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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Deficiencies in the provision and the barriers in accessing family planning services for women working in Avissawella export processing zone(Sri Lanka Medical Association., 2019) Pathirana, V.P.S.D.; Pathmeswaran, A.; Jayaratna, A.INTRODUCTION & OBJECTIVES: Women working in export processing zones (EPZs) are reported to have risky sexual behaviors leading to unwanted pregnancies. The purpose of this study was to describe the deficiencies in the provision and the barriers in accessing family planning (FP) services for reproductive age women working in Avissawella EPZ. METHODS: Deficiencies in provision and barriers in accessing FP services were explored and described by individual interviews and focus group discussions conducted with a purposively selected sample of 55 comprised of EPZ workers, factory managers and healthcare workers. A semi-structured interviewer guide was used. Thematic analysis of data was done using inductive method. RESULTS: Non-availability of FP services after working hours was the main perceived deficiency in service provision and high opportunity cost for visiting clinics for FP services was the main barrier in accessing FP services among women working in Avissawella EPZ. No major bad comments on the staff, availability of contraceptive items of infrastructure facilities were given although overcrowding and need for improvement of privacy of clients and punctuality of the staff were highlighted by some women. They had more trust on government services than the private sector. Myths and misconceptions were not enormously highlighted as barriers to use of contraceptives. Side effects were seemed to be having a higher impact on non-use of contraceptives. Importance of use of social media to disseminate to be having a higher impact on reproductive health and FP among workers in EPZs was highlighted. CONCLUSION: There is a need for workplace based client friendly FP service integrated with other health services.Item Knowledge on family planning and use of contraceptives among women working in Avissawella export processing zone(Sri Lanka Medical Association., 2019) Pathirana, V.P.S.D.; Pathmeswaran, A.; Jayaratna, I.L.K.INTRODUCTION & OBJECTIVES: Women working in export processing zones (EPZs) are reported to have risky sexual behaviors leading to unwanted pregnancies.The purpose of this study was to describe the level of knowledge on family planning (FP) and prevalence of contraceptive use among reproductive-age women workers of Avissawella EPZ. METHODS: Descriptive cross-sectional study was conducted to assess knowledge on FP and use of contraceptives among 515 unmarried and 515 married women selected by stratified random sampling from factories in Avissawella EPZ. Pretested, self-administered questionnaire was used. RESULTS: Forty two percent (CI37.7-46.3) of married and 7% (CI4.8-9.3) of unmarried women had "Satisfactory Overall Knowledge" on FP. Asignificantly higher knowledge was observed among married women (OR=8.3; CI=5.5-12.5),who were over 35 years (OR=2.2;CI=1.5-3.3), having passed GCE (0/L) examination (OR=1.7) and having a monthly income of more than Rs.30,000/- (OR=2.2). Contraceptive prevalence rate (CPR) for married women for any method and any modem method were 47.8% (CI43.4% -52.2%) and 40.9% (CI 36.6%-45.2%) respectively. Oral contraceptive pill (11%), intrauterine device (8%) and injectable (6%) were the most commonly used methods by married women. Having "Satisfactory Overall Knowledge" on FP (OR= 1.6; Cl=1.7-3.9), age below 35 years (OR=2.2;CI=1.3-3.9) and having two or more children (OR=2.7;CI=1.6-4.5) were in dependently associated with higher CPR. CONCLUSION: Knowledge on FP and use of contraceptives were low among women of Avissawella EPZ.Item Workplacebased intervention to improve knowledge on family planning and use of contraceptives among reproductive-age women workers of Avissawella export processing zone(Sri Lanka Medical Association., 2019) Pathirana, V.P.S.D.; Pathmeswaran, A.; Jayaratna, I.L.K.INTRODUCTION & OBJECTIVES: Women working in export processing zones(EPZs) are reported to be involved in risky sexual behaviors leading to unwanted pregnancies which are associated with high maternal morbidity, mortality and many psychosocial issues. The purpose of this study was to develop and assess the effectiveness of a workplace-based intervention to improve knowledge on family planning (FP) and prevalence of contraceptive use among reproductive-age (15 to 49 years) women workers of Avissawella EPZ. METHODS: Quasi-experimental study was conducted to assess the effectiveness of a workplace-based intervention to improve knowledge on FP and use of contraceptives. Two factories, each for the intervention and control groups were selected purposively. Samples of 100 married and l00 unmarried women were randomly selected from each factory; the total sample size was 800. The intervention that was developed following a baseline assessment included lectures, video presentations, distribution