Browsing by Author "Silva, K.T."

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Social and economic impact of chronic kidney disease of unknown aetiology in Sri Lanka
(National Academy of Sciences Sri Lanka, 2013) Silva, K.T.; Hettige, S.; Jayathilake, R.; Liyanage, C.; Karunathilake, K.
Teenage pregnancy in Colombo Municipal Council area
(Sri Lanka Medical Association, 2011) Perera, J.A.P.S.; Kumarendran, B.; Silva, K.T.
INTRODUCTION AND OBJECTIVES: To describe the distribution of teenage pregnancy (TP) in Colombo Municipal Council area. METHODS: This descriptive cross-sectional study was based on secondary data analysis from the management information system related to maternal and child care for the period of 2004 to 2009. TP is defined as a pregnant female aged <20 years. Permission was obtained from CMC officials. Results: Of the registered pregnancies during 2007, 2008 and 2009, the percentage of TP (TPP) were 10% (1043/10386), 7.9% (805 / 10194) and 7.3 (660/9036) respectively. The average incidence of registered TP over these three years was 8.5%. Of the thirteen antenatal clinics (ANC) in the CMC, TPP was higher in Maligawatte (11.5%) and Bandaranayake Mawatha (11.3%) and lower in Kirullapone (6.1%) and Wasala Road (5.4%) clinics. The percentage deviation of TP from CMC level showed higher levels in CMC districts 2A (23.5%), 2B (8.2%) and lower levels in Districts 4 (-27.1%), 5 (-12.9%), 3 (-11.8%) and 1 (-10.6%). Linear regression of population in districts with TPP was significant (R2=0.91, p = 0.003). The range of population covered by PHM (PCP) varied widely among districts (7017 to 15969). Districts with lower PCP (Districts 2A and 2B) had higher TPP. Conclusions: Despite the reducing trend, TPP in CMC is higher than national and Colombo district levels. TPP and population per PHM area in CMC districts vary widely. Cadre revision of PHM should consider service needs in the districts in addition to population per PHM.
What factors deny access to pregnancy support mechanisms? Experiences of slum-dwelling pregnant teenagers in Colombo city
(University of Kelaniya, 2011) Perera, J.A.P.S.; Silva, K.T.
Teenage pregnancy (TP) is a key public health issue among urban slum-dwellers in Colombo. The adverse outcomes of TP often result from poor social support backgrounds. Understanding the factors which deny access to social support mechanisms would be useful both in preventing and managing the adversities associated with TP. This paper examines the experiences of pregnant teenagers (PTs) regarding the factors which deny access to pregnancy support mechanisms both from the perspectives of support recipients and providers. Having obtained ethical approval, this descriptive-cross sectional study was conducted among 139 respondents including 109 PTs and 30 support providers (SPs) from Colombo Municipal Council (CMC) area during 2008 July to 2010 July. Both qualitative and quantitative data were collected through an interviewer-administered questionnaire, case studies and focus group discussions; data were analyzed using framework analysis method and SPSS software. Poor awareness of PTs on available support services, lack of autonomy as females of teen-age and limited mobility, were identified barriers. Being pregnant out of marriage constrained them seeking support from divers support networks. Since underage sex is considered a statutory rape, social fear, created by unmarried status and bearing pregnancy underage contrary to law have prevented PTs from seeking care. Non-availability of sufficient number of SPs constrained PTs seeking pregnancy care from PHM. Poor coordination between statuary law and reproductive health policy, inadequate attention given for specific reproductive and sexual health needs of teenagers in the National Maternal and Child Health policy in Sri Lanka were recognized as barriers for utilization and provision of social support for PTs. There is a need to review the existing marriage law so as to prevent it from being an instrument of social exclusion. Considering the unmarried and under-aged women, a special pregnancy care component should be included in MCH policy in Sri Lanka.