As Sri Lanka navigates economic recovery through reforms and stabilisation efforts, concerns over malnutrition persist, particularly among children and vulnerable populations.
The latest World Food Programme (WFP) Country Brief (November 2024-January 2025) highlights the improving economic conditions but warns that food security and livelihood challenges remain. Rising temperatures and extreme heat further threaten human health and agricultural productivity.
State of malnutrition in SL
With a population of 22 million and classified as a lower middle-income country, Sri Lanka ranked 78 out of 193 countries in the 2023/2024 Human Development Index (HDI). Despite its economic improvements, chronic malnutrition remains a significant concern, affecting 17% of children aged 6-59 months.
Speaking to The Sunday Morning, Government Medical Officers’ Association (GMOA) Spokesperson Dr. Chamil Wijesinghe pointed out that high inflation and food price hikes during the economic crisis had worsened malnutrition, particularly among children and adults with chronic illnesses.
Reports, including those from the WFP, indicate that some families were forced to sell their property to afford food and education.
Need for targeted nutrition programmes
Dr. Wijesinghe highlighted that malnutrition levels had demonstrated an upward trend in 2022, prompting experts to call for a survey to identify the most affected areas. “We suggested the commencement of a survey to determine the problematic areas,” he stated.
He emphasised that targeted programmes were essential, as blanket nutrition programmes – such as providing supplements to all students – would be inefficient and a waste of resources. Instead, surveys should identify specific districts and the areas most in need within them, ensuring that interventions yield the best possible outcomes.
Dr. Wijesinghe also pointed out that even in Colombo, Sri Lanka’s economic hub, there were underprivileged communities facing malnutrition.
Accordingly, the proposed survey is to be conducted by the health sector through the Ministry of Health system and Public Health Midwives (PHMs). He noted that while nutrition programmes were currently being implemented, they were not based on a structured survey, which limited their effectiveness.
Dr. Wijesinghe added that once targeted areas and vulnerable groups were identified, specialised programmes could be implemented to support those most at risk, such as pregnant women, children with chronic diseases, and adults with chronic conditions.
Initiatives to combat malnutrition
According to the WFP, Sri Lanka launched a Home-Grown School Feeding (HGSF) Farmers’ Society in December 2024, aimed at uniting poultry and agricultural farmers to strengthen local food production.
Meanwhile, the WFP has supported the development of a rice-based Thriposha formula tailored to the needs of communities in Nuwara Eliya, a region known for its unique demographic and dietary challenges.
The WFP is also funding machinery procurement for Thriposha production, ensuring its long-term sustainability. Dr. Wijesinghe acknowledged Thriposha as a landmark programme in the country’s health sector, but noted that there was a lack of scientifically formulated nutritional initiatives beyond it.
Challenges in addressing malnutrition
Dr. Wijesinghe identified the lack of accurate statistics as a major challenge in tackling malnutrition in Sri Lanka, emphasising the need for targeted programmes rather than generalised interventions.
“Identifying who needs the most support is the main challenge,” he stated. With the country facing a financial crisis, the Government has limited funds for nutrition programmes. Therefore, accurately identifying the most vulnerable groups is essential to maximise the impact of available resources.
Referring to the ‘Aswesuma’ social welfare programme, he stressed the importance of ensuring that assistance reached those who needed it the most. Proper targeting will not only reduce unnecessary expenses but also ensure that allocated funds produce the best possible outcomes.
Additionally, low public awareness of nutrition remains a significant issue. Dr. Wijesinghe noted that educating communities on affordable and nutritious food choices was crucial for long-term improvements in malnutrition levels.
“There needs to be a multisectoral approach involving education, public administration, rural development, agriculture, food safety, and the Health Ministry,” he said.
He added that the Public Administration Ministry could conduct awareness campaigns focusing on providing insight on affordable and nutritious food alternatives, rather than relying solely on meat and fish.
According to Dr. Wijesinghe, despite inflation stabilising, the cost of living remains high while incomes have not increased. A WFP survey discovered that families are prioritising education and healthcare over nutrition, further exacerbating malnutrition levels.
Gaps in nutrition programmes
While programmes exist to address childhood malnutrition, there are limited interventions for adults. Dr. Wijesinghe highlighted the lack of structured programmes for addressing vitamin deficiencies among adults, especially in contrast to initiatives like the vitamin A supplementation for children.
Meanwhile, Family Health Bureau School Health Unit Consultant Community Physician Dr. Ayesha Lokubalasuriya pointed out that Sri Lanka faced a dual nutrition crisis of malnutrition and obesity among school children, with high sugar intake and unhealthy foods near schools contributing to the rising rates of childhood obesity.
While supplements are being provided for nutrition deficiencies, she expressed concern that no recent surveys had been conducted due to lack of funding. The last major study was in 2017, raising questions over whether deficiencies have worsened or improved.
“Initially, they considered stopping the supply of supplements, but experts recommended continuing them, as many children lack sufficient animal protein in their diet due to the economic crisis.” she said.
Dr. Lokubalasuriya added that in 2017, iron deficiency levels had decreased to 5%, leading to the decision that fortified food alone would be sufficient, rather than additional supplements. “We are providing fortified food to secondary school children under the school feeding programme,” she stated.