Browsing by Author "Abeysena, C."

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Adherence to infection control practices in relation to neonatal care in major hospitals in a district of Sri Lanka
(College of Community Physicians of Sri Lanka, 2019) Jayasinghe, C.; Abeysena, C.
INTRODUCTION: Adherence to infection control practices are crucial for neonatal care. OBJECTIVES: To describe the adherence to clean birth and postnatal care practices by healthcare workers in selected procedures in major hospitals in a district of Sri Lanka METHODS: This was a qualitative observational study. The study sample comprised healthcare workers (doctors, nurses and midwives) attached to the labour room (LR), postnatal ward (PNW), neonatal intensive care unit (NICU) and operating theatre (OT). A total of 70 healthcare workers from the LR, 90 from the PNW, 50 from the NICU and 60 from the OT were assessed in relation to each procedure they carried out. Four checklists were used to record the observations on infection control standards. The performance of each healthcare worker for each specific procedure was observed only once. RESULTS: Hand washing practices among the healthcare workers in LR, NICU, PNW and OT varied, with better practices seen in NICU and PNW. Recapping of the needles was done by 18.6%, 18.0% and 31.2% in LR, NICU and PNW, respectively. Disposal of sharps to the bin was done by almost all healthcare workers in the LR, NICU and PNW, respectively. All the healthcare workers used 70% alcohol to disinfect the skin, of whom the majority used povidone iodine when drawing blood samples for blood culture in the NICU. Changing or washing gloves before cutting the umbilical cord was observed in the majority of healthcare workers in LR and the minority in OT. CONCLUSIONS: Adherence to infection control standards by healthcare workers in observed procedures was not up to the standard. KEYWORDS: Birth, Infection, Hand washing, Postnatal, Neonates, Sepsis
Adverse pregnancy outcome: do we know the risk factors
(College of Community Physicians of Sri Lanka, 2010) Abeysena, C.
The contents of this oration are based on a series of four studies carried out by the author. These studies were conducted to determine the risk factors for adverse pregnancy outcomes. Adverse pregnancy outcomes considered were low birth weight, pre term birth, small for gestational age births, maternal complications during pregnancy and spontaneous abortions. Conclusions are drawn and recommendations made based on available evidence.
Assessment of foetal growth retardation: small for gestational age
(College of Community Physicians of Sri Lanka, 2010) Abeysena, C.; Jayawardana, P.
Growth retardation cannot be described by a single weight measure because, birth weight is dependant on both duration of gestation and intrauterine growth rate. It has also been shown that foetal weight is dependant on constitutional as well as pathological factors. Constitutional factors include maternal height, weight, parity, ethnicity and foetal sex. When assessing foetal growth retardation, it is important to consider constitutional factors as well. Of the different assessments developed small for gestational age defined based on the customised birth weight standards assess foetal growth retardation more accurately.
Association of physical activity and consumption of snacks on weight retention at six months after childbirth
(College of Community Physicians of Sri Lanka, 2020) Perera, S.N.S.; Abeysena, C.
Introduction: Postpartum weight gain places a woman at risk of developing overweight and obesity in later life. OBJECTIVES: To determine the factors associated with weight retention at six months after childbirth among mothers who attended child welfare clinics in two medical officer of health (MOH) areas. METHODS: This was a descriptive-cross sectional study conducted among all mothers who had been registered before 12 weeks in the antenatal clinics during their last pregnancy and attended field child-welfare clinics for pentavalent vaccination. The sample was 387 recruited consecutively until the required sample was achieved. Validated culturally adopted, pretested questionnaires were used. Logistic regression analysis was performed, and the results expressed as adjusted odds ratio (aOR) and corresponding 95% confidence interval (CI). RESULTS: The percentage of mothers who retained weight from a booking visit to six months after childbirth was 67.8%. Low physical activity (aOR=12.0; 95% CI=6.0, 23.8) and consuming ≥1 snack/day (aOR=2.1; 95% CI=1.3, 3.4) had positively; and being obese or overweight at booking visit (aOR=0.4; 95% CI=0.3, 0.7) and age >33 years (aOR=0.5; 95% CI=0.3, 0.9) negatively associated with weight retention at six months after childbirth. No significant associations were observed with parity, education status, income, social class, employment, sleep hours, breastfeeding status, quality of diet and psycho-social stress. CONCLUSIONS: Low physical activity and consuming ≥1 snack per day, aged ≤33 years and not being obese or overweight at booking visit were associated with weight retention at six months after childbirth. KEYWORDS: Body mass index, Obesity, Physical activity, Postpartum, Weight retention
Association of poor social support and financial insecurity with psychological distress of Chronic Kidney Disease patients attending National Nephrology Unit in Sri Lanka
(Hindawi Limited, 2018) Hettiarachchi, R.; Abeysena, C.
