demographics: overview of key developments in sri lanka - key developments i… · sri lanka...
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F r o n t i e r R e s e a r c h
Demographics: Overview of key
developments in Sri Lanka
F r o n t i e r R e s e a r c h
Key Definitions & Overview of Trends in Sri Lanka’s Population
• Lower infant mortality
• Better access to immunization
• Increased survival Rate to adulthood
Increase in Labourforce
• Population movement from rural to urban
• Increased awareness on reproductive health
• Lower fertility rate
Decline in share of the young
• Better access to health care
• Increase in life expectancyAgeing Population
F r o n t i e r R e s e a r c h
Overview of key health trends in Sri Lanka
Population
20.5 mn
Young Population
(<15 years)
5.1 mn ( 25%)
Working age Population (15-64
years)
13.6 mn ( 66%)
Labour Force
8.5 mn ( 62%)
Inactive
8.5 mn ( 38%)
Elderly Population
(>65 Years)
1.7 mn ( 9%)
Source: World Bank Data bank, 2014
F r o n t i e r R e s e a r c h
The demographic bulge
20121971Source: Population.lk
The First demographic dividend is recorded to have started in 1992 The conservative estimates are that the demographic dividend will end in 2017 but other estimates suggest that the
working age will start to decline by 2037
F r o n t i e r R e s e a r c h
Demographic dividend – growth in labour force
Since the early 90’s the advances made in terms of health care in previous decades, reflected in low female & infant mortality rates and higher survival ratios paid off in the form of a “Demographic dividend”.
The payoff of the demographic dividend is reflected in the increase in the size of the labour force compared with the total population which peaked in 1998 (42.9%) and 2006 (43,2%). As at 2013 it stood at 41.3%
Source: World Bank Data Base
36.0%
37.0%
38.0%
39.0%
40.0%
41.0%
42.0%
43.0%
44.0%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Labour force % of population
South Asia 39%
World 47%Pakistan 35%Bangladesh 49%
Sri Lanka 41%
F r o n t i e r R e s e a r c h
Sri Lanka stands out from the region as a Late Dividend Country
F r o n t i e r R e s e a r c h
Key stats
F r o n t i e r R e s e a r c h
Sri Lanka Population growth over time
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Ethnic Unrest
War intensifies
Cumulative impact of war
Mns.
Pakistan 185
Bangladesh 159
Sri Lanka 21
F r o n t i e r R e s e a r c h
Survival rates improve with better health care access leading to a bulge in working age population
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Survival rates of children over time
Survival to age 65, female (% of cohort) Survival to age 65, male (% of cohort)
Better access to health care services, the prevalence of freely available maternity and vaccination services has led to a drop in maternal and infant mortality rates
Male Female
South Asia 64.0 72.3
World 71.0 79.1
Pakistan 67.2 71.3
Bangladesh 72.4 76.8
Sri Lanka 72.2 86.7
F r o n t i e r R e s e a r c h
Drop in fertility rates result in a slowdown in growth of the young population
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Fertility rates over time
Source: World Bank databank
South Asia 2.6
World 2.5
Pakistan 3.2
Bangladesh 2.2
Sri Lanka 2.3
F r o n t i e r R e s e a r c h
Ageing population
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Population ages 65 and above (% of total)
Increasing disposable income, coupled with better access to health care has results in an increase in the life expectancy of the elderly
At the same time, declining fertility rates and net immigration has led to a shrinking of the child & young adult population
From 480,000 in 1960 to 1.8 mn in 2014 – 3% CAGR growth
Source: World Bank databank
South Asia 5.30%
World 8.10%
Pakistan 4.5%Bangladesh 5.0%
Sri Lanka 8.90%
F r o n t i e r R e s e a r c h
Dependency ratio of the elderly trending up
The dependency ratio for Sri Lanka is below that of the South Asian region (55%)
However this increase in Sri Lanka is mainly on account of the increase in dependency of the elderly due to the combination of increased life expectancy and declining fertility rates.
This has implications for the provision of public and private health care sector in terms of the areas of investment.
