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AIDE MEMOIRE ON FINDINGS THE MISSION FROM THE U.
POPULATION
ASSESMENT OF NEEDS IN T]
SRI
1349
AIPpor
4 issued by the rhe directive of His Excellency.
all those

5 AND RECOMMENDATIONS OF NITED NATIONS FUNDS FOR I ACTIVITIES ON HE FIELD OF POPULATION IN LANKA
NS
Ministry of, Plan Implementation on The President for implementation by
concerned.)

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612.9
เ89 4, 1.44”

MOITA
U

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elde
AIDE MEMOIRE ON FINDINGS THE MISSION FROM THE U POPULATION ACTIVITIES ON
THE FIELD F POPULA
The UNFPA Mission on Assessi lation in Sri Lanka arrived in Coloml its field work on April 8th, 1980. :
ernme
" (i) within the framework (
ives and policies, to development or streng
population strategy ar
(ii) to assist the Governme conosce
field of population, i giese
over a period of time orier som
tion of population po] (iii) to assist the Governme
and bi-lateral donors areas for external ass
In the course of its work wi organizations in Colombo and in fourt cultural, ethnic and economic diversi had an opportunity to appraise in a g going projects and to see the need fo and projects. However, it was not th or disapprove the numerous project ic National Team which assisted so ably Mission will report its findings and will make use of them as a basis for concerning its programme and projects This stage will be followed by more s development,
ba
The Mission has made a long areas of population policy, planning, service delivery; information educati and management of the population prog involvement of non-governmental orgar

AND RECOMMENDATIONS OF IITED NATIONS FUNDS FOR ASSESSMENT OF NEEDS IN ION IN SRI LANKA.
ment of Needs in the field of Popu-o on March 9th and will complete Its mandate is:
of the Government's overall object
assist the Government in the Chening of the on-going national ad programmes; ent in identifying its needs in the un order to become self-reliant
in the formulation and implementaLicies and programmes; ent, UNFPA and other multi-lateral
in delineating coherent programme sistance. "
.th official and non-governmental teen districts representative of the .ty of the country, the Mission has jeneral way the effectiveness of onr certain new policies, programmes e mandate of the Mission to approve leas which were put before the in preparing for the Mission. The recommendations to the UNFPA, which discussions with the Government
over the next five-year period. pecific project appraisal and
list of recommendations in the
data collection and research; on and communications; organisation ramme; community participation, isations and of special groups,

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Dan
However, before the report is r present these recommendations in izations concerned. Under thesi nay be useful to record a few o for discussion with policy-makei population problems. There are many of the Missions recommende
Istoric
that population gro to rapid economice living of the poore that crude birth re greater numbers of age groups now mear and health personne The long decline in age of marriage, in remaining unmarried in marital fertilit programmes) appears trends are developi urgency in the Gove all necessary measu rate while at the s programmes are acce
A number of policydevelopment appeare (fertility, mortali and distribution) a related and that ea the other. Policie shed without analys
(b) While a number of s
responsibility for recognise the urgen is required, there is heading towards resources account f funds spent specifi

- 2 -
viewed by UNFPA, it is not possible to
toto to the Government and other organ
circumstances the Mission believes it * the major findings and recommendations s and senior officials concerned with three overall findings which condition tions. These are:
wth rates still present a major obstacle Levelopment and to raising the levels of
st sections of the population. The fact tes have risen in 1978 and 1979 and that young people are coming into the fertile s that jobs, food production, schools 1 must grow by ever-increasing rates,
birth rates are due largely to rising creasing number of eligible persons , high levels of literacy and reduction sy (partially due to family planning
to be slackening and disturbing new ng. This should create a sense of rnment and in the public to undertake res to moderate the population growth ame time economic and social development lerated.
PW
makers and officials concerned with d to be unaware that population dynamics ty and morbidity, migration, composition nd socio-economic development are interzh is a determinant and consequence of 3 and programmes are sometimes establi- . Ls of their demographic impact.
ONO
enior officials who have immediate |population and related questions do fully sy of the problem and the priority which !s little evidence that the Government ?lf-reliance in this area. External ir a very substantial proportion of the
ally to promote the family health

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programme, A number (
tive supplies for the feature in the natione
a key donor could spel (c) The demand for service
lisation and injectibl as presently organised shortages of nurses an bottleneck in providing management of the humar management will involve further decentralisatic training for health per
Seega
If the Mission is correct i specific findings and recommendation the Government and other Sri Lankan national donors.
While there is a general awa and of the existence of family plann: their fertility, two distinct kinds
(a) information to national
dealing with development trends in the country ar by the Government to me
(b) much more face-to-face
and individual families communities utilising t involved in development planning methods mainly and trained community h teer). Considering the Lankan family, more eff the male population to size, Voluntary organi both these levels.

