Sri LankaUrban population

2019 Health SDG Profi le: Sri Lanka

Out-of-pocket expenditure⁴ In most cases, high percentage of out-of-pocket

expenditure out of the total health expenditure is associated with low financial protection.

Sri Lanka

Urban population²

18.5%

Life expectancy at birth

Life expectancy⁵ measures how long people will live and is an indication of overall mortality of a country's population. Lost healthy life expectancy (HALE) represents equivalent year(s) of full health lost through years lived with morbidity and disability. Although females live longer, lost HALE is longer as well, on average 1.5 years or 19.5% more than males.

Population (000s)¹

21 324

Poverty³

0.8%

GDP per capita³ (Current US$)

4102.5

Current health expenditure as share of GDP

⁴ 4.2%

0 20 40 60 80 100

Age (years) Male

Female

HALE Lost HALE

Monitoring the health SDG goal: Indicators of overall progress

(ppp < $1.90 a day)

5.7%

The goal of universal health coverage (UHC) is that all people and communities receive the health care they need, without suffering financial hardship. Monitoring UHC requires measuring health service coverage and financial protection (SDG target 3.8).

Universal health coverage: At the centre of the health goal

HEALTH SERVICES COVERAGE

The summary measure of essential health services coverage, service coverage index of 16 indicators in four main areas: (1) reproductive, maternal, newborn and child health; (2) infectious diseases; (3) noncommunicable diseases; (4) service capacity, access and health security.

FINANCIAL PROTECTION

Financial protection is measured through two indicators:

(1) impoverishment, and (2) catastrophic health expenditure.

Impoverishment: 0.7% or approximately 149 200 people are being pushed into poverty because of out-of-pocket health spending¹⁷.

Catastrophic expenditure on health: 5.4% of people spent more than 10% of their household's total expenditure on health care¹⁷.

Family planning

coverage⁶ Pregnancy and

delivery care⁶ Child immunization

coverage⁷ (DTP3) Care seeking behaviour suspected pneumonia⁶ 0

50 100

Coverage (%) ₉₉

74 96

52

Reproductive, maternal, newborn and child health

Tuberculosis (effective) treatment

Coverage⁸

HIV antiretroviral

therapy coverage⁹ Insecticide-treated bednets/IRS coverage for malaria prevention

Access to basic sanitation¹⁰ (%) 0

50 100

Coverage (%)

53 37

94

Infectious diseases

Prevalence of normal fasting glucose level¹¹

Prevalence of normal blood pressure¹¹

Cervical cancer

screening¹² Tobacco non-use¹³ 0

50 100

Coverage (%)

86 78

25

74

Noncommunicable diseases

Density of hospital beds¹¹, expressed as % of global threshold, 18/10

000

Heath worker density¹⁴, expressed as % of

global threshold, 44.5/10 000

Acess to essential

medicine¹⁵ Health security: IHR compliance¹⁶ 0

50 100

Coverage (%)

100

71 75

46

Service capacity, access and health security

UHC services coverage index of essential health services To provide a summary measure of

coverage, an index of national service coverage is computed by averaging service coverage values across the 16 tracer indicators. The UHC coverage index ranges from 0% to 100%, with 100% implying full coverage across a

range of services.

0 50 100

Coverage (%)

53 66

UHC services coverage index

Out-of-pocket expenditure, as % of the health expenditure (2016)

Public spending on health⁴ is determined by the capacity of the government to raise revenues and the level of priority it attaches to the health sector.

This profile provides an overview of the current status of progress towards the 13 targets under the

Sustainable Development Goal #3 (SDG3): Ensure healthy lives and promote well-being for all at all ages.

All SDG3 indicators plus other selected health-related indicators are presented using global health estimates or country comparable reported values if available.

When nationally reported indicators from other sources are available, these are included in the references.

50.1%

72.1 78.5

5.7%

2019 Health SDG Profi le: Sri Lanka

Variation by education

Equity status and trends: Variation by income, geographical location and education*

*There are many dimensions of equity, including but not limited to examples based on income, geographical location, and education presented here but also age, sex, race, and others. SDG 17.18 emphasizes the need for disaggregated data to facilitate better measurement of inequalities.

