Striving for Equity

Focusing on the period from independence in 1948 to the millennium this book is an historical analysis of the process by which Sri Lanka became a model of how a nation with limited resources could nevertheless achieve health indicators on a par with the developed world through the development of a primary healthcare system. In so doing it had to interact and negotiate with global health actors such as the World Health Organization while maintaining its own agency. Based on a close reading of original archival sources it is an in-depth exploration of these questions viewed through a series of case studies which highlight both the successes which contributed to this outcome and the inadequacies of those efforts when seen at the micro level. A primary health care infrastructure is an essential prerequisite for the delivery of preventive health care; how this was developed and delivered to the entire population forms the first substantive chapter. Since the incidence of tuberculosis in a community serves as a marker of a country’s achievement in meeting basic needs and establishing social justice there follows an examination of policies to control TB. The most vulnerable group in a nation are its children and they are also the source of a nation’s future human capital. Two chapters discuss children’s health; firstly the problem of childhood malnutrition and secondly the implementation of the successful immunization programme. Demographic change means a double disease burden of non-communicable diseases alongside communicable diseases and how this considerable challenge is met is the subject of the last chapter. Furthermore these topics enable a discussion of the significance and problems of an international policy transfer to less well-resourced environments