vital components such as contracepamily planning programme do not
budget at all and the withdrawal of disaster for this critical programme. in family planning, especially steri3, is much greater than the facilities can provide. Except for critical
midwives in some areas, the major such services seems to be the resources and facilities. Better some political decisions as well as 1 of decision-making and management sonnel.
- this overall analysis, a number of s deserve policy-level attention by organisations as well as by inter
areness of the population question ing programmes to help people control of information are still required:
policy-makers, especially those : programmes, concerning the new d the urgency of coordinated action t the problems; and
ommunication with community leaders ɔn population problems of their own a network of extension workers and specific information on family through frontline health personnel ilth workers (both paid and volunraditional way of life of the Sri its should be directed to educating cept responsibility for family tions can play an important role on

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2.
Specific attentio groups as well as isolated yet in a position to appre spacing of their children i poorest communities, specie may be required to make fa
The failure to mee of family planning and for in a country with an excel. is the opinion of the Miss: management of resources wh: para-medical personnel have ing and health facilities neighbouring country. Howe using their skills for var: provincial and base levels
maternity centres are unde: often suffer break-down in time to repair. Patients : lack of a simple communica an ambulance or specialist organise a polyclinic at ti of these facilities is und and a system of referral o facilities should be put in are completed.
4.
Public health nur health workers) and public districts and in some few not speak the local langua 2,606 new midwives will be | are multiplied or enlarged (c) curriculum reforms ado training and subsequent se health workers. The Missi external assistance.

is required for certain ethnic and religious villages and estate populations who are not ciate the advantages of a small family and For their own health and welfare. For the al development efforts as well as education nily planning a realistic choice.
et the growing demand for reversible methods
sterilisation is the biggest disappointment Lent reputation for primary health care. It ion that this is largely the result of poor ich exist. Significant numbers of doctors and e been trained in all aspects of family plannare more abundant in Sri Lanka than in any ever, many trained doctors and nurses are not ious reasons and hospitals at district and
are overcrowded while peripheral units and r-utilised. Both central and peripheral units
equipment which take inordinate lengths of Flock to the units with more specialists for tion system at the peripheral unit to callfa
help or failure to repair the water pump or ne periphery. A campaign to upgrade a number erway with UNICEF, WHO, and UNFPA assistance f patients to specialists only through these nto effect as rapidly as these improvements
zes, field midwives (now to be called family
health inspectors are in short supply in many others are assigned to areas in which they do ge. The current drive to recruit and train
successful only if (a) the training facilitie ;(b) intake scheduled on a regular basis;, oted and (d) quarters are provided both for rvice for public health nurses and family on is recommending this area for further

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5.
Other service facilities an agencies should also be given a largi ble government grants. Private allo
practitioners could make a much large |'if supplies are made available by Got
sector has proved that it can meet a and spermicides and new efforts shoul pand its social marketing programme village areas,
The question of contraceptis since SIDA, the major donor for many ding such supplies at the end of 198• hood Federation has also informed the tion that it cannot continue to incr at present day costs. The Mission is prepare a four year rolling plan for into account that the need for contra the expanding young generation marrie work and health institutions are put discuss the aid possibilities with SI potential donors after making a first over the years until the health facil and the commercial market are able to of distribution. Supplies of injecti should get priority attention along tion programmes. Injectibles will ne sections of the population for some i for those coming forward for sterilis
Training Government personne better stores management are areas ir
may be interested.
2.
The Mission is of the opinie for the Family Health Programme coule organisational measures among which
(a) clarifying the functions
Health and Colombo Hosp: responsibility of that

3 personnel available to voluntary er role with more liberal and flexipathic doctors as well as ayurvedic er contribution in providing services vernment at cost. The commercial
growing demand for pills, condoms d be made through the SLFPA to ex- co reach more remote rural and
ve supplies is critical particularly
years, is scheduled to cease provi1. The International Planned Parente Sri Lanka Family Planning Associarease the quantity of contraceptives s recommending that the Government
all contraceptive requirements taking aceptives will grow substantially as es and as trained personnel for field' in place. The Government might then DA, UNFPA, IPPF and all past and : budget contribution to be increased ities, institutional establishments | absorb a large part of the business .bles are particularly short and rith supplies needed for sterilisated to be subsidised for the poorer
ime to come and expenses reimbursed iation.
447
:1 in bulk purchasing as well as in
which donors providing supplies
on that the management of resources I be improved significantly by certain Ire:
i of the Project Ministry for Family .tals and gazetting the authority and inistry and providing a budget.

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The Mission recommends that t responsible for the planning, of the family health programm the delivery and education as provided by the Ministry of E
tary organisations in this fi (b) Strengthening the organic lin
Health and Colombo Hospitals which currently retains the E Secretary's post) and account health and provides the deliv health education. The first be to make the Secretary of t Additional Secretary of Healt ween him and the Director of further delegation of authori to the Superintendent of Heal decisions and organisational of their resources in the dis
situation, (c) The Ministry of Plan Implemer
in formulation of population not only the Minister of Hea
Family Health and Indigenous
Ener
tries of Education, Labour, Lands and Land Development, Planning, and Home Affairs. Chairmanship of the Presiden Implementation) should exami policy questions in the fiel rate of population growth, c bidity in various regions of bution and internal and exte major development programmes variables and the impact of
ment. These consultations i raruus on pun. take the form of a sub-comm ests ontbin

