Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Use of a public-private partnership in malaria elimination efforts in Sri Lanka; a case study(BioMed Central, 2018) Fernando, D.; Wijeyaratne, P.; Wickremasinghe, R.; Abeyasinghe, R.R.; Galappaththy, G.N.L.; Wickremasinghe, R.; Hapugoda, M.; Abeyewickreme, W.; Rodrigo, C.BACKGROUND: In special circumstances, establishing public private partnerships for malaria elimination may achieve targets faster than the state sector acting by itself. Following the end of the separatist war in Sri Lanka in 2009, the Anti Malaria Campaign (AMC) of Sri Lanka intensified malaria surveillance jointly with a private sector partner, Tropical and Environmental Diseases and Health Associates Private Limited (TEDHA) with a view to achieving malaria elimination targets by 2014. METHODS: This is a case study on how public private partnerships can be effectively utilized to achieve malaria elimination goals. TEDHA established 50 Malaria Diagnostic Laboratories and 17 entomology surveillance sentinel sites in consultation with the AMC in areas difficult to access by government officials (five districts in two provinces affected by war). RESULTS: TEDHA screened 994,448 individuals for malaria, of which 243,867 were screened at mobile malaria clinics as compared to 1,102,054 screened by the AMC. Nine malaria positives were diagnosed by TEDHA, while the AMC diagnosed 103 malaria cases in the same districts in parallel. Over 13,000 entomological activity days were completed. Relevant information was shared with AMC and the data recorded in the health information system. CONCLUSIONS: A successful public-private partnership model for malaria elimination was initiated at a time when the health system was in disarray in war ravaged areas of Sri Lanka. This ensured a high annual blood examination rate and screening of vulnerable people in receptive areas. These were important for certification of malaria-free status which Sri Lanka eventually received in 2016.Item Satisfaction with intrapartum and postpartum hospital care among mothers delivering at Colombo North Teaching Hospital(Sri Lanka Medical Association, 2012) Herath, K.K.W.H.P.; Galappaththy, G.N.L.; Herath, H.M.R.P.INTRODUCTION: Institutional intrapartum care with skilled attendance at delivery has greatly contributed to the reduction of maternal mortality in Sri Lanka. Users' evaluations are important for continuous quality monitoring and further improvement of maternal care services. AIMS: The aims were to describe satisfaction with intrapartum and postpartum hospital care, and to determine sociodemographic and pregnancy related factors associated with satisfaction. Methods: A cross sectional analytical study was conducted in Colombo North Teaching hospital (CNTH) Ragama involving 422 postnatal mothers with uncomplicated birth outcome. Data were collected using an exit interview. Patient satisfaction with intrapartum and postpartum care was assessed using two composite scales covering five satisfaction dimensions. Sociodemographic and pregnancy related factors associated with patient satisfaction were determined by odds ratio with 95% confidence interval. Results: The majority of mothers were "satisfied" with intrapartum (90.3%) and postpartum (91%) care. Interpersonal aspects of care was the most satisfied dimension. Mothers were least satisfied with physical environment. Factors significantly associated with satistaction with ftoth intrapartum and postpartum care were intended pregnancy, multiparity, having received field antenatal care and vaginal delivery. Age > 30 years, delivery > 40 weeks of POA and postpartum hospital stay 1 - 3 days were significantly associated with intrapartum care satisfaction. Residing within 10km of CNTH, immediate skin to skin contact and initiation of breastfeeding within 30 minutes were significantly associated with postpartum satisfaction. CONCLUSIONS: Factors associated with maternal satisfaction identified in this study should be used to deliver a more patient centered service and gain patient satisfaction.