Browsing by Author "Ameratunga, S."

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The Alcohol marketing policy environment and adolescent drinking in Sri Lanka: A qualitative exploration of stakeholder perspectives
(Wiley-Blackwell, 2022) Athauda, L.; Peiris-John, R.; McCool, J.; Wickremasinghe, R.; Ameratunga, S.
ABSTRACT: Adolescents continue to be exposed to alcohol marketing, despite the existence of alcohol control policies in Sri Lanka. National-level policies restrict all forms of alcohol advertising, promotions, and sponsorship and sale to minors. The act calls for the need to protect children and adolescents from exposure to the harm of alcohol. This article investigates stakeholders' perceptions of the alcohol marketing policy environment in Sri Lanka, with a specific focus on policies designed to prevent or curtail adolescent drinking. Between May and July 2019, in-depth interviews were conducted with policy stakeholders in Colombo, Sri Lanka. Thematic analysis was conducted on the audio-recorded interviews that were transcribed and translated and imported to NVivo12. Fifteen policy stakeholders from government and nongovernment organizations participated in this study. The overarching theme identified a lukewarm alcohol marketing policy environment. This situation was facilitated by the alcohol industry acting as the vector, an amber light approach towards public health programs, and other factors contributing to the perceived ineffectiveness of the alcohol marketing policy environment. A unified public health approach supported by policy and political commitment may pave the way for better alcohol control in Sri Lanka.
Disability studies in Sri Lanka: priorities for action
(Informa Healthcare, 2014) Peiris-John, R.J.; Attanayake, S.; Daskon, L.; Wickremasinghe, A.R.; Ameratunga, S.
ABSTRACT PURPOSE: To review the published literature relating to disability in Sri Lanka, identify research gaps and inform priorities for action. METHODS: A narrative literature review was undertaken and relevant articles extracted using electronic databases such as Medline and PubMed. The available literature was examined in relation to the nine key recommendations of the World Report on Disability. RESULTS: Over the past 30 years, published disability research in Sri Lanka has primarily focussed on mental health, visual impairment and healthcare delivery. Significant gaps were apparent in evidence relating to the status and services for people with intellectual disability, policies and their impact, provider attitudes, barriers to education and employment, health workforce training and access to healthcare. CONCLISIONS: While published studies provide insights on several dimensions of disability, there are important research gaps pointing to unmet needs that require attention to support the health and wellbeing of people living with disability in Sri Lanka. To address these gaps, it is imperative that a critical mass of multi-disciplinary researchers including people living with disabilities collaborate on a strategic program of research using effective participatory approaches that engage all sectors and communities relevant to uphold the rights of people living with disability. Implications for Rehabilitation All nine key recommendations in the World Report on Disability are highly pertinent to the needs and status of people living with disabilities in Sri Lanka. Significant gaps in research on disability-related health issues exist and warrant more focussed attention by researchers, funders and policy makers. It is imperative that national stakeholders including the Ministries of Health and Social Welfare, organisations representing people living with disability and related advocacy groups, work collaboratively to identify and implement a research strategy that would better inform disability policies and programmes that have access and equity as core principles. Implementation of a national disability survey by the Department of Census and Statistics, will help prioritize disability research in the country
Factors influencing alcohol use among adolescents in South Asia: A Systematic review
(Piscataway, NJ, 2020) Athauda, L.K.; Peiris-John, R.; Ameratunga, S.; McCool, J.; Wickremasinghe, R.
OBJECTIVE: Alcohol is the leading cause of disability-adjusted life years among 15- to 19-year-olds globally; yet, social and structural determinants of alcohol use among adolescents in low- and middle-income countries are largely unknown. Given that a quarter of the global adolescent population lives in South Asia, this systematic review aims to identify factors influencing alcohol use among 10- to 19-year-olds living in South Asia (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka). METHOD: We systematically searched eight databases (SCOPUS, MEDLINE, EMBASE, CINAHL Plus, Cochrane Library, PsycINFO, AMED, EBSCO Host), gray literature, and relevant websites for studies reporting influences at psycho-individual, family, school, peer, neighborhood, or country levels. QATSDD (Quality Assessment Tool for Studies with Diverse Designs) was used for quality assessment. The study protocol was registered with PROSPERO (CRD42017084773). RESULTS: Twenty-three studies were eligible for inclusion. Male gender, age greater than 14 years, depression, religious belief, parental/family members' drinking, reduced parental attention, peer-drinking/pressure/approval, and urban neighborhood were associated with increased risks of adolescent drinking. No information was available from Afghanistan, Bhutan, Bangladesh, Pakistan, and Maldives. There is little evidence available on the determinants at a national (legislature, industry, and media), school, and personality level. CONCLUSIONS: The distal determinants of alcohol use among adolescents living in South Asia are largely unknown. As adolescent drinking behaviors change in response to social media and industry influence, more evidence is needed to reflect the South Asia context.