SDG 3: Health targets

Maternal and child mortality (SDG target 3.1, 3.2)

Births attended by skilled health personnel⁶

¹⁸

²³

2000 2006 2016

0 50 100

Pe rc en ta ge (% )

96.0 98.6 99.5

Maternal mortality ratio²²

2000 2005 2010 2015

0 50 100 150

M M R (p er 1 00 0 00 li ve b irt hs )

57.00

30.00

2000 2005 2010 2015

0 25 50 75 100

C M R (p er 1 00 0 liv e bi rth s)

8.8 5.8

Child mortality²⁴

Neonatal mortality rate Under-five mortality rate

Health service delivery

NCD risk factors

2000 2005 2010 2015

0 50 100

Su cc es s ra te

TB treatment success rate for new cases²⁰

2000 2005 2010 2015

0 50 100

Pe rc en ta ge (% )

Coverage of DTP3 immunization⁷

Cervical cancer screening¹²

Female Male

2000 2005 2010 2015

0 10 20

Pe rc en ta ge (% )

0.9 2.9

3.2

7.3

Prevalence of obesity among adults²⁰

(18+ years of age)

2006 2016

0 50 100

Pe rc en ta ge (% )

84.4 93.6

Antenatal care coverage¹⁸ (4+ visits)

Rural Urban

2006 2016

0 50 100

Pe rc en ta ge (% )

14.1 15.9

28.7 27.2

41.0 37.6

Prevalence of stunting among children under-five by mother's education level⁶

None Primary Secondary

2006 2016

0 50 100

Pe rc en ta ge (% )

97.4 99.2

Proportion of births attended by skilled birth attendant⁶

Quintile 1 (poorest) Quintile 5 (richest)

Variation by geographical location

2006 2016

0 50 100

Pe rc en ta ge (% )

66.8 63.1

Children < 5 yrs with diarrhoea receiving ORT and continued feeding⁶

Bed occupancy rate²¹ (BOR)

Variation by income

2000 2005 2010 2015

0 25 50

Pe rc en ta ge (% )

22.2 23.0

19.8 21.6

Prevalence of raised blood pressure among adults²⁰ (18+ years of age)

Female Male

2014 0

25 50 75 100

Pe rc en ta ge (% )

45.7

5.3

Prevalence of tobbaco use¹³

Female Male

Women aged 30-49 years who had a cervical cancer screening test (%)

2011 2012 2013 2014 2015 2016 0

2 4 6

Pe r p er so n pe r y ea r

2.4 2.5

OPD utilization¹⁹ (per person per year)

71 25%

2019 Health SDG Profi le: Sri Lanka

TB incidence rate²⁶

2013 2014 2015 2016 2017 0

50 100 150

TB incidence (per 100,000 pop.)

66 65 65 65 64

Communicable diseases (SDG target 3.3)

Indicators SDG

target Year Sri

Lanka Regional estimate Probability of dying from any of CVD,cancer,

diabetes,CRD between age 30 and age 70²⁷ 3.4.1 2016 17.4 23.1 Noncommunicable diseases and injuries

Malaria incidence is calculated for confirmed cases.Only small number of imported cases have been reported

Indicators Year Sri Lanka Regional estimate Hepatitis B surface

antigen prevalance among children under 5 years²⁷ (%)

2015 0.64

Number of people requiring interventions against neglected tropical diseases²⁷

2016 1,87,588

0.26

73,300,000

2006 2016

0 50 100 150 200

Adolescent birth rate

28.0 21.0

Adolescent birth rate⁶

(per 1000 women aged 15 to 19 years)

Proportion of married or in-union women of reproductive age who have their need for family

planning satisfied with modern methods⁶ 3.7.1 2016 74.2 71.4 Sexual and reproductive health

Female Male

2000 2005 2010 2015

0 250 500 750 1000

Total NCD mortality rate (per 100 000 pop.)

606.0

696.3

429.3

517.7

Total NCD mortality²⁰

2006 2008 2010 2012 2014 2016 0

5 10 15 20

Deaths per 100 000 population

14.3

11.4

Reported road traffic deaths²⁹ (per 100 000 population)

Adolescent birth rate⁶ (per 1000 women aged 15

to19 years) 3.7.2 2016 21 33.0

Age-standardized mortality rate attributed to household and ambient air pollution²⁷

(per 100 000 population) 3.9.1 2016 79.8 165.8

Mortality due to environmental pollution

Note: A dash (-) implies relevant data are not available

Total net official development assistance to medical research and basic health per capita²⁷

(US$) 3.b.2 2017 2.35

Proportion of health facilities that have a core set of relevant essential medicines available and

affordable on a sustainable basis¹⁵ 3.b.3 2017 75

0.6

-

Health worker density¹⁴ (per 10 000 population) 3.c.1 2016 31.7 - Health workforce

2013 2014 2015 2016 2017 0.0

0.5 1.0

HIV infection (per 1000 pop.)

