESTATE
HEALTH WORKERS

ADDRESSING SEXUAL
HARASSMENT AT WORK PLACE

FHB 15
Curative Health Institutions Preventive Health sector

FHB 16
Service provision on management of GBV
through “Friendly Haven” in Sri Lanka

Hospital based GBV care centres “Friendly Haven/ Mithuru Piyasa/


Natpu Nilayam”

Provide comprehensive care, namely medical services, psych-social


supportive services and referral to other supportive medical and non-
medical services such as legal and social services.

FHB 17
FHB 18
Distribution of
‘Mithuru Piyasa’
centres in Sri Lanka

By the end of 2018, there are 66 centres


established in major hospitals throughout the
country.

FHB 19
Year Number of “Mithuru Total number of new Total number of Total number of Total number of Total number of
Piyasa” centres survivors seeking subsequent consultation held consultation held consultations
care over the year consultation held with the family with the
with the survivors members of perpetrators
survivors

2011 06 447 230 232 101 1010

2012 08 870 355 432 249 1906

2013 16 1722 726 827 471 3746

2014 20 2949 1360 1309 717 6335

2015 31 4670 2683 2135 1261 10749

2016 46 7426 4131 2977 2194 17028

2017 56 7463 4743 FHB 3276 2834 18316


20
Response to GBV
through Public
Health Care
Providers

FHB 21
Challenges
• Seeking help from affected individuals and interest among healthcare staff
• Customary Muslim marriage and divorce laws do not specify the minimum
age at marriage
• Marital Rape is not a punishable offense in Sri Lanka
• Not having an overseeing body for the inter-sectoral collaborative responses
such as NPoA-SGBV
• Multi-sectoral and inter-ministerial basis and not by the Ministry of Health
alone
Thank you