Sri Lanka has made significant improvements in the lives of children during the past decade, according to a UN report which commended the country's strong commitment to improve child health and well-being.
The report 'Improving Children's Lives, Transforming the Future - 25 years of child rights in South Asia' by the United Nations' children agency UNICEF analyzes the progress made over the last 25 years on nine key issues that directly affect the lives of children in South Asia.
Releasing the report, on September 11 in New York, Karin Hulshof, Regional Director for UNICEF in South Asia said the region continues to be one of the riskiest places in the world to become pregnant or give birth, with the second highest number of maternal deaths worldwide.
The report, published to celebrate this year's 25th anniversary of the Convention on the Rights of the Child (CRC), says Sri Lanka is one of the countries where very progressive legislation has been enacted, establishing children's legally enforceable rights to health, education, protection and participation.
Addressing the infant health and mortality, the report said Sri Lanka has seen a significant improvement in the rate of exclusive breastfeeding in infants younger than six months, which increased from 53 percent in 2000 to 76 percent in 2007 due to policy and programme improvements.
One of the first countries to translate the International Code of Marketing of Breast milk Substitutes into a national law, Sri Lanka has also achieved significant progress in maternity protection. In 1992, paid maternity leave in government jobs was extended from six weeks to 84 working days. Private sector employees covered under the Shop and Office Act are granted 84 days (including weekends and public holidays) of fully paid maternity leave for the first two children and 42 days for subsequent births.
Expanding the coverage and quality of the support provided to pregnant women and breastfeeding mothers has been central to Sri Lanka's progress on breastfeeding, the report highlighted.
Practically the entire health workforce in the country - pediatricians, obstetricians, primary care physicians and nurses - has benefitted from a 40-hour training course on lactation management.
"Sri Lanka's achievements in breastfeeding are the result of strong political commitment, a well-developed health system with professionals trained to support breastfeeding, a well-equipped and dedicated workforce of public-health midwives, and multiple strategies to raise awareness of the benefits of breastfeeding among mothers, families and communities."
Sri Lanka and Maldives have the lowest neonatal mortality rate while there are marked disparities between countries. Figures range from six deaths per 1,000 live births in Sri Lanka and the Maldives to 42 per 1,000 in Pakistan.
Sri Lanka's neonatal mortality rate declined from 13 per 1000 live births in 1990 to 6 in 2012 while 2,000 neonatal deaths were reported in 2012.
In Sri Lanka births are attended by the skilled health staff at almost every birth with 99% attended births while only 32 percent of births in Bangladesh occur in the presence of skilled health staff.
In Sri Lanka, the prevalence of stunting among children under five declined by more than one third form 30 percent in 1990 to 19 percent in 2010. However, the prevalence of stunting among children born to women without formal education is two and a half times higher than the educated women.
Sri Lanka has made significant improvements in immunization since 1990. In 1990, only 86% of children were immunized for DPT3 and the rate has improved to 99% by 2012. However, there were 4,000 unimmunized children in the country in 2012.
Most countries in the region have seen remarkable progress in expanding access to education - the biggest increases being in Bhutan and Nepal. However, there has also been a slight decrease in enrolment rates over the last decade in Sri Lanka and the Maldives, where enrolment was near universal 10 years ago. For Sri Lanka net enrolment rate in primary education decreased from 100% in 1999 to 94% in 2013.
There is a small gap in the gender of children in Sri Lanka, with 972 girl children per 1,000 boys.
One alarming trend in Sri Lanka was the number of children of lower secondary school age (aged 5-13) who are out of school. Most of these children live in rural areas and urban slums, and in the estate sector (tea plantations).
Even when there is near universal access to basic education, some groups are still excluded from schooling in Sri Lanka. Lower secondary school-age children from the tea plantation estates in Sri Lanka are more than three times more likely to be out of school than the average Sri Lankan child, the report said. The rate of exclusion for children from the poorest families is twice the national average.
National average of children of lower secondary school age who are out of school was 3.2% but the rate in plantations reached 10.1% while in poorest areas 6.8% of children did not receive a secondary education.
Although in some countries such as Sri Lanka, very progressive legislation has been enacted, establishing children’s legally enforceable rights to health, education, protection and participation, pervasive poverty and disparities prevent children from living in dignity, reaching their potential and making choices about their own future, the report says.