‘Equity and Well-Being: Measurement and Policy Practice’: A Sri Lankan perspective

Sri Lanka’s economy has grown at five per cent on average over the last two decades. But has such growth been equitably distributed? In other words, did the poor benefit more from this growth than the rich?

Nisha Arunatilake and Priyanka Jayawardena of the Institute of Policy Studies of Sri Lanka (IPS) attempt to answer this question in their chapter on ‘Equity in Education and Health Services in Sri Lanka’ in a book by Hyun Hwa Son of the Asian Development Bank (ADB) and published by Routledge, New York. ADB and IPS hosted jointly the launch of this book titled ‘Equity and Well-Being: Measurement and Policy Practice’ on 13 March at the IPS auditorium.

The Chief Guest at the event was Deputy Minister of Finance and Planning Geethanjana Gunawardana. IPS Executive Director Saman Kelegama and ADB Resident Representative Rita O’ Sullivan represented the two organising institutions at the event. Hyun Hwa Son, the author of the book and Senior Economist, Economics and Research Department, ADB provided an overview of the book. Further, Ministry of Health Director, Policy Analysis Development Susie Perera, Ministry of Education Director, Monitoring and Planning of Education for All Badra Withanage and IPS Chairman Prof. W.D. Lakshman reviewed the Sri Lankan chapter of the book.

The book begins with an extensive discussion on equity, followed by a chapter on well-being, where the concepts of functioning and capability are discussed. This is succeeded by a discourse on what an equitable distribution is and how equity can be measured.

The book then presents various empirical illustrations and three country case studies to assess whether health and education services are equitable in developing Asia, examining the extent to which these social services favour the poor as well as the policy challenges to a more equitable delivery of these services. Finally, these country studies provide evidence-based policy recommendations to improve equity in social service delivery in developing countries.  

The results detailed in Sri Lanka’s case study in the book highlight the fact that most children are able to attend school in Sri Lanka. At the primary level almost all children attend school. Further, findings show that the opportunities to attend school have improved over time in the country. However, these opportunities are still not equitably accessible, especially at higher grades.

On the health front, the study finds that there is high access to qualified medical personnel and health facilities for child delivery. This is further indicated by the fact that most pregnant mothers receive the tetanus injection during pregnancy indicating high access to medicines. By and large, the opportunities to access these services have improved over time at the national level, and for the most part, the poor have benefited more from these improvements.

Meanwhile, however, nutrition continues to pose a challenge to Sri Lanka’s health sector with more than one fifth of children and mothers malnourished. The study finds that nutrition levels have improved at the national level over time. Again the poor have benefited more from these improvements for the most part. However, the changes in these health outcomes over time are not equitable for all health indicators at the sub-national level.