Browsing by Author "Perera, J.A.P.S."

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The effectiveness of “Zakath” contribution in poverty reduction among Muslims in Sri Lanka
(University of Kelaniya, 2008) Perera, J.A.P.S.
Socio-economic gradient in the inequality of health related risk factors among slum dwellers in Colombo Municipal Council area
(Sri Lanka Medical Association, 2011) Perera, J.A.P.S.; Kumarendran, B.
INTRODUCTION AND OBJECTIVES: To describe the socio-economic inequalities in selected health related risk factors among slum dwellers in Colombo Municipal Council area (CMC). METHODS: This descriptive cross sectional study included 1000 slum dwelling households (HH) selected using multistage random sampling from twenty five neighborhoods in CMC during 2009. Data were collected by data collectors using a predesigned questionnaire and analysed using SPSS software. When appropriate, comparisons were made with the findings of Census of Population and Housing, 2001. Socio-economic quintiles were obtained from a composite score comprised of 13 variables. RESULTS: There were 5375 HH members in 1000 HH. Proportion of houses with five to nine HH members was higher in slums (60.7%, n = 607) than in CMC (45.2%, n = 51812, in 2001 census). Almost one fourth (24.9%, n= 774) of those aged ^8 had only primary or no formal education. Some health risks among the participants included usage of kerosene oil (55.5%, n - 2981) and firewood (16.1%, n= 863) for cooking, no separate kitchen inside the house (45%, n =2418), metal roof (21%, n=1131) and wooden wall (13.6%, n=730). Of the males aged >18 years, 42.6% (n=1491) reported consuming alcohol and 34.9% (n=509) reported smoking. Health related risk factors (n=12) showed significant gradients along the socio-economic quintiles. CONCLUSIONS: Several health risk factors were observed in higher proportion among slum dwellers than the overall population in CMC. Significant gradient of inequalities in health related risk factors were observed among socio-economic quintiles of slum dwellers in CMC.
Straddled Boundaries of Health Care in a Sri Lankan Village: A Medico-Anthropological Analysis
(International Postgraduate Research Conference 2019, Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2019) Perera, J.A.P.S.; Angammana, B.H.
Medical Pluralism (MP) is a vital phenomenon, deeply focused and widely studied in Medical Anthropology and Medical Sociology. Sri Lanka is a medically pluralistic country which offers a wide array of health care/treatment options which are available and utilized successively, alternatively, and/or simultaneously. However, the scholarship on MP in the Sri Lankan context mainly carries the biomedical perspective. In this background, we explored how socio-cultural factors and structures shape MP in a Sri Lankan rural village while there is a rapid proliferation of bio-medicine and health care technologies ranging from basic rural dispensaries to e-health facilities at the macro level. Our objectives were to; identify the dynamics of MP in the chosen village, identify how pluralist medical environment influence the health seeking behavior of the villagers and identify the reasons to cross/straddle and continue medically pluralistic situation in the village. This was an ethnographic study conducted in Dorakumbura Village in Matale district in 2018. The method of data collection included observations, interviews (10), and focus group discussions (05) conducted with a wide array of respondents (ranging from peasants, traditional healers, exorcists, astrologers, doctor, nurses, treatment seekers, to village administrative and related stake holders). We adopted the narrative analysis as the method of data analysis. The research revealed that there are three main sectors of medical pluralism; popular sector, folk sector and professional sector and villagers adopt a combination of treatment practices drawing from local, regional and cosmopolitan medical systems. Kinship and family ties still play a major role in transmitting the traditional knowledge on diseases and related treatments among the villagers studied. The peasants revealed very divers health beliefs and they follow diverse health care/treatment practices from various health traditions which are based on a wide range of social, cultural, ecological and structural factors that shape people’s choices and decisions on health. Although there seems to be a co-existence of several treatment traditions among the villagers, bio-medicine still exerts dominance. Further, cultural propensities and religious faith play a significant role in shaping pluralistic medical practices among villagers studied
Teenage pregnancy in Colombo Municipal Council area
(Sri Lanka Medical Association, 2011) Perera, J.A.P.S.; Kumarendran, B.; Silva, K.T.
INTRODUCTION AND OBJECTIVES: To describe the distribution of teenage pregnancy (TP) in Colombo Municipal Council area. METHODS: This descriptive cross-sectional study was based on secondary data analysis from the management information system related to maternal and child care for the period of 2004 to 2009. TP is defined as a pregnant female aged <20 years. Permission was obtained from CMC officials. Results: Of the registered pregnancies during 2007, 2008 and 2009, the percentage of TP (TPP) were 10% (1043/10386), 7.9% (805 / 10194) and 7.3 (660/9036) respectively. The average incidence of registered TP over these three years was 8.5%. Of the thirteen antenatal clinics (ANC) in the CMC, TPP was higher in Maligawatte (11.5%) and Bandaranayake Mawatha (11.3%) and lower in Kirullapone (6.1%) and Wasala Road (5.4%) clinics. The percentage deviation of TP from CMC level showed higher levels in CMC districts 2A (23.5%), 2B (8.2%) and lower levels in Districts 4 (-27.1%), 5 (-12.9%), 3 (-11.8%) and 1 (-10.6%). Linear regression of population in districts with TPP was significant (R2=0.91, p = 0.003). The range of population covered by PHM (PCP) varied widely among districts (7017 to 15969). Districts with lower PCP (Districts 2A and 2B) had higher TPP. Conclusions: Despite the reducing trend, TPP in CMC is higher than national and Colombo district levels. TPP and population per PHM area in CMC districts vary widely. Cadre revision of PHM should consider service needs in the districts in addition to population per PHM.
What factors deny access to pregnancy support mechanisms? Experiences of slum-dwelling pregnant teenagers in Colombo city
(University of Kelaniya, 2011) Perera, J.A.P.S.; Silva, K.T.
Teenage pregnancy (TP) is a key public health issue among urban slum-dwellers in Colombo. The adverse outcomes of TP often result from poor social support backgrounds. Understanding the factors which deny access to social support mechanisms would be useful both in preventing and managing the adversities associated with TP. This paper examines the experiences of pregnant teenagers (PTs) regarding the factors which deny access to pregnancy support mechanisms both from the perspectives of support recipients and providers. Having obtained ethical approval, this descriptive-cross sectional study was conducted among 139 respondents including 109 PTs and 30 support providers (SPs) from Colombo Municipal Council (CMC) area during 2008 July to 2010 July. Both qualitative and quantitative data were collected through an interviewer-administered questionnaire, case studies and focus group discussions; data were analyzed using framework analysis method and SPSS software. Poor awareness of PTs on available support services, lack of autonomy as females of teen-age and limited mobility, were identified barriers. Being pregnant out of marriage constrained them seeking support from divers support networks. Since underage sex is considered a statutory rape, social fear, created by unmarried status and bearing pregnancy underage contrary to law have prevented PTs from seeking care. Non-availability of sufficient number of SPs constrained PTs seeking pregnancy care from PHM. Poor coordination between statuary law and reproductive health policy, inadequate attention given for specific reproductive and sexual health needs of teenagers in the National Maternal and Child Health policy in Sri Lanka were recognized as barriers for utilization and provision of social support for PTs. There is a need to review the existing marriage law so as to prevent it from being an instrument of social exclusion. Considering the unmarried and under-aged women, a special pregnancy care component should be included in MCH policy in Sri Lanka.