of leaflets, and the establishment of peer groups for the promotion of FP and provision of modem FP methods. Baseline and follow-up evaluations were done using pretested self-administered questionnaire. Chi-square test and Mann Whitney U test were used to assess statistical significance and P<0.05 was considered significant. RESULTS: At follow up, the overall percentage knowledge score (mean; SD) was higher (85.9; 7.1) among women in the intervention arm (IA) compared to women in the control arm (CA) (49.5; 18.4) (P<0.001)and the contraceptive prevalence rate of married women was higher( P<0.001) in IA (79%) than in CA (42.5%). CONCLUSION: This workplace-based intervention was effective in improving knowledge on FP and use of contraceptives.Item Menstrual disorders among grade twelve adolescent school girls in Seethawaka Educational Division(Sri Lanka Medical Association, 2016) Pathirana, V.P.S.D.; Jayaratne, K.INTRODUCTION AND OBJECTIVES: Menstrual problems are common among adolescent girls. Uncorrected menstrual problems may have serious pathological consequences and can adversely affect the daily routine. Seeking care on menstrual morbidities by adolescents is low worldwide. The study aimed to determine the prevalence of menstrual disorders, their association with daily activities, sources of information and health seeking behaviour among grade twelve girls. METHOD: Descriptive cross-sectional study was conducted using a self-administered questionnaire. All grade twelve female students (n=348) attending government schools in Seethawaka Educational Division were studied in 2013. RESULTS: Mean age at menarche was 12.37 (SD+_1.37) years. Four (1.2%) cases of precocious puberty and 1 (0.3%) case of delayed puberty were observed. Menstrual disorders reported among study participants were; Dysmenorrhoea 234/348 (67.2%), Irregular cycles 52/348 (14.9%), Premenstrual syndrome (PMS) 51/348 (14.7%), Menorrhagia 88/337 ( 26.1%), Hypomenorrhoea 29/337 (8.6%), Polymenorrohea 10/187 (5.3%) and Oligomenorrhoea 5/187 (2.7%). Dysmenorrhoea and PMS were significantly associated with disturbance to daily activities (p<0.001). Main source of information was mother (n=282, 83.9%) while girlfriends and sisters were second and third respectively. Girls stated that both male and female health workers were almost equally acceptable for providing information. A larger proportion of girls with menstrual problems perceived them as a normal phenomenon (n=157, 46.7%). More than three quarters did not seek proper treatment (n=243, 87.7%). Only 32(11.5%) sought western type treatment for menstrual cycle problems. CONCLUSIONS: Menstrual disorders were common among this study population. Knowledge and utilization of available reproductive health services were very low. Further research to explore need of context-specific health education measures and adolescent friendly healthcare services is recommended.Item Menstrual disorders among grade twelve adolescent school girls in Seethawaka Educational Division(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Pathirana, V.P.S.D.; Jayaratne, K.; Pathirana, R.P.R.L.; Dhammika, U.BACKGROUND: Menstrual problems are common among adolescent girls. Uncorrected menstrual problems may have serious pathological consequences and can adversely affect the daily routine. Seeking care on menstrual morbidities by adolescents is low worldwide. OBJECTIVES: To determine the prevalence of menstrual disorders, their association with daily activities, sources of information and health seeking behaviour among grade twelve girls. METHODS: A descriptive cross-sectional study was conducted using a self-administered questionnaire. All grade twelve female students (n=348) attending government schools in Seethawaka Educational Division were studied in 2013. RESULTS: Mean age at menarche was 12.37 (SD=1.37) years. Four (1.2%) cases of precocious puberty and 1 (0.3%) case of delayed puberty were observed. Menstrual disorders reported among study participants were; dysmenorrheal 234(67.2%), irregular cycles 52(14.9%), premenstrual syndrome (PMS) 51(14.7%), menorrhagia 88/337(26.1%), hypomenorrhoea 29/337(8.6%), polymenorrohea 10/187(5.3%) and oligomenorrhoea 5/187(2.7%). Dysmenorrhoea and PMS were significantly associated with disturbance to daily activities (p<0.001). Main source of information was mother (n=282, 83.9%) where as friends and sisters were second and third respectively. Almost an equal preference was observed for both male and female health workers when seeking information. A larger proportion of girls with menstrual problems (46.7%; n=157) perceived those as normal phenomena. More than three quarters did not seek proper treatment (87.7%, n=243). Only 32(11.5%) sought allopathic treatment for menstrual cycle problems. CONCLUSIONS: Menstrual disorders were common among this study population. Knowledge and utilization of available reproductive health services were very low. Further research to explore need of context-specific health education measures and adolescent friendly healthcare services is recommended.