se,
e Project Ministry be made implementation and evaluation • , involving coordination of pects of family health services alth and the efforts by volun.- Bld.
ss of the Ministry of Family with the Ministry of Health udget, personnel (except the ing authority for the family ery service system as well as step in this direction might he Project Ministry also an h. A direct relationship bet. Health Services, together with .ty from the Ministry of Health .th Services for operating
changes to maximise utilisation strict should improve the
otation has important functions
policy which should involve Lth and the Ministries for
Medicine, but also the MinisAgriculture, Rural Development, Information, Finance and
These Ministers under the t (who is also Minister of Plan ne from time to time, broad d of population including the ifferential mortality and mor
the country, population distrirnal migration, the impact of
and projects on population population dynamics on developt Ministerial level (which might ttee of the Cabinet or any other

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appropriate mechanism functions) would add • ion questions and pror
This Ministerial leve. a National Population ries of the above ment entatives of non-gover Chairmanship of the Se would provide a useful policy formulation but and educational effort by the Population Divi continuing demographic graphic aspects and co projects, and feed-bac any necessary adjustme ful for this Council t Parliamentary Committe med on demographic tre
ing national goals. (d) The Ministry of Plan I
implementation of the evaluate performance i * Technical and manageme programme would contin Committee of the Famil
Ministry. (e) The establishment of t
a step in the right di quickly with a clear s major aspects of popul of these Committees sh population factors and Plan. The establishme tion and development is the next step in de and offers an opportur

***
for periodic considerations of these so the sense of urgency about populatmote co-operation by all Ministries.
consultation should be supported by Advisory Council composed of Secreta-ioned Ministries and selected represnmental organisations, under the cretary of Plan Implementation. This
vehicle not only for assisting in = also for the coordination of services s. Its secretariat should be provided sion, which should be able to furnish = data and analysis, analysis of dernounsequences of economic and social Ek on the effectiveness of policies and ents to these policies. It will be use. co keep the Ministers and the proposed se on Population and Development inforEnds, policies and progress in achiev
mplementation should also monitor the programme by the line ministries and n achieving the policy objectives. nt functions of the family planning ue to be dealt with by the Advisory y Health Bureau and the Project
he District Population Committees is rection and should be followed up tatement of functions covering all ation policy. An important function ould be to ensure consideration of
projects in the District Development at of divisional committees on populander the chairmanship of the AGA'S centralisation of operating functions ity to step up community participation
s

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in the programme through local organisations as we these steps will require level and divisional leve but also in team work. I financial resources to be community level projects.
Many of these recommendations capacity and resources of the Governme recommend certain other areas as prior include -
(a) improvement of rural heal
the upgrading of peripher midwives and providing qu
(b) provision of contraceptiv
appropriate government ce in the national budget;
(c) training extension worker
front-line development wo leaders to analyse their develop projects at local
families and provision of (d) training of teachers for
population education and
schools; training adulte subjects and providing su
support for expansion of to reach young people wi counselling outside the 1
(f) stepping up motivational
public and private sector with the providers of the promotion of vasectomy ir f the Estates and provision
services through the NGO | cient way to do this.

* NO
S
involvement of RDS's and other ell as Grama Sevakas. However,
training or re-training of district el officials not only in population It is also important to promote e allocated to the Committees for
s are, of course, well within the ent of Sri Lanka. The Mission will rities for external aid. These will
Eth infrastructures, particularly
al units, training of nurses and
uarters and appropriate transport;
ses on a long-term basis with Dunterpart funds to be included
S of all categories and other orkers, grama sevakas and community
bwn demographic problems and Level to influence size of
Eservices;
accelerated development of family life education in the education organisers in these
uitable materials for such work;
existing non-governmental efforts th family life education and Formal school system;
efforts at the work site for both - employees in close cooperation e service. This should involve
many industries as well as in a of information and mobile Es appears to be the most effi

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(G) involving development age
and bi-lateral programmes programmes! with special fertility. This involven place on technical educat and expansion of small ir producing projects. The Bureau provides new oppor area of education, vocati projects for women.
The Mission Report will encou projects in wider district development projects such as Mahaweli and integrat expectation that such approaches will morbid
tality and population
should view t accept
BOOK CAF
Class.
TITLE.ASSES MENT OF NEEDS
**PBPILSBw***wrdeiro AUTHOR..MINSTRY PRICE.
DATE PE Date Lont
Borrower.
Dal
Returi

1cies such as UNDP, the World Bank,
in 'beyond family planning attention to the effects on ent may concentrate in the first ion, food production and nutrition dustry and agricultural income establishment of the Women's tunities to invest on the vital onal training and income-producing
rage the integration of population
plans or special area development ed rural development with the have a greater impact on fertility,
distribution. Every effort
sommunity with a icreasing the
ID 447.
IN THE FIELD O ANZAen AMPERMENTAZIOA
| Remarks

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ਸਿੰਘ ਨੂੰ

多數