While Sri Lanka has recorded modest improvements in key child nutrition indicators recently, official data suggest that malnutrition among children under five remains a significant public health challenge.
According to the 2025 National Nutrition Month report, the country has seen a reduction of underweight, wasting, and stunting among children under five years of age when compared with 2024, while the overweight and obesity percentage has risen slightly.
The prevalence of underweight children under five declined from 17% in 2024 to 16.1% in 2025, while wasting fell from 9.3% to 8.6% and moderate acute malnutrition (MAM) from 8.5% to 7.7%.
Most districts reported modest gains, although Puttalam showed increases in underweight, wasting, and MAM, while some northern districts, including Vavuniya and Mullaitivu, also recorded setbacks in certain indicators. Sector-wise, underweight, wasting, and MAM continued to decline across estate, rural, and urban communities.
Despite these improvements, significant geographical disparities persist. Nuwara Eliya remained the district with the highest rates of underweight and stunting among children under five, although both indicators improved compared with 2024. Stunting nationally declined slightly from 10.5% to 10.1%.
Severe acute malnutrition (SAM) showed only marginal improvement nationally, with 9,542 affected children (0.81%) reported in 2025 compared with 10,323 children (0.82%) in 2024.
However, several districts recorded increases in the proportion of SAM cases. At the same time, overweight and obesity among children under five continued an upward trend, rising from 0.49% in 2024 to 0.57% in 2025, with most districts reporting increases.
The report also highlights growth faltering as a major concern. Acute faltering can lead to wasting and, if prolonged, stunting. In 2025, only 13 districts improved the detection and reporting of growth faltering among children classified within the normal growth range. Overall, 46.2% of children were found to have at least one growth-related problem, including growth faltering, underweight, wasting, stunting, or overweight/obesity, underscoring the continuing burden of child nutrition challenges despite gradual national progress.
While The Sunday Morning contacted the Family Health Bureau for comment, it was directed to refer to the Nutrition Month report for current data.
A problem largely unchanged
According to Nutrition Physician Dr. Thimathi Wickramasekara, Sri Lanka’s nutrition indicators have shown little significant fluctuation over the past two decades.
“There isn’t a big difference in malnutrition status. There hasn’t been a big change in Sri Lanka’s low birth weight rates or weight-for-age and weight-for-height measurements; those levels have been maintained in the same way.”
Addressing the impact on child nutrition outcomes post-2022 due to the economic crisis, Dr. Wickramasekara observed that available indicators did not show a significant fluctuation compared to pre-crisis levels.
However, he acknowledged the persistence of acute and chronic undernutrition despite strong public health services, noting that certain conditions could be emerging due to factors we did not fully understand yet.
“Identifying those factors and changing our intervention based on those factors is important. Sometimes, if we do certain things without knowing the reasons, the expected results won’t be achieved.”
He also noted that one of the country’s most persistent challenges remained stunting. “For about three decades, we haven’t found an answer for stunting. Therefore, the Ministry of Health is currently considering new interventions. It may not be the traditional reasons we usually associate with undernutrition that are causing stunting to remain at the same level.”
While undernutrition remains a concern, Dr. Wickramasekara said an equally pressing issue was overnutrition among children.
“The most serious problem we see now is that while previously we had malnutrition, over-nutrition is now emerging. Even among children under five years old, a significant number of overweight children have already been reported.
“In addition, among school-aged children, overweight rates have reached about 3–4% as well. Children already reaching these levels of overweight means that, inevitably, when they become adults, they will have to face problems regarding non-communicable diseases.”
He therefore explained that Sri Lanka was experiencing the triple burden of malnutrition.
“We describe this situation as the triple burden of malnutrition, indicating the presence of those with over-nutrition, under-nutrition, and micronutrient deficiencies at the same time,” he said.
The importance of targeted interventions
To address these challenges, the Ministry of Health has adopted blanket intervention measures. Dr. Wickramasekara explained that this included targeted interventions alongside the provision of micronutrient supplements and food rations.
However, he stressed that blanket interventions alone were no longer sufficient. “The problem in Sri Lanka now is that the situation has stagnated, since the nutritional level has neither improved nor worsened. We need to look into why it has remained at the same level for decades.”
He cautioned that traditional nutrition interventions could unintentionally worsen overnutrition if not carefully targeted. “For example, if we identify that children lack energy and start giving energy-dense food to that family, an overweight family member may also consume those foods, worsening their condition. That is why targeted interventions are important.”
In this context, Dr. Wickramasekara considers the Ministry of Health’s ongoing plans for targeted interventions through nutrition clinics in hospitals, as well as through Medical Officer of Health (MOH) offices and Public Health Midwives (PHMs) in the community, as significant.
Further, the Ministry of Health has begun establishing medical centres under the new Arogya initiative. “One of the main purposes of these centres is to provide communities with accurate information regarding nutritional deficiencies and the nutrition problem, to empower people, and to help find a solution,” he said.
Nutrition literacy
According to Dr. Wickramasekara, one of the greatest obstacles to improving nutrition outcomes is misinformation.
“The biggest challenge is misinformation. No matter how many messages the Ministry of Health sends regarding nutrition, misinformation spreads within society.”
He added that the presence of food security alone did not guarantee good nutrition. “Even if food security exists and food is available, there is often a problem with knowledge regarding how to use that food correctly. Nutritious food may be available at home, but people do not necessarily consume it.”
Dr. Wickramasekara further noted that the primary objective of the Arogya programme was to address these knowledge gaps in society, improving public awareness and nutrition literacy.
Room for improvement
In such a context, Cyclone Ditwah has placed additional pressure on already vulnerable households in terms of nutrition.
According to humanitarian partners such as the United Nations (UN), child malnutrition has been further complicated by the aftermath of Cyclone Ditwah with heightened nutritional vulnerability.
In its May Situation Report produced by the Office of the Resident Coordinator in Sri Lanka, the UN notes that nutrition services remain difficult to access for all the population due to high out-of-pocket costs and increasing food prices due to the current fuel price adjustment and transport cost increase.
An estimated 161,013 people, including pregnant and breastfeeding women and children under five, continue to require nutrition assistance following the cyclone. Although many have received partial support, the report notes that they remain highly dependent due to rising costs of food and loss of livelihood options.
The UN notes that four civil society organisations have initiated treatment of access facilitation for children with SAM in 11 Regional Directorate of Health Services (RDHS) areas and made significant progress amid many challenges within the last two months. Out of the 2,021 children (aged 6-59 months) with SAM, 1,110 (55%) have been enrolled in treatment programmes using Ready-to-Use Therapeutic Food (RUTF).
According to Dr. Wickramasekara, while Sri Lanka’s nutrition programmes remain commendable, their achievements should not lead to complacency.
“If we take South Asia and the world, Sri Lanka’s nutrition programmes are at a very high level. Especially within South Asia, Sri Lanka is often used as a model. Likewise, our health programmes are praised globally. However, we can do more than this. We must make necessary changes in the future. Otherwise, we will remain at the same level indefinitely.”
Among the priorities, he said, were identifying shortcomings in existing nutrition programmes, investigating previously overlooked factors that may be contributing to persistent nutrition problems, and remedying them.