Gender and health in Sri Lanka

Abstract

Sri Lanka has today easily the longest life-expectancy of any nation in South Asia. The country's achievements have been particularly impressive in the health of women and girls who have substantially lower mortality levels than males; this is unexceptional in the developed world where it is the norm but striking in South Asia where it is not. It has been suggested that low female mortality may reflect a high involvement of Sri Lankan women in decision-making over health care and feeding practices which has benefited their health and that of their children, especially their daughters. Yet census data indicate that until recent decades overall mortality levels were little lower than in other South Asian countries and female age-specific mortality rates were higher than male rates. The paper explores the issues involved concluding that the autonomy of women has contributed to the decline of overall mortality, once modern health services developed. However, women's autonomy has not in itself overcome the sex differential in care, given the economic dependence of women and their families on males: husbands while the women are raising children and ultimately sons for old-age support.