Safer childbirth – a success story in Sri Lanka

3rd July 2009, firstlanka.com

Sri Lanka’s remarkable decline in maternal deaths is an commendable fact that could be emulated over the South Asian Region. Regardless of the 30-year-old civil war, Sri Lanka’s emergence as a success story in safer childbirth has been commended by diverse groups of medical professionals. Presenters at the Royal College of Obstetricians and Gynecologists (RCOG) South Asia Day conference will portray Sri Lanka as a model for cost-effective healthcare.

Running at relatively low healthcare budget compared with other countries in the region, Sri Lanka’s maternal and child health indicators are vastly more favourable than what would be expected. The maternal mortality ratio of Sri Lanka has declined dramatically as a direct result of the availability of midwives and trained assistance. “In 1960, the child mortality was 340 per 100,000, however, it was lowered into 43 per 100,000 live births in 2005,” Dr Hemantha Senanayake, from the University of Colombo, said.

‘Sri Lanka midwives made an important contribution and they are the backbone of local health care industry,” Dr. Hemantha Senanayake said. These midwives are recruited from villages close Maternal Care Centers and they are meant to serve, which ensures minimal geographic and cultural barriers. However, the hallmark of the procedure is that they are low-cost and indigenous.

At present, every household in Sri Lanka belongs to a certain Public Health Midwife (PHM) area and the norm is for the PHM to provide home-based care. During the past few decades the Government has made a policy decision to increase the number of midwives. The number of women having a minimum of 4 antenatal visits has reached 99% in Sri Lanka.

In addition, there have been other policy decisions that have had significant effects on maternal deaths. Home births have been discouraged (1% in 2006) and the availability of comprehensive emergency obstetric care is being expanded. Presently, 85% of births take place in facilities that have the services of a specialist obstetrician.

The provision of free education without gender discrimination over the past six decades has been a key non-health intervention that has had a major impact on maternal mortality. “Our experience demonstrates the fundamental importance of ensuring trained assistance at birth. These simple interventions have made a tremendous difference for women in Sri Lanka,” Dr. Hemantha Senanayake said.(JS)

Courtesy: Government Information Department