It’s normal to drink, isn’t it? a qualitative study on factors influencing adolescent drinking in Sri Lanka
(Sri Lanka Medical Association, 2021) Athauda, L.K.; Pereis-John, R.; McCool, J.; Ameratunga, S.; Wickremasinghe, A.R.
Introduction and Objectives In Sri Lanka, adolescent drinking behaviour has been linked to parental, family influence as well as culture and living location. While proximal level social determinants play an important part in influencing adolescent drinking, determinants operating at the distal level have not been discussed adequately. This study aimed to describe the factors influencing adolescent drinking among school going adolescents in the Colombo District. Methods Focus Group Discussions (FGD) were conducted separately for males and females in selected Public Health Midwife (PHM) areas in the Colombo District. A semi structured interview guide facilitated the discussion. Transcripts were translated, transcribed and managed on NVivo 12. Inductive thematic analysis was used to interpret the ideas expressed in the FGDs. Results Fifty adolescents (24 females and 26 males) aged between 16-17 years participated in eight FGDSs. The findings elaborate one overarching theme: it’s normal to drink, isn’t it? Media, culture and society contributed towards building social norms around adolescent drinking. Based on the perception of normalcy around drinking, adolescents were inclined to test their limits and experiment with alcohol, while being influenced by peers. However, they also experienced some restraints, in terms of law, family and culture, which made them question the normalcy around drinking. Conclusion Adolescents engage in social learning, through their distal environment which creates norms and aspirations. Peer engagement facilitates social capital which also contributes towards their decisions to drink. Distal level social determinants are important contributory factors of adolescent alcohol use. Restrictions within this environment may restrict their drinking
Road injuries among older people in a tertiary care hospital in Sri Lanka – a comparative analysis
(College of Community Physicians of Sri Lanka, 2020) Tennakoon, V.; John, R.P.; Wickremasinghe, R.; Kool, B.; Ameratunga, S.
INTRODUCTION: With escalating incidence of road traffic crashes (RTCs), related injuries and deaths in Sri Lanka, understanding its burden on vulnerable road users such as older people and people with disability have important implications for traffic injury prevention and transport policy planning. OBJECTIVES: To determine crash characteristics and patterns of injuries sustained by victims of RTCs admitted to a tertiary-care hospital and investigate if these differ for older people. METHODS: Recorded data of all victims of RTCs admitted to the Colombo South Teaching Hospital from 1 January to 31 March 2017 were systematically extracted and analysed. RESULTS: Of the 573 victims, 70 (12.2%) were older people aged 60 years and above. Pedestrians (46%) were the most common road user type injured among older people. In contrast, among younger victims, the motorcyclists dominated (54%). Older people were involved in RTC between 9.01 am and 12.00 noon more often than those who were younger (22% vs. 9.5%), and had significantly higher incidence of severe head injuries (13% vs. 3%), fractures (54% vs. 40%) and deaths (10% vs. 2%), and referrals to rehabilitation services at discharge (60% vs. 39%). CONCLUSIONS: Older road crash victims are at higher risk of head injuries, fractures, and deaths than younger people. Given the lack of documented data, the influence of pre-existing disability on road injury outcomes could not be investigated. Future injury surveillance, intervention and evaluative efforts should explicitly consider the needs of these vulnerable road users. KEYWORDS: Road traffic injuries, Hospital-based, Older-people, Sri Lanka
Transport equity in Sri Lanka: Experiences linked to disability and older age
(Elsevier Ltd, 2020) Tennakoon, V.; Wiles, J.; Peiris-John, R.; Wickremasinghe, R.; Kool, B.; Ameratunga, S.
INTRODUCTION: Transport, a well-recognised determinant of health, is particularly salient to well-being and equitable health outcomes amongst older people and people living with disabilities living in low-and middle-income countries. This study explored the facilitators and barriers for safe and accessible transportation from the perspectives of older people and those living with disabilities in Sri Lanka. METHODS: The community-based qualitative research study involved eight focus group discussions conducted among older people (60 years and above) and people living with disabilities (physical, sensory, learning impairment; aged 12 years and above) in the Colombo district, Sri Lanka. Thematic analysis was used to analyse data. RESULTS: The transport challenges perceived by participants were multi-faceted and often inter-related. Participants identified barriers embedded in the built environment and transport infrastructure, such as poorly designed road systems and public vehicles, unsatisfactory services, lack of representation in road development programs, reduced opportunities for meaningful participation in the society and negative attitudes of the general public, as limitations for safe and accessible transportation. Poverty exacerbated the transport inequities experienced by the participants, affecting their quality of life and well-being. CONCLUSIONS: The study findings indicate the need for a national policy and legislative reforms that prioritise age- and disability-inclusive transport systems and infrastructure, and accessible and affordable transport modes in Sri Lanka. To ensure equitable opportunities and wellbeing, it is also imperative to foster meaningful relationships and positive societal attitudes towards older people and those living with disability. © 2020 Elsevier Ltd