Source: World Bank databank
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2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Old Young
4851
F r o n t i e r R e s e a r c h
The transformation in the participation rate has been less pronounced
Mostly affected by Socio-economic factors which have not materialized
A key indicator of developed is the increase in Female Labour participation however, this has not materialized
Source: World Bank databank
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Labor force participation rate, total (% of total population ages 15+) (national estimate)
Labor force participation rate, total (% of total population ages 15+) (national estimate)
F r o n t i e r R e s e a r c h
Transformation in female participation not materialized
Female
1992 2002 2012
36.9% 33.60%32.90%
Male76.4% 67.90% 75%
Source: World Bank databank
F r o n t i e r R e s e a r c h
Key forecasts
F r o n t i e r R e s e a r c h
Expectation is for a sharp lowdown in working age population growth
Source: WHO Mental Health Atlas 2011 – Sri Lanka
F r o n t i e r R e s e a r c h
While elderly population is expected to accelerate..
Source: Global Monitoring report 2015
The Elderly population is expected to account for 1/4th of the population by 2041
F r o n t i e r R e s e a r c h
Secondary Dividend => Narrow of the gender gap witnessed in Post dividend countries
Source: Global Monitoring report 2015
It is vital to tap into the 2nd demographic dividend in order to sustain groth
F r o n t i e r R e s e a r c h
Key medium term forecasts
F r o n t i e r R e s e a r c h
20,653
20,869
20,328
20,483
20,639
20,762
20,973
21,199
21,371
21,463
19,600
19,800
20,000
20,200
20,400
20,600
20,800
21,000
21,200
21,400
21,600
2010 2011 2012 2013 2014 2015f 2016f 2017f 2018f 2019f
Tho
usa
nd
sPopulation
Source: Frontier Research & Dr. Indralal forecasts
0%
0.8%
F r o n t i e r R e s e a r c h
1,514 1,603 1,641
1,739 1,838
2,031
2,331
2,638
2,866 2,994
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500
1,000
1,500
2,000
2,500
3,000
3,500
2010 2011 2012 2013 2014 2015f 2016f 2017f 2018f 2019f
Tho
usa
nd
sElderly population
5%
10%
Source: Frontier Research & Dr. Indralal forecasts
F r o n t i e r R e s e a r c h
Population Mix
Source: Frontier Research
25% 25% 25% 25% 25% 24% 24% 23% 23% 23%
67% 67% 67% 67% 66% 66% 65% 64% 64% 63%
7% 8% 8% 8% 9% 10% 11% 12% 13% 14%
0%
20%
40%
60%
80%
100%
120%
2010 2011 2012 2013 2014 2015f 2016f 2017f 2018f 2019fYoung Population Working age population Elderly Population
F r o n t i e r R e s e a r c h
Key Challenges
F r o n t i e r R e s e a r c h
Increasing risk caused by NCD’s
As the economy transitions to a middle income status, the dietary habits of individuals tends to change in line with this As a result, diet related factors leads to a rise in the incidence of Non communical diseases(NCD’s) such as Diabetes, Smoking &
Alcohol related issues.
“Government hospital statistics indicate that 71% of all annual deaths are attributed to chronic Non-Communicable Diseases (NCDs).”
- Daily FT
F r o n t i e r R e s e a r c h
Suicide rates more prevalent amongst elderly males
With a suicide rate of 44.6 for Males and 16.8 for females per 100,000 individuals, Sri Lanka possesses one of the highest suicide rates in the world
A striking factor is that the absolute number is suicides is highest amongst elderly males (Over 60 years of age)
Source: IPS report: Investing in the demographics dividend, may 2013
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< 20 21-30 31-40 41-50 51-60 >60
Female Male
F r o n t i e r R e s e a r c h
Mental health care – An unserved market
One of the leading causes of high suicide rates is a lack of treatment for mental health care
This is an area which has traditionally been neglected in the mental health services and the World Health Organization (WHO) hasidentified this as one of the critical areas that needs to be addressed.
“In 2007 There were only 81 psychiatrists available to treat 40333 persons with different mental disorders” - IPS report: Investing in the demographics dividend, may 2013
Apart from health care professionals there is also a growing demand for hospice care and full time assisted living services
Source: WHO atlas of Mental health 2011
F r o n t i e r R e s e a r c h
Key takeaways
Dependency ratio tilt towards the elderly - The proportion of the young population is on the decline in line
with the dip in the number of births. However the share of elderly population is rising at a faster pace in
line with greater life expectancy and better access to health care.
Increase the burden on working population - The combined effect is expected to reduce the share of the
working age population which places a greater strain on the population to support an increasing number of
dependents.
Shift in demand for types of health care - The shift in the mix of dependents from the young to the elderly
would shift the demand for different types of health services as the incidence of chronic and degenerative
diseases rise.
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F r o n t i e r R e s e a r c h
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