<0.01 <0.01 <0.01 <0.01 <0.01

New HIV infections⁹

²⁵

Suicide mortality rate²⁷ (per 100 000 population) 3.4.2 2016 14.6 Total alcohol per capita (age 15+ years)

consumption²⁷ 3.5.2 2016 4.3

Road traffic mortality rate²⁷ ⋅ ²⁸ (per 100 000

population) 3.6.1 2016 14.9

13.2 4.5 20.7

DTP3 immunization coverage among 1-year-

olds⁷ 3.b.1 2017 99

MCV2 immunization coverage by the nationally

recommended age²⁷ 3.b.1 2017 99

PCV3 immunization coverage among 1-year

olds²⁷ 3.b.1 2017 -

88 77 12 Essential medicines and vaccines

International Health Regulations Core Capacity

Index¹⁶ 3.d.1 2018 46 56

National and global health risks

Mortality rate attributed to exposure to unsafe

WASH services²⁷ (per 100 000 population) 3.9.2 2016 1.2 Mortality rate attributed to unintentional

poisoning²⁷ (per 100 000 population) 3.9.3 2016 0.4

15.4 1.8

Prevalence of tobacco use among 18-69 years

old¹³- Female 3.a.1 2014 5.3

Prevalence of tobacco use among 18-69 years

old¹³- Male 3.a.1 2014 45.7

- - Tobacco use

Malaria incidence rate

2019 Health SDG Profi le: Sri Lanka

References

1.World population prospects: the 2019 revision. New York: United Nations, Department of Economic and Social Affairs, Population Division; 2019 (https://population.un.org/wpp/, accessed 29 June 2019).

2. World urbanization prospects: 2018 revision. New York: United Nations, Department of Economic and Social Affairs, Population Division; 2018 (https://population.un.org/wpp/, accessed 29 June 2019).

3.World Bank. (https://data.worldbank.org/, accessed 28 May 2019)

4.Global health expenditure database. Geneva: World Health Organization; June 2019

5.Global health estimates 2016: Life expectancy, 2000–2016. Geneva: World Health Organization; 2018 (https://www.who.int/gho/mortality_burden_disease/life_tables/en/, accessed 29 June 2019).

6. Department of Census and Statistics (Sri Lanka), ICF International. Sri Lanka Demographic and Health Survey 2016.

7. WHO/UNICEF estimates of national immunization coverage. (http://apps.who.int/immunization_monitoring/globalsummary/countries?countrycriteria%5Bcountry%5D%5B%5D=BGD, accessed 29 June 2019) 8. Global tuberculosis report 2018. Geneva: World Health Organization; 2018 (https://www.who.int/tb/publications/global_report/en/, accessed 15 March 2019).

9. UNAIDS/AIDSINFO [Online database]. (http://aidsinfo.unaids.org/, accessed 29 June 2019) 10. WHO/UNICEF Joint Monitoring Programme estimate 2015.

11. Tracking universal health coverage: 2017 global monitoring report 12. Sri Lanka STEPS survey 2015

13. Sri Lanka (2014) Tobacco Factsheet 2018. New Delhi: World Health Organization/SEARO; 2018 14. HRH profiles 2018

15. Sri Lanka Service availability and readiness assessment (SARA), 2017-18.

16. International Health Regulations (2005) Monitoring Framework, GHO data. Geneva: World Health Organization (https://www.who.int/gho/ihr/en/, accessed 21 March 2019).

17. SEARO staff estimates from (Sri Lanka) Household Income and Expenditure Survey 2016

18. Department of Census and Statistics (DCS) and Ministry of Healthcare and Nutrition (MOH). 2009. Sri Lanka Demographic and Health Survey 2006-07. Colombo, Sri Lanka: DCS and MOH.