BACKGROUND: Chronic kidney disease (CKD) is associated with high morbidity and mortality. Hence, CKD patients are often in chronic psychological distress. The objective of the study was to describe factors associated with psychological distress of CKD patients attendingNational Nephrology Unit. METHODS: A descriptive cross-sectional study was conducted among 382 CKD patientsabove 18 years of age applying systematic sampling. The data was collected using self-administered questionnaires to assess the psychological distress (GHQ-12), social support(SSQ6), coping strategies (BRIEFCOPE), pain (0 to 10 numeric pain rating scale), and physical role limitation due to ill health (SF36QOL). Sociodemographic and disease-related data were collected using an interviewer administered questionnaire and a data extraction sheet. Multiple logistic regression was applied for determining the associated factors. The results were expressed as adjusted odds ratio (AOR) and 95% confidence intervals (95% CI). RESULTS: Percentage of psychological distress was 55.2% (95% CI: 48.4% to 62%). Poorsocial support (AOR = 1.81, 95% CI: 1.14-2.88), low satisfaction with the social supportreceived (AOR = 4.14, 95% CI: 1.59-10.78), stages IV and V of CKD (AOR = 2.67, 95% CI: 1.65-4.20), presence of comorbidities (AOR = 2.38, 95% CI: 1.21-4.67), within one year of diagnosis (AOR = 2.23, 95% CI: 1.36-3.67), low monthly income (AOR = 2.26, CI: 1.26-4.06), higher out-of-pocket expenditure per month (AOR = 1.75, 95% CI: 1.75-1.99), and being a female (AOR = 2.95, 95% CI: 1.79-4.9) were significantly associated with psychologicaldistress. CONCLUSIONS: More than half of the CKD patients were psychologically distressed. Factors such as financial and social support will be worth considering early because of their modifiability.
The attitudes and practices, regarding pre hospital care and emergency medicine, among ambulance drivers and minor employees accompany patients in ambulances
(College of Community Physicians of Sri Lanka, 2009) Nandasena, L.G.S.; Abeysena, C.
OBJECTIVE: To describe, the attitudes and practices, regarding pre hospital care and emergency medicine among the ambulance drivers and minor employees. METHODS: A descriptive cross sectional hospital based study was carried out at the National Hospital of Sri Lanka from 15th August to 13th October 2008. The staff arrived in 409 ambulances (from any part of the country), consisting of 335 drivers and 675 minor employees were recruited. All were given an interviewer administered questionnaire to assess attitudes and practices. Likert scale was used to assess the level of attitudes. Practices were self reported ones. The analysis was done by using chi square test. RESULTS: Good attitudes towards, training needed in pre hospital care among drivers was 99.7% (n=334), low cost involved in adopting certain life saving measures, 50.4% (n=169) and positive outcome of pre hospital care in terms of survival, 4.8% (n=16). Among minor employees the respective figures were 96.8%(n=654), 36%(n=243) and 2.4%(n=16). Twenty four percent (n=164) of minor employees has had training in pre hospital care. Of them 84.8% ^=139) have used their knowledge to assist other ambulance staff in emergencies. Twenty three percent (n=95) of drivers wore seat belts and 6.4%(n=26) wore gloves. Among minor employees, 53%(n=360) used gloves, 45.2%(n=305) face masks, 5.9%(n=40) safety boots and 2.2% (n=15) safety caps. There is no statistically significant difference in attitudes of drivers and minor employees according to age, sex, education level, hospital they work, or training they had received. CONCLUSION: Attitudes towards training needed in pre hospital care were good, but with regard to low cost and positive outcome of pre hospital care, attitudes were relatively poor. The use of personal protective equipment during work was poor among all staff categories.
Availability of facilities and equipment to provide emergency care in ambulances, which transport patients to the National Hospital of Sri Lanka
(Journal of the College of Community Physicians of Sri Lanka, 2018) Nandasena, G.; Abeysena, C.
