A Sri Lankan government maternal health program that dates to 1926, when the country's newly established health units began training and posting public health midwives to provide home based antenatal, delivery and postnatal care within local communities, building on earlier steps including the government maternity hospital Sri Lanka opened in 1879, thought to be the first in Asia, its first midwife training school in 1881, and the appointment of six trained midwives to Colombo municipal hospitals in 1906. Public health midwives became the frontline of Sri Lanka's long term drive to cut maternal deaths, a period in which the country's maternal mortality ratio fell from more than 1,500 deaths per 100,000 live births in 1940 to 1945, to 555 per 100,000 by 1950 to 1955, to 239 per 100,000 within another decade, and to 95 per 100,000 by 1980, a decline researchers attribute substantially to the program's community based midwifery care.
Facts
Program StatusActive; midwives remain part of the health-unit network, complete an 18-month training program, and are backed by supervision and a referral network 1 Sponsoring BodyGovernment of Sri Lanka, through its Ministry of Health rural health-unit network 1 Target PopulationPregnant women nationwide; each public health midwife serves a population of 3,000 to 5,000 and lives within her local area 1 Health GoalReduce maternal mortality nationwide through broad, free access to maternal health care built on the professionalization of midwives and systematic use of health information 1 Geographic ScopeSri Lanka, nationwide, with particular early emphasis on a largely rural population 1 Measured ResultsMaternal mortality ratio fell from 500 to 600 deaths per 100,000 live births in 1950 to 60 per 100,000 by the time of this report; skilled practitioners attended 97 percent of births, up from 30 percent in 1940 1 Classification
Program KindHealth Education Program 1 Connections
Associated With
Delivers Practice
Entity-backed identity for the program-kind enum value this public health program already carries, resolved to a health practice by an explicit value-to-entity map (phase 3 bucket conversion, docs\design_entity_backed_browse_buckets_20260928.md). The program-kind fact itself stays on the program unchanged.
In the Other Atlases
- Also in Geography Atlas: Asia, found in there.
Sources
1. CGD Millions Saved, Case 6: Saving Mothers' Lives in Sri Lanka
Center for Global Development (CGD), Millions Saved seriesIntervention or program summary box, opening sentence
Beginning in the 1950s, the government of Sri Lanka made special efforts to extend health services, including critical elements of maternal health care, through a widespread rural health network.
Intervention or program summary box, success-factors sentence
Sri Lanka’s success in reducing maternal deaths is attributed to broad access to maternal health care, which is built upon a strong health system that provides free services to the entire population, including in rural areas; the professionalization of midwives; the systematic use of health information to identify problems and guide decision making; and targeted quality improvements to vulnerable groups.
Elements of Success, Access subsection, opening sentence
The first challenge in this country that is largely rural was access.
Impact summary box, closing sentences
This has meant a decline in the maternal mortality ratio from between 500 and 600 maternal deaths per 100,000 live births in 1950 to 60 per 100,000 live births today. In Sri Lanka today, skilled practitioners attend to 97 percent of the births, compared with 30 percent in 1940.
Professionalization of Midwifery subsection, midwife-caseload sentence
Each midwife serves a population of 3,000 to 5,000 and lives within the local area.
Professionalization of Midwifery subsection, training sentence
Supervision and a referral network back up midwives, who undergo an 18-month training program.
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