Browsing by Author "Guruge, D."

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    Community perceptions on intimate partner violence: A qualitative study from Sri Lanka
    (SAGE Publications, 2023) Reyal, H.P.; Perera, M.N.; Guruge, D.
    Although plenty of research is conducted to explore the causes of intimate partner violence (IPV), findings are inadequate about the community members' perceptions on IPV. This qualitative study was conducted in a health administrative area of Sri Lanka to explore IPV as perceived by community members in terms of what is IPV, what causes IPV, and what are the responses to prevent IPV. Five focus group discussions and 11 in-depth interviews were conducted with 34 women and eight men. Data were thematically analyzed, and a model on community perception of IPV was developed. It incorporated the individual, relationship, community, and societal levels of the existing ecological framework on causes of interpersonal violence. Perceived apparent and underlying determinants were operating directly and indirectly with complex interactions for the occurrence and continuation of IPV. Pathways of preventing or responding to IPV were identified. Findings on determinants can be incorporated into IPV interventions.
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    Empowering communities to use healthy lifestyle centres: an implementation research from Sri Lanka
    (BMJ Publishing Group Ltd, 2024) Herath, T.; Perera, M.; Guruge, D.; Kasturiratne, A.
    OBJECTIVE Healthy lifestyle centres (HLCs), a state service that screens for major non-communicable disease (NCD) risk factors and promotes lifestyle modifications in Sri Lanka, report underutilisation. The study aimed to assess the effectiveness of a participatory intervention to empower communities in improving HLC utilisation.DESIGN A quasi-experimental study based on the principles of community-based participatory research SETTING: Six rural communities each as the intervention (IG) (Gampaha district) and comparison (CG) groups (Kalutara district) from the capital province of Sri Lanka.PARTICIPANTS Study population was healthy individuals aged 35-65 years, the target group of HLCs in Sri Lanka. A random sample of 498 individuals was selected from each group for evaluation.INTERVENTIONS Community support groups (CSGs) were established and empowered using health promotion approach from August 2019 to February 2020. Group discussions and participatory mapping were conducted to identify determinants of underutilisation of HLCs, design activities to address prioritised determinants and develop indicators to monitor the progress of CSGs.PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was improvement of HLC utilisation and the secondary outcome was initiation of lifestyle modifications.RESULTS Significant improvements were seen in the IG, compared with the CG in the seven determinants that contribute to HLC utilisation. The largest differences were seen in reducing negative perceptions of susceptibility for NCDs (pre=64.7%; post=33.3%; p<0.001) and usefulness of screening (pre=66.6%; post=17.3%; p<0.001). The HLC utilisation in IG increased by 29.5% (pre=5.85%; 95% CI 3.74 to 7.95, post=35.3%; 95% CI 30.9 to 39.8, p<0.001), while the utilisation of the CG showed no difference. Furthermore, there was an improvement in the proportion of users who initiated lifestyle modification (pre=64.3%; post=89.9%; p=0.039) in IG, which was not observed in CG.CONCLUSION HLC utilisation and initiation of lifestyle modification can be improved by a community-based health promotion intervention through empowering CSGs.TRIAL REGISTRATION NUMBER SLCTR/2019/028.
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    Prevalence of intimate partner violence across urban, rural and estate sectors: A preliminary study
    (College of Community Physicians of Sri Lanka, 2021) Reyal, H.P.; Perera, M.N.; Guruge, D.
    INTRODUCTION: Intimate partner violence (IPV) against women continues to be a silent health problem in Sri Lanka. Studies on IPV across different socio-demographic divisions are limited, thus uniform approaches are used to address IPV despite the varying prevalence across different study settings. OBJECTIVES: To compare the prevalence of IPV across the urban, rural and estate sectors through a study conducted in Nawalapitiya Medical Officer of Health (MOH) Area. METHODS: A cross-sectional survey was designed to conduct with 701 ever-married women aged 15-49 years using a multistage cluster sampling method. A pre-tested interviewer-administered-questionnaire was used to assess the abuse experienced by the participants during lifetime and past twelve months in the form of physical, psychological, sexual acts and controlling behaviours. Bivariate analysis was performed to compare the prevalence of IPV among the three sectors. RESULTS: The response rate was 85.6% (n=600). Lifetime prevalence of physical (n=237; 39.5%), psychological abuse (n=234; 39.0%) and controlling behaviours (n=188; 31.3%) were high among everpartnered women. Estate women reported more abuse (n=143; 79.4%), physical (n=110; 61.1%), psychological (n=99; 55%), sexual abuse (n=29; 16.1%) and controlling behaviours (n=62; 34.4%) compared to urban and rural women. CONCLUSIONS & RECOMMENDATIONS: IPV prevalence significantly differed across sectors. IPV was highest in the estate sector followed by urban and rural sectors. Designing of IPV intervention should focus on different sectors. The contributory factors within the sectors should be explored and addressed. KEYWORDS: Physical abuse, Psychological abuse, Sexual abuse, Women, Sri Lanka