ABSTRACT: Objective To describe available facilities and equipment in ambulances, to provide essential emergency care, which transport patients to the National Hospital of Sri Lanka Methods A descriptive cross-sectional hospital based study was carried out at the National Hospital of Sri Lanka from August to October 2008. All ambulances that arrived at the hospital during the study period with an emergency patient were selected as study sample (n=409). A Check list was used to assess in situ facilities and equipment that should be available for basic life support (BLS) and advanced life support (ALS). Results Most of the ambulances were equipped only with very basic facilities such as wheeled stretcher 95.4% (n=390), ABC fire extinguishers 75.3% (n=308) and warning siren 94.4% (n=386). Among ventilation and air way equipment, ‘oxygen cylinders’ showed highest percentage {68.7%; n=281) of availability in ambulances and oropharyngeal air ways were available only in 4.9% (n=20). Ventilation and air way equipment required for ALS were available only in less than 1% of all ambulances. Among patient assessment equipment, pen lights were available in 19.6% (n=80) and blood pressure apparatus in 2.2% (n=9) of ambulances. Obstetrical supplies, splinting equipment, surgical dressings except bandages, drug delivery devices, intravenous equipment except IV hook were available among < 5% of all ambulances. Most of the ambulances were equipped with safety and accessory equipment, except child safety seat 0.5% (n=2), triage tags 1.7% (n=7) and hack saw 0.7% (n=3), which were available in <2% of all ambulances. Conclusion The facilities and equipment that should be available in both basic and advanced life support ambulances were poor.
Availability of facilities and equipment, in ambulances that provide care in pre hospital set up
(College of Community Physicians of Sri Lanka, 2009) Nandasena, L.G.S.; Abeysena, C.
OBJECTIVE: To describe available facilities and equipment, in ambulances that provide care in pre hospital set up. METHODS: A descriptive cross sectional hospital based study was carried out at the National Hospital of Sri Lanka (NHSL) from 15th August to 13th October 2008. All ambulances that arrived at the NHSL during the study period with an emergency patient were selected as study sample (n=409). A check list was used to assess in situ facilities and equipment that are available in the ambulance. RESULTS: Most of the ambulances were equipped only with very basic facilities such as wheeled stretcher (95.4%; n=390), ABC fire extinguishers (75.3%; n=308) and warning sirens (94.4%; n=386). Among ventilation and air way equipment required for basic life support, oxygen cylinders showed highest percentage (68.7%; n=281) of availability where as oropharyngeal air ways were available only in 4.9% (n=20) of ambulances. Availabilty of ventilation and air way equipment required for advanced life support ranged from 0.7% each (n=3) of adult endotracheal tubes and portable ventilators to 0.2% each (n=l) of peadiatric endotracheal tubes and Magill forceps. Patient assessment equipment such as pen lights and blood pressure apparatus were available only in 19.6%(n=80) and 2.2%(n=9) respectively. Communication equipment, obstetric supplies, splinting equipment, surgical items, drug delivery devices, and intravenous equipment, were available only among less than 5% of all ambulances. Most of the ambulances were equipped with safety and accessory equipment, except child safety seat 0.5% (n=2), triage tags 1.7% (n=7) and hack saw 0.7% (n=3), which were available only in less than 2% of all ambulances. Body substance isolation equipment were available only in less than 30% of all ambulances. CONCLUSION: The facilities that should be available for basic and advanced life support were poor in ambulances. From equipment that should be available for basic life support, most of the ambulances contained more basic elements only, which have no direct impact on patient care. Most of the equipments required for advanced life support were available only in less than 1% of ambulances.
Awareness and care seeking pattern for symptoms associated with endometrial carcinoma among postmenopausal women in the district of Colombo: a cross-sectional study
(Ceylon Medical Journal, 2019) Jayawickrama, W. I. U.; Abeysena, C.
