Browsing by Author "Hemachandra, D.K.N.N."

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The knowledge and preparedness on maternal and child health during disasters among Public Health Midwives serving in Medical Office of Health areas covered by National Institute of Health Sciences
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Madarasinghe, H.P.; Hemachandra, D.K.N.N.
BACKGROUND: In a disaster situation, pregnant women and children are at a higher risk and the presence of an experienced health worker, with good knowledge and preparedness on how to handle their special needs is essential. OBJECTIVES: To assess the knowledge and preparedness and associated factors related to maternal and child health during disasters among Public Health Midwives (PHMs) serving in Medical Officer of Health (MOH) areas covered by National Institute of Health Sciences(NIHS). METHODS: Between July to September 2015, PHM in NIHS area (74) were selected and they were surveyed on information about their field, history of occurrence of disasters, knowledge on maternal and child care in disasters, level of disaster preparedness and training received on disaster management. Data was statistically analyzed using SPSS software. The association between knowledge and preparedness were analyzed against socio-economic and demographic characteristics of the participants. RESULTS: Proportion of PHMs with good knowledge was 47.3% and adequate preparedness for disasters was 33.8%. There was no significant association between the age, educational qualifications, field experience, MOH area and past experience in disasters with the knowledge and preparedness. CONCLUSIONS: Knowledge on natal, newborn and infant care was lacking in the PHM in NIHS area and they were not prepared to handle disasters in their field with a proper response plan. Recommend inclusion of disaster management into their basic curriculum and conduct of regular in-service training programmes and drills to ensure sustainability of knowledge and skills on disaster preparedness and management.
Public health midwives’ perception on breast cancer early detection services provided through well woman clinics in the Gampaha District, Sri Lanka
(College of the Community Physicians of Sri Lanka, 2013) Vithana, P.V.S.C.; Hemachandra, D.K.N.N.; Ariyarathne, M.A.Y.; Jayawardana, P.L.
INTRODUCTION: Being most common cancer diagnosed in Sri Lanka, breast cancer accounts for 27% of female cancer-mortality. Early-detection of breast cancer is conducted using clinical breast examination (CBE) and increasing awareness on breast self-examination through well woman clinics (WWCs). OBJECTIVE: To identify Public health midwives' (PHMs') perception on the importance and deficiencies of the breast cancer early-detection services provided through WWCs, and their suggestions on improving the breast cancer early-detection services. METHODS: A qualitative study using four focus group discussions (FGDs) consisting of 8-10 participants per each FGD were conducted among 38 PHMs in the Gampaha District during July to September 2008. FGD guide included discussion points on availability of guidelines and protocols, training received, time for clinic-sessions, adequacy of resources, support from other sectors, and reasons for low-participation and their recommendations for improving utilization of services. Two experts conducted FGDs as moderator and data recorder. FGDs were audio-recorded, transcribed and analyzed using constant comparison and identifying themes and categories. Results were presented in narrative form. RESULTS: All the PHMs had a firm realization on the need of breast cancer early-detection. FGDs revealed non-availability of guidelines, lack of training, lack of skills and material to provide health education, inability to provide privacy during CBE, shortage of stationery and lack of community awareness and motivation. The suggestions for the improvements identified in FGDs were capacity building of PHMs, making availability of guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination between clinical and preventive sectors, and improving community awareness. CONCLUSIONS AND RECOMMENDATIONS: The components to be improved in breast cancer early-detection services were identified. Study recommends training programmes at basic and post basic levels on a regular basis and supervision for the sustenance of the program.
Reasons for seeking private sector antenatal care by pregnant women delivering in government hospitals in Kalutara district
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Pathirage, I.D.; Hemachandra, D.K.N.N.; Wijegunasekara, H.; Priyangani, Y.M.M.
BACKGROUND: Anecdotal evidence suggests there is an increased tendency to use private sector for antenatal care in the recent past, despite provision of high quality free antenatal care services by the country. OBJECTIVE: To assess the reasons for seeking antenatal care from the private sector by pregnant women who deliver in government hospitals. METHODS: Descriptive cross sectional study was carried out in the Kalutara district of Sri Lanka over a period of two months using an interviewer administered questionnaire and a check list, from pregnant women admitted for the delivery to all the government hospitals in the district with specialized care. RESULTS: Among the study participants, 70% (n=282) of the pregnant women had visited the Consultant Obstetrician in the private sector and majority (more than 70%) had done the investigations the in private sector. Ethnicity, residence, planned pregnancy and not having children were significantly associated with private sector clinic attendance. Field staff had more influence over family in the selection of private health services. Availability of an appointment system (52.6%), less waiting time (47.1%) and being a primipara (33.7%) were the commonest reasons behind their choice. Not been seeing by the Consultant Obstetrician in all hospital clinic visits (47.3%) and husbands’ desire to meet Consultant Obstetrician (15.2%) made them attend private sector while attending the specialized hospital clinics. CONCLUSIONS: This study reveals the extent of peoples’ demand for antenatal care from both public and private sectors. Public sector service delivery need improvements related to patients’ aspirations.