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Health Ministry denies UNICEF report, but people confirm malnutrition
View(s):By Chrishanthi Chtrisopher and Tharushi Weerasinghe
The Health Ministry has rejected the United Nations Children Fund (UNICEF) report that placed Sri Lanka in the top 10 countries with child malnutrition.
Claiming that it was based on outdated data, Health Ministry Secretary Janaka Sri Chandraguptha noted that more recent statistics from the Medical Research Institute showed a decrease in stunting and added that Sri Lanka had no acute malnutrition conditions such as Kwashiorkor and Marasmus — the two main types of severe protein-energy undernutrition recognised by healthcare providers worldwide.
Mr Chandragupta said malnutrition was a measurement of three factors — stunting, wasting and weight-for-height ratio measured in a short period.
But the UNICEF report was based only on wasting, he said. Also, he said that no consistent data were used in the survey, as records of different years had been taken for countries in the region. He said Sri Lanka data was from 1995 to 2016.
UNICEF said Sri Lanka ranked among the top 10, with 5.7 million, including 2.3 million children, in need of food assistance.
This is not the first time that Sri Lanka has denied the claims of a UN agency. In April 2018, the Health Ministry denied UN Food & Agriculture Organisation’s (FAO) report ranking Sri Lanka the second highest in under-nourishment among five year olds in South Asia. The report said Sri Lanka had 22.1% malnutrition among children under five years, a step better than its impoverished neighbour, Afghanistan.
The then Health Services Director General Dr. Anil Jasinghe questioned the report’s credibility. He said the report was not a measure of malnutrition, but a measure of under-nourishment in children.
He said that it was a figure calculated using a given formula and estimated food data consumption obtained via surveys, taking into account total supply and use of all food commodities in a given country.
UNICEF, when contacted on Friday, defended its report and said the figures were taken from the Health Ministry’s Demographic and Health Survey 2016 published by the Census and Statistics Department.
Its Communications Chief Bismarck Swangin said it was based on the latest data available.
Wasting, which is a measure of malnutrition, has increased in Sri Lanka, although stunting data has improved. “We focus on weak areas to call attention to them,’’ he said.
Sri Lanka has gone through tough times including the coronavirus disease pandemic in 2020 and 2021 and the current economic crisis and, therefore, there was no way that the situation could be better from 2016, he said.
“Our message is clear. This situation should be a concern and (should be) prioritised,’’ he added.
A World Health Organisation Report of 2019 on childhood malnutrition quoting DHS (Department of Health Services) figures from 2016, has said that stunting, a measurement of malnutrition, in children below five years remained relatively unchanged at 17.3% between 2006 and 2016.
The Health Ministry’s latest data is from the DHS 2016 survey.
However, the UNICEF report comes in the wake of the recent World Bank food security update that placed Sri Lanka in 5th place on the countries with the highest food price inflation. “A loaf of bread costs as much as a kottu used to cost,” noted one garment worker from Rajagiriya. The 38-year-old lives in a household of three and noted that their three meals of rice and curry a day were often eaten with curry.
“Anyone who has not been able to keep their incomes on par with inflation will undoubtedly be affected by rising food prices, but disproportionately it will be the poorest, the newly poor and those from low income households who will be most severely affected,” economist Rehana Thowfeek said. She noted that this problem was not necessarily in the future or a “will be” scenario since people were already skipping meals, eating smaller portions, and eating less nutritious food. Vulnerable groups like children, the elderly, disabled people and pregnant women are at an even higher risk, she said.
“I think we will be contending with worse malnutrition and associated risks in the future — pregnant women, for example, if unable to receive adequate nutrition are at risk of giving birth to children with low birth weights and putting their baby and themselves at higher risk of disease,” she said. Inadequate nutrition can have severe impacts on children’s development which can affect their lives throughout, including education outcomes.
Even adult malnutrition was somewhat of a problem before, now it could lead to a worse situation, and could put further pressure on the healthcare system. “If people are consuming less nutritious food, then they are unfortunately sacrificing their health as well,” Ms. Thowfeek said.
Economically vulnerable communities as a whole were struggling more than usual.
“Plantation workers struggled to have three meals a day before all this, but even one meal a day is a struggle now,” said S T Ganeshalingam, Convener for Plantation Peoples’ Land Rights.
(MCPLR).
He noted that estate worker communities in general had few alternatives than even those in villages in Sri Lanka since even home gardening or farming was not an option. “If we try to plant something on the land we live in, the owners will file police complaints against us.”
There was also the issue of wages. Even though plantation workers were now entitled to a hard-won Rs. 1000 a day as wages, owners have reduced the number of work days. “So sometimes people have to work for 20 days a month, and earn Rs. 20,000. What can we do with Rs. 20,000 a month?” he asked.
According to LIRNEasia, in 2019 three million people (14.3% of the population) were living in poverty in Sri Lanka. As of 2022, UNOCHA (UN Office for the Coordination of Humanitarian Affairs) estimates that this number has almost doubled given the record inflation and unemployment caused by the economic crisis.
“Inflation adjusted cash transfers and even in-kind transfers of things like food could serve as social safety nets which are now a necessity,” LIRNEasia research manager Gayani Hurulle. Sri Lanka has more than five ministries and 12 agencies overseeing the provision of targeted welfare schemes. However, the efficacy of poverty reduction programmes was below par. LIRNEasia research noted that the duplication of work, unnecessary administrative burdens, higher transaction costs and the lack of inter-agency coordination were some key issues that needed to be addressed.
Commenting on the economy as a whole, Ms. Thowfeek noted that while she didn’t see a “huge improvement”, there was some movement in the right direction. “With an IMF staff level agreement, we will be in a better situation. Hopefully it will unlock some bridging finance for Sri Lanka. Sri Lanka can then start to increase necessary imports and this might help restore some normalcy. But the reform agenda is the most important economic plan, which we are yet to see,” she noted.
She held that the focus should be on minimising government expenditure and diverting everything available for social assistance and ensuring that adequate supply of essential food and non-food items reach the people.
“This should be supplemented with an adequate boost to revenue by way of taxes. The reform process is important and should be implemented swiftly where possible.”
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