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| Tuesday, 02 November 2004 |
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Health in Millennium Development Goals - Sri Lankan situation by Dr. Sunil Senanayake, Director - Ministry of Health Health is central to development projects and a well-established health service with curative, preventive and promotive components is desirable for the development of any country. Sri Lankan health service has implemented many curative and preventive health programmes even from the pre-independence era and is now expanding the scope for promotive health programmes. Sri Lanka achieved many important goals during the last few decades by implementing Health For All by 2000 programme through a primary care approach adopting the Alma-Ata-Declaration. We have reached many targets such as reduction of maternal mortality, infant mortality, child mortality, universal coverage of immunisation and use of family planning methods, among many others. Millennium Development Goals, United Nations road map for the millennium declaration, will be the global effort of human development for the next decade. Sri Lanka is a signatory to the Millennium Declaration and all the development programmes will be focused on achieving MDG targets. Three out of the eight goals and nine out of sixteen targets of MDGs are directly related to health. Eighteen out of the forty-eight indicators that are used to monitor the progress of MDG come from health sector. This shows the importance of health in human development efforts. Ministry of Healthcare, Nutrition and Uva Wellassa Development; the ministry responsible for implementing MDG related health activities, appointed a national focal point and a committee to assess the Millennium Development Goals and adopt them in to the national health programme monitoring mechanism. The focal point initiated reviewing and adaptation of MDG goals, targets and indicators in July 2003 in association with World Health Organisation. Several national consultative meetings were conducted with many professionals to review global targets and indicators in health and targets were adopted to the Sri Lankan situation as we have achieved very good health indicators under HFA 2000 programme. Indicators in the areas of care provided to pregnant mothers, maternal mortality, infant mortality, child mortality and immunisation are on par with any developed country. Although we have achieved our targets and goals at national level there is a gross district variation in many indicators. Therefore there is a need to adopt MDG targets to suit national standards as well as to improve the district and regional situation. Some of the indicators adopted in MDG monitoring process are not relevant to Sri Lanka; especially in the area of HIV/AIDS control activities. Sri Lanka is considered a low prevalence country for HIV infection. Prevalence of HIV among pregnant mothers and orphans of HIV related deaths are negligible in the country. Implementation strategy The national committee and sub-committees have conducted a series of consultative meetings to develop strategies for implementation and monitoring of health-related MDGs. Family Health Bureau, Epidemiology Unit, Nutrition Division, National STD/AIDS Control Programme, Malaria Control Programme, National Programme for Tuberculosis and Control of Chest Diseases, Directorate of Environmental and Occupational Health and Medical Supplies Division are responsible for MDG implementation and monitoring activities. The Health Ministry is developing new strategies to address district variation of MDG monitoring indicators and District Health Plans have taken care of district variation of MDG monitoring indicators and all other important health issues in the district. Health Master Plan; which is being prepared, will address policy planning and action against all the health problems anticipating for the next decade. Since pre-independence era health sector has implemented and monitored preventive health programmes to control plague, smallpox, cholera, malaria and other communicable diseases at that time. Also the first community health unit in 1926 at Koholana, Kalutara and since then the Maternal and Child Health Service, Epidemiological Surveillance, Health Education, Disease specific control programmes have been established, implemented and monitored their programmes. In the past we have adopted a project and programme approach for monitoring purposes and with new plans, sector-wide monitoring mechanism will be adopted to monitor the health sector including MDG indicators. A sector wide approach will cover financial, physical, performance, outcome and impact monitoring of all the areas of health service including national, provincial, district and institutional levels. Health-related MDG targets |
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