Maternal, New Born, Child, Adolescent and Reproductive Health

 

Sri Lanka has made remarkable progress in the last few decades in lowering infant, child and maternal mortality. This is attributed to a number of factors that have had a mutually beneficial effect which included, high political commitment to health, provision of free health care, a well-developed health infrastructure, implementation of evidence based intervention, free education, subsidized food schemes and other socio economic welfare measures. However, wide disparities in mortality rates exist between geographic regions as well as population groups. The Infant Mortality Rate (IMR) and Neonatal Mortality Rate (NNMR) have been stagnant over the past decade.

 

Much has been achieved in maternal health, but the quality of care, both at institutional level and in the field, needs improvement. Pre-conception needs which are coming into focus, has to be addressed preferably through existing programmes such as school health and adolescent / youth health programmes. Antenatal care though having a broad coverage needs to be rationalised to avoid duplication of services as well as to improve some quality aspects of the services. In particular, improvements in intrapartum care need special focus on many service issues, which would improve the outcome of labour and impact on the health of the mother and the neonate. Coverage and quality of services for postpartum care were also addressed during the review process.

 

Newborn care in the country’s health system needs much improvement. Unlike for maternal health that has a national focal point in the FHB, there is none with regard to neonatal services.

 

WHO Country Cooperation Strategy focuses on:

Strengthen the existing Maternal, Perinatal, Newborn, Child, Adolescent , and Reproductive Health program by supporting the addition of new evidence based interventions and approaches, through effective policies and strategies. Emphasis will be more focused on perinatal care, newborn care, and vulnerable groups such as adolescent’s, children with special needs, through continuum of care through out the lifecycle plus nutrition issues and economic evaluation of interventions.

 

WHO in Sri Lanka has focused its technical support to the government in following areas:

1.      Development of the capacity of programme managers strategic planning in the programme areas.

2.      Development of a National strategic Plan on Maternal and new born Health.

3.      Quality of ANC to be improved & evidence based ANC intervention to be introduced in to the health system with redesigning the existing maternal care package.

4.      Intra partum care to be improved with main steaming of near miss enquiry into existing surveillance system and developing and implementing treatment guidelines.

5.      National strategies, standards and guides on New born care to be developed and expanded

6.      MNC / RH programs to be monitored and evaluated by using the performance appraisal tools and Monitoring of MDG 4 and 5 to be continued and mainstreamed with newly developed indicators.

7.      Mainstreaming of health package developed for newly married couples to address the reproductive health need of the women.

8.      Support to conduct operational research on RH/CAH

9.      Development of comprehensive evidence based strategic plan for children with special needs and planning and implementation of community based program for developmental, behavioral & emotional disorders in 2 pilot districts.

10.  Capacity building of central & peripheral staff on Adolescent health including life skills Adolescent Friendly Health Service package developed & implemented in schools.

Gender, Women and Health

*      Gender & Health – WHO Focus