INTRODUCTION: Variations in endometrial carcinoma awareness among postmenopausal women may explain the variations in care seeking pattern for symptoms associated with endometrial carcinoma. OBJECTIVES: To describe the awareness and care seeking pattern for symptoms associated with endometrial carcinoma among postmenopausal women in the district of Colombo. METHODS: A community based descriptive cross sectional study was conducted among 1168 postmenopausal women in the district of Colombo, using multistage cluster sampling technique. A pre-tested interviewer administered questionnaire was used. Descriptive statistics were used to describe the awareness and care seeking pattern. RESULTS: Of the sample, 83.6% (95% CI: 81.5-85.7, n=977) had heard about endometrial carcinoma. About 56% of women (n=654) were aware that postmenopausal bleeding was a suggestive symptom of endometrial carcinoma. Only 24.0% (n=280) knew that never conceived was a risk factor, 20.6% and 20.9% knew that physical inactivity and obesity were risk factors respectively and 28.0% knew that hormone replacement therapy was a risk factor, for endometrial carcinoma. Of the women, 26.6% (n=311) had experienced some gynaecological symptoms similar to symptoms of endometrial carcinoma during their postmenopausal period. Majority of them had disclosed to the children (n= 155, 49.8%) about the symptoms, 70.7% (n=220) had sought treatment, and the most common reason for seeking treatment was physical discomfort (n=83, 37.8%). A majority had gone to the government hospital (n=75, 34%) to get treatment. CONCLUSIONS: Low awareness of common symptoms, risk KEYWORDS: Endometrial cancer, Awareness, Care seeking pattern, Postmenopausal
Blood sugar lowering effect of Coccinia grandis (L.) J. Voigt: path for a new drug for diabetes mellitus
(Hindawi Pub. Corp, 2011) Munasinghe, M. A.; Abeysena, C.; Yaddehige, I. S.; Vidanapathirana, T.; Piyumal, K. P.
BACKGROUND: Role of herbs in the management and control of diabetes has emerged fast over the years. We assessed the efficacy of Coccinia grandis (locally known as Ken, Kovakka) leaves as a hypoglycemic agent. METHODS: Double-blind phase I clinical trial was conducted at the general hospital and a private hospital in Matara in August 2009. All the participants were given a common meal for dinner, and they maintained a 10-hour fasting period. Sixty-one healthy volunteers were given a meal containing 20 g of leaves of Coccinia grandis which was mixed with a measured amount of scraped coconut and table salt for breakfast, and other 61 were given the placebo meal which also contained scraped coconut and salt. Glucose tolerance test was performed blindly for the two groups. Mixed factorial design analysis of variance and student's t-test were applied. RESULTS: Overall blood sugar levels of the experimental group were also significantly lower than those of the control group (F(1,117) 5.56, P < 0.05). Increase in the blood sugar levels from fasting to one hour (F(1,117) 6.77, P < 0.05) and two hours (F(1,117) 5.28, P < 0.05) postprandially was statistically significant for participants who were in the control group than those of in the experimental group. The mean difference of postprandial blood sugar levels (mg/dL) after one hour (20.2, 95% confidence interval, 4.81 to 35.5) and two hours (11.46, 95% confidence interval; 1.03 to 21.9) was statistically significant between the two groups. CONCLUSIONS: Coccinia grandis has a blood sugar lowering effect. However further studies are needed to validate our findings.
Body mass index and gestational weight gain in two selected Medical Officer of Health areas in the Gampaha District.
(College of Community Physicians of Sri Lanka, 2011) Abeysena, C.; Jayawardana, P.
OBJECTIVE: To describe gestational weight gain pattern according to the body mass index (BMI) categories. METHODS: This is a descriptive study conducted in two Medical Officer of Health areas of the Gampaha District. Pregnant women were recruited on or before 16 weeks of gestation and followed up until delivery. Maternal weight was measured at the booking visit, during the second trimester and at delivery. Inadequate and excessive weight gain were defined as weight gain below and above the Institute of Medicine (IOM) 2009 recommendations for the BMI categories as well as Ministry of Health (MoH) recommendations. RESULTS: Two hundred and forty seven (30%) of the women were underweight, 432(52%) were normal weight and 131(18%) overweight and obese. According to the Asian BMI classification, 338(41 %) were normal weight and 225(29%) were overweight and obese. Total mean weight gain for the sample was 10.6(SD 3.3) kg and mean rate of gestational weight gain was 0.27(SD 0.08) kg/week. Mean weight gain during second trimester was 6.7(SD 2.7) kg and during third trimester 3.9(SD 2.2) kg. Mean gestational weight gain and rate of weight gain per week was higher among underweight women. Of the 710, 404(57%) women gained less and 62(8.7%) more weight, than recommended by the IOM, whereas 108(15%) gained more weight by MoH standards. CONCLUSIONS: One third of the women were underweight and mean gestational weight gain and rate of weight gain per week were higher amongst them. More than half of the women gained less weight than recommended.
Cause of death of Sri Lankan migrant workers employed in the Middle East
(British Medical Association, 2006) Samarakkody, D.M.P.; Jayawardana, P.; Abeysena, C.
