Effective health policies brought lower MMR rate - Minister

Community participation and effective health policies are instrumental in maintaining a very low maternal mortality ratio (MMR) over the years, Healthcare and Nutrition Minister Nimal Siripala de Silva said.

The Minister was addressing the Conference on Maternal Health on Asia Pacific Region at Bali, Indonesia from August 13 to 15. It was organised by the Forum of Parliamentarians of the Asian Region.

Malaysia, Thailand and Sri Lanka have managed to reduce maternal mortality ratio from over 400 per 100,000 live births to 50 per 100,000 live births within 50 years. In Sri Lanka, the MMR was very high which was over 500 maternal deaths for every 100,000 live births five decades ago. During that time our GNP per capita was around 250 US dollars," the Minister said.

It was through a combination of economic policies and technical inputs Sri Lanka managed to reduce its MMR down to 100 by mid 1970s. This was lower than many countries that had higher GNP per capita at that time. Today Lankas MMR is under 40 per 100,000 births.

He said "We have managed to achieve the millennium Development Goals in MMR and IMR ahead of targets but there is still much more to be done to reduce some of the disparities that exist in vulnerable and marginalised population groups in remote areas in the North and the East, estate sector and also in the urban slums," the Minister said.

"There have been many internal and external evaluations of the Sri Lankan's performance in maternal and child health; there are a number of key factors that have been identified for the success of our efforts over the past few decades."

"The chief among them have been the strong political will consistently displayed by successive governments since the independence", he said.

The Government policy to provide free education and free health to the people have always been considered as investments made to produce a healthy and a literate work force that would support the economic development of the country".

"There was lot of emphasis on the education and training of key health personnel for the urgent MCH tasks to make them skillful, efficient and responsive. Attention paid to the socio economic determinants of maternal and child health has been an additional factor. Intersectoral action to supplement the health sector inputs has added value to our health programs," the Minister said.

The establishment of a separate Ministry for Women's Affairs has ensured the rights of women. A women's charter instituted by that Ministry has strengthened the position of women in society especially in relevance to their rights and privileges.

Meaningful participation of women and communities in the design and implementation of programs and policies have been important to improve health and welfare of women.

The political will probably was the most significant factor because this meant that in spite of being a low income country we appropriated sufficient funds to provide all the MCH services free.

We extended the basic health services of coverage to the most remote and peripheral areas, paying special attention to the most needy, the poor, and marginalised segments of society. Expansion of the services has ensured access to, and equity in, maternal and child health care to all, there by making a sea of change in the MMR scenario in rural areas.

Alongside this Sri Lanka invested in training skilled birth attendants to serve in the remote areas and in the peripheral institutions and set up a referral service for those mothers who needed specialist attention, including emergency obstetric care.The Minister said the estimates we have indicate that at the global level, we will need to increase funds for maternal and newborn health by $US5 billion annually by 2010 and by an additional US $8 billion annually by 2015.