Abstract

Sri Lanka is a lower middle income country with per capita income of <US$1024 and is expected to achieve middle income level in the near future. The infant mortality rate in the country was as high as 263 per 1000 births in year 1935 and at present it is 11 per 1000 live births although there are district disparities. A rapid decline in infant mortality rate is attributed to change in the health policy in Sri Lanka which has lead to the diffusion of maternal and childcare services throughout the country with a focus on the domiciliary and institutional care to the mother and child. A strong infrastructure has also been established at the community level with development of a cadre of public health and institutional midwives. The focus of the care is to provide prenatal, antenatal, natal and post natal care to the mothers and follow-up care of infants by early registration of pregnant women and interventions through public health midwives. The system is also streamlined by continuous monitoring by supervising officers, supported by proper record keeping. The Infant motality rate has further been reduced by improving institutional delivaries (94%), free healthcare, elimination of neonatal tetanus, improvement in female literacy rate (88%) and a high immunisation coverage (98%) of pregnant mothers and infants.