No Abstract Available
Chlorhexidine for umbilical cord care of the newborn: summary of evidence and its application in Sri Lanka.
(College of Community Physicians of Sri Lanka, 2019) Jayakody, H.; Abeysena, C.
No abstract available.
Completeness of consent forms in research proposals submitted to an ethics review committee
(Forum for Medical Ethics Society, 2012) Abeysena, C.; Jayamanna, K.; Dep, S.
This was a descriptive cross-sectional study which analysed the consent forms submitted to the ethics review committee at the faculty of medicine of the University of Kelaniya, Sri Lanka, between January 2007 and December 2008. Of the 145 consent forms reviewed, 94.5% (137) explained the purpose of the study, 77% (111) included a statement that participation was voluntary, 44% (64) stated that refusal of participation did not affect care, 65.5% (95) mentioned the ability to withdraw consent at any time, 79% (115) that confidentiality of records would be maintained and 45.5% (66) that further clarifications were possible. Thirty nine (75%) of 52 eligible consent forms described the potential benefits and 19% (18) of 93 consent forms explained that there were no benefits to the participants. Twenty eight (59%) of 47 eligible consent forms described possible risks or discomfort to patients and 30% (29) of 98 consent forms explained that there were no risks to the participants. In conclusion, essential elements of the consent forms were missing in this study. It is recommended that a checklist of compulsory elements to include on forms be used before proposals are submitted to an ethics review committee.
Completeness of the consent forms in research proposals submitted to an ethics review committee
(University of Kelaniya, 2011) Abeysena, C.; Jayamanna, K.
The voluntary consent of human subjects is essential prior to any medical research. A consent form should provide all the information needed for an individual to make an informed decision. In order for that to occur, the consent form must be replete with all the necessary information to give a complete picture of the research study to the participant. The objective of this paper is to assess the completeness of consent forms submitted for ethical approval. This was a descriptive cross sectional study which analysed the consent forms submitted to the Ethics Review Committee of the Faculty of Medicine of the University of Kelaniya, Sri Lanka, between January 2007 and December 2008. The consent forms submitted with undergraduate research proposals were excluded. A record sheet was used to extract data. Of 145 consent forms reviewed, 94.5% (137) explained the purpose of the study, 77% (111) included a statement that participation was voluntary, 44% (64) refused participation and did not affect care, 65.5% (95) gave ability to withdraw consent at any time, 79% (115) stated that confidentiality of records would be maintained, and 45.5% (66) said further clarifications were possible. Thirty nine (75%) of 52 eligible consent forms described the potential benefits, and 19% (18) of 93 consent forms explained that there were no benefits to the participants. Twenty eight (59%) of 47 eligible consent forms described possible risks or discomfort to patients, and 30% (29) of 98 consent forms explained that there were no risks to the participants. Only 48% (15) of 31 eligible consent forms described the procedure of physical examination and 21% (31) used a separate section to assess the participant‟s understanding of her/his role. We conclude that essential elements of the consent forms were missing, and recommend that a checklist of compulsory elements to be included on forms be used, before proposals are submitted to the Ethics Review Committee.
Content analysis of policy documents related to non-communicable diseases prevention and control in Sri Lanka: a developing country in the South-East Asia
(F1000 Research, 2024) Talagala, I.; Abeysena, C.; Wickremasinghe, R.
BACKGROUND: Health policies form the foundation for provisioning best level care and are important for all stakeholders including patients and healthcare providers. Health policy analysis and evaluation allows policy makers to improve an existing policy, terminate a non-effective policy and to successfully implement future policies. The objective was to assess the coherence between the two local policy documents on NCD prevention and control in Sri Lanka, the national NCD policy (NCD policy) and the multisectoral action plan (MSAP), and to assess the consistency of MSAP with the global action plan for NCDs. METHODS: The content analysis of the NCD policy and MSAP of Sri Lanka was conducted based on the modified criteria developed to the ‘Analysis of determinants of policy impact’ model, by two reviewers independently. Coherence between MSAP and the global NCD action plan were also assessed by two reviewers independently. Consensus for discrepancy was achieved through discussion. RESULTS: Accessibility was the strongest criteria for the NCD policy, while, resources and obligations were the weakest. Goals and monitoring and evaluation criteria were the strongest in the MSAP. Requirement for improvement were identified in policy background, goals, monitoring and evaluation, and public opportunities for the NCD policy. Accessibility, policy background, resources, public opportunities and obligations require further improvement in the MSAP. The MSAP is well coherent with the global road map for NCD prevention and control. CONCLUSION: Policy documents related to NCD prevention and control in Sri Lanka are coherent with the global action plan, while, there are areas within the local policy documents that need to be improved to enhance the coherence between the local documents. Lessons learnt by this activity need to be utilized by Sri Lanka and other countries to improve the uniformity between the NCD policy documents within the country as well as internationally.
