Linear growth retardation in the first 2 years of life and subsequent obesity are known risk factors for NCDs, especially CVD (Black et al., 2013). Table 1.12 shows that the rates of childhood undernutrition remain unacceptably high. There are interdistrict and intersectoral disparities. There has been little change between 2006 and 2016, except in the prevalence of stunting in the estate sector,4 probably a result of many nutrition-specific and nutritionrelated programmes carried out especially in this sector. Table 1.12 Prevalence of stunting and wasting, 2006 and 2016 Source
Prevalence of stunting % Sri Lanka
Urban
Rural
Estate
Prevalence of wasting % Sri Lanka
Urban
Rural
Estate
DHS (2006)
17.3
13.8 (2.8)
16.2 (3.3)
40.2 (14.2)
14.7
14.7 (3.2)
14.8 (2.7)
13.5 (3.8)
DHS (2016)
17.3
14.7 (3.6)
17.0 (4.0)
31.7 (8.8)
15.1
12.9 (1.6)
15.6 (3.2)
13.4 (3.7)
DHS: Demographic and Health Survey Sources: Department of Census and Statistics, 2009; Department of Census and Statistics, 2017
1.5 Human-induced and natural disasters Sri Lanka experiences many natural hazards such as drought, floods, landslides, cyclones and coastal erosion. Some of these events have impacted life and infrastructure to an extent that can be called a disaster. The vulnerability of the country to natural disasters is noted to have increased in recent times and is attributed to increasing population pressure, land degradation and climate change. The tsunami of 26 December 2004 was the most devastating natural disaster in the recorded history of the country, resulting in nearly 31 000 deaths and causing extensive damage to property (Galappathi and Karunanayake, 2007). The tsunami reached the east coast of the island within 2 hours of the earthquake, wrapped round the island affecting the south-east, southern, south-western and parts of the western coastline (Galappathi and Karunanayake, 2007). Since Independence, Sri Lanka has experienced three armed conflicts, which impacted the whole country. Two insurgencies originated in the south of the
4
Urban sector: all areas administered by municipal and urban councils constitute the urban sector. Estate sector: estate sector consists of all plantations that are 20 acres or more in extent and with 10 or more resident labourers. Rural sector: all areas other than urban and estate sectors comprise the rural sector. Source: Department of Census and Statistics, 2011a 24
