Background: The determination of behaviours that lead to noncommunicable diseases (NCDs), such as high dietary salt intake, are multifactorial. The prevention of NCDs, including the promotion of healthy dietary choice, including low salt intake, therefore requires multisectoral working. Although the need of a multisectoral approach to risk factor modification has been globally accepted, there is minimal evidence for its application in the real world.Methods: This quasi-experimental trial was designed to study the impact of a community led multisectoral approach to integrate nutrition prevention into the development agenda, in two districts in Sri Lanka, a lower-middle income country undergoing a phase of rapid socioeconomic development.Results: Results from logistic regression found that those living in the district (Ampara) that identified salt intake as a health issue had significantly higher odds (OR =1.4; 95% CI =1.1, 1.9) of high salt consumption (>5 grams/day) at baseline compared to control areas (Kurunegala), in multivariable models. Postintervention, individuals in this district had lower odds (OR =0.6; 95% CI =0.4, 0.9) of consuming high levels of salt in all models, including multivariable models whilst controlling for baseline high salt consumption. Conclusions:The findings from this study demonstrate the positive impact in improved diet, in reduced salt consumption, through a community led multisectoral intervention, in areas in which the community identified high salt consumption as a health issue. These findings demonstrate that multisectoral approaches can be effective in the real world setting and highlight the need to engage with many stakeholders, including targeted communities throughout their development and implementation.

IntroductionStigma is defined as a negative attitude based on a distinguishing characteristic such as a health condition and could lead to discriminatory behaviour towards those who are being stigmatised (1). Mental illnesses, certain neurological diseases (e.g. epilepsy), obesity, disabilities,

IntroductionComplex interventions are widely used in public health practices in other social areas with prominent health consequences which leads to practical and methodological difficulties, which must be overcome successfully. Importantly, the Communication for Behavioural Impact (COMBI) plan is an effective method directed at enacting behaviour change to benefit health and social development which encourage precise behavioural outcomes and is effective in planning a behavioural change for dengue control.ObjectiveThe aim was to develop a COMBI plan to change the behaviour to prevent dengue in a major district of Sri Lanka.MethodsThe plan was developed according to World Health Organization (WHO) COMBI planning 10 steps with the scientific evidence and expert opinion. The situation analysis was conducted using mixed-methodology from