DAG: method for causal modelling in epidemiological research
(College of Community Physicians of Sri Lanka, 2017) Gamage, A.; Abeysena, C.
Development and assessment of psychometric properties of model medication adherence (MMA) questionnaire to measure adherence to oral medication among patients with type 2 diabetes mellitus
(College of Community Physicians of Sri Lanka, 2023) Perera, S.; Abeysena, C.
INTRODUCTION: Medication adherence among patients with type 2 diabetes (DM) is assessed in everyday clinical practice. OBJECTIVES: To develop a questionnaire to measure adherence to oral medication among patients with DM and to assess its psychometric properties METHODS: The “Model Medication Adherence (MMA)” questionnaire was developed using the evidence from literature review and interviews with key stakeholders and patients. Answers were set on a five-point Likert scale that scored from 1 to 5, with 15-73 as the possible range of the total score. MMA was drafted in English and translated to Sinhala language by forward- backward translation. A descriptive cross-sectional study was carried out among adult patients with type 2 DM who attended clinics in Gampaha District General Hospital (DGH). A sample of 150 patients was recruited consecutively. The construct validity of MMA was assessed by Exploratory Factor Analysis (EFA) through Principal Component Analysis (PCA) with Varimax rotation RESULTS: EFA yielded four factors; sick role behaviour, autonomy, forgetfulness, and barriers that explained 64.36% of the variance of the total score of MMA. Internal consistency was acceptable (Cronbach’s alpha 0.73). The testretest reliability coefficient was 0.85 (p=0.01). Acceptability of the MMA was established by non-response items (none) and the time taken to complete (20 minutes). CONCLUSIONS & RECOMMENDATIONS: MMA is a simple valid questionnaire that adds a novel concept to the adherence literature; sick role and autonomy. It has a good factor structure with established construct validity and is recommended to be used in the clinical setting.
Development of a complex intervention package for dengue prevention
(Ministry of Health, Sri Lanka, 2022) Rajapaksha, R.M.N.U.; Abeysena, C.; Balasuriya, A.; PannilaHetti, N.; Alagiyawanna, A.; Manilgama, S.
INTRODUCTION: Complex interventions are widely used in public health practices with noteworthy health impacts. Communication for Behavioural Impact (COMBI) plan is an effective method directed at enacting behaviour change to benefit health and social development which encourage precise behavioural outcomes and is effective in planning a behavioural change for dengue control. The aim of this study was to develop an intervention package to change the behaviour to prevent dengue in one of the highest dengue-endemic areas of Sri Lanka. METHODS: The development of the intervention package was formulated according to the two phases, the ‘Theoretical phase’ and ‘Modelling phase’ of the framework for ‘Developing and Evaluating Complex Interventions’. World Health Organization’s 10 key steps in planning COMBI strategies were followed in order to develop the present intervention package. A situational market analysis was conducted in the highest dengue-endemic area in Kurunegala district to identify the Specific Behavioural Objectives (SBOO) for the COMBI plan. The development of the COMBI plan was conducted using the mixed methodological approach including quantitative and qualitative designs. RESULTS: The overall goal of the COMBI plan was to decrease the morbidity and mortality due to dengue illness by improving the dengue prevention behaviours among householders. The SBOO for the plan were to improve the proper waste management practices according to the ‘3R concept’ (Reduce, Reuse and Re-cycling) and to improve the dengue prevention practices by 30 minutes of weekly cleaning. The strategies of intervention package were to conduct a community empowerment program to improve household waste management and weekly practices on dengue prevention by conducting administrative mobilization and public relationship, public advocacy, community mobilization, personal selling, advertising, and point of service promotion during follow-up. CONCLUSION: Developing a COMBI plan for an area after the identification of SBOO would be feasible to implement in order to empower the community to prevent dengue and improve community health services.
Disability in medical officer of health area, Ragama: prevalence and extent of handicap
(University of Kelaniya, 2008) Abeysena, C.; Jayawardana, P.; Wijerathne, L.