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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Effectiveness of a community based health educational intervention in reducing unmet need for modern methods of family planning among ever married reproductive age women in the Kalutara district, Sri Lanka(Insight Medical Publishing, 2012) Malwenna, L.I.; Jayawardana, P.L.; Balasuriya, A.INTRODUCTION: Unmet need is defined as the percentage of all fecund women who are married or living in union and thus presumed to be sexually active but are not using any method of contraception, either do not want to have any more children or want to postpone their next birth at least for two more years or do not know when or if they want another child 1. Unmet Need for Modern Methods includes all in the unmet need group and those who are using natural and traditional methods at the time of survey (The Westoff Model) 2. It describes the discrepancy between sexual and contraceptive behaviors and stated fertility preferences of women in the reproductive age. OBJECTIVE: This study was designed to evaluate the effectiveness of a health educational intervention in improving the knowledge and attitudes on family planning (FP) among Public Health Midwives (PHMM) who function as community health workers and acceptance of modern FP methods planning which eventually reduce the Unmet Need (UMN) and thereby reducing the risk of unintended pregnancy among 15 - 49 year old married women in in the Kalutara district. METHOD: Initially the perceptions on unmet need in community service providers was assessed by three Focus Group Discussions conducted among Medical Officers of Health, Public Health Nursing Sisters and PHMM. It was followed by assessment of the baseline knowledge and attitudes on FP and UMN among all the PHMM and a group of married women in reproductive age (15-49) with unmet need for modern methods selected from cluster sampling of PHM areas in the district using PPS technique, allocating 22 clusters of 12 women in each Intervention (IA) and Control Area (CA).The developed health education intervention was applied on PHMM followed by the selected group of women with unmet need for modern methods only to the IA. The effectiveness was assessed in terms of the change in knowledge and attitudes of PHMM after 2 months of intervention, of target group of women after 6 months of intervention and the reduction of unmet need for modern methods in the IA compared to CA. RESULT: In PHMM, overall percentage mean knowledge score in IA at pre and post intervention were 29.9% and 65.7% respectively with a statistically significant difference (p<0.001) but with no such difference (p=0.10) in CA between pre (20%) and post (30%) scores. Median attitude scores were 37.5% and 86% in IA at pre and post intervention with a statistically significant difference (p<0.001). For CA respective figures were (40%) and (41%) with no significant difference (p=0.09) Regarding the target group, in IA had pre (37.6%) and post (70.6%) mean knowledge scores with a statistically significant difference (p<0.001); but with no significant difference (p=0.06) in CA between pre (39.0%) and post (40.2%) scores. Similarly, between groups comparison shows statistically significant difference (p<0.001) between IA and CA in post intervention, the scores being 70.6% and 40.2% respectively. CONCLUSION: The training conducted on PHMM revealed a significant impact on knowledge and attitudes in both service providers and clients leading to change in the FP practice and reduction in unmet need for modern methods of FP. AUTHOR KEYWORDS: Family planning; Health education intervention; Married women; Reproductive age; Unmet needItem 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.