19. Calculated. Sri Lanka Annual Health Bulletin

20. WHO. Global Health Observatory (GHO) (https://www.who.int/gho/en/ - accessed 29 June 2019) 21. Sri Lanka Annual Health Bulletin 2014

22. Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva; 2015

(https://apps.who.int/iris/bitstream/handle/10665/194254/9789241565141_eng.pdf;jsessionid=56B6C12830EA6EA8CD0F30A8433E8FC3?sequence=1, accessed 28 May 2019). See for maternal mortality. Country reported value. 2013=26.8, 2014=32, 2015=33.7, 2016=33.8, 2017=39. Data Source: Family Health Bureau

23. See for Birth attended by skilled health personnel. Country reported value: 2009=99.7, 2010=99.8, 2015=100, 2016=99.9, 2017=99.4, 2018=99.9. Data Source: Family Health Bureau

24. Levels & trends in child mortality: report 2017: estimates developed by the UN Inter-agency Group for Child Mortality Estimation. New York (NY), Geneva and Washington (DC): UNICEF, World Health Organization, World Bank, United Nation; 2017 (http://www.childinfo.org/, accessed 28 May 2019). See for under-five mortality. Country reported value: 2015=9.4, 2016=10.1, 2017=10.9, 2018=10.6. Data Source:

Family Health Bureau. See for neonatal mortality. Country reported value: 2016=5.6, 2017=6.3, 2018=6.5. Data Source: Family Health Bureau 25. See for New HIV Infections. Country reported value: 2013=0.02, 2014=0.02,2015=0.03, 2016=0.03, 2017=0.01. Data Source: NSACP

26. WHO Global Tuberculosis database [online]. ((https://www.who.int/tb/country/data/download/en/, accessed 29 June 2019). See for TB incidence rate. Country reported value. 2013=44.1, 2014=43.7, 2015=44.5, 2016=40.9. Data Source:NPTCCD

27. World Health Statistics 2019.

(https://apps.who.int/iris/bitstream/handle/10665/324835/9789241565707-eng.pdf?ua=1, accessed 28 May 2019) 28.See for road traffic mortality. Country reported value: 2013=13.4, 2016=14.2. Data Source: Sri Lanka Police Department 29. Calculated. Country reported

30. National nutrition and micronutrient survey. Part I: Anaemia among children aged 6-59 months and nutritional status of children and adults. Colombo, Sri Lanka, 2013

Other health-related SDGs

Annual mean concentrations of fine particulate

matter (PM2.5) in urban areas²⁶ (µg/m3) 11.6.2 2016 15.2 57.3 Ambient air pollution

Mortality rate due to homicide²⁶ (per 100 000

population) 16.1.1 2016 3 4.1

Homicide and conflicts

Birth registration coverage¹⁸ 16.9.1 2006 97 -

Birth registration

Note: A dash (-) implies relevant data are not available

Completeness of cause-of-death data (%) 17.19.2 2017 - 10 Cause-of-death data

Indicators SDG

target Year Sri

Lanka Regional estimate Domestic general government health expenditure

as percentage of general government

expenditure⁴ (%) 1.a 2016 8.6 6.7

General government health expenditure

2000 2005 2010 2015 2016 2017 0

50 100

Percentage (%)

16.0 19.0 22.0 25.0 26.0 28.0

Population with primary reliance on

clean fuels and technologies²⁰ (%)

2006 0

50 100

Percentage (%)

97.2

Birth registration coverage¹⁸ (%)

Proportion of ever-partnered women and girls aged 15 yrs and older subjected to physical, sexual or psychological violence by a current or former intimate partner in previous 12 months²⁶

5.2 2017 - -

Intimate Partner Violence

Amount of water- and sanitation-related official development assistance that is part of a government-coordinated spending plan²⁶ (constant 2016 US$ millions)

6.3 2017 142.8 1484.41

Proportion of population using safely managed

drinking-water services (%) 6.1 2015 -

Proportion of population using safely managed

sanitation services (%) 6.2 2015 -

- - Drinking water services and sanitation

Children under 5 years who are stunted⁶ 2.2.1 2016 17.3 Children under 5 years who are wasted⁶ 2.2.2 2016 15 Children under 5 years who are overweight⁶ 2.2.3 2016 2

15.2 33 3.4 Child nutrition

Proportion of population with primary reliance on

clean fuels²⁶ (%) 7.1 2017 29 45

Clean household energy

Prevalence of stunting among children under-five⁶

¹⁸

³⁰ (%)

2006 2012 2016

0 50 100

Percentage (%)

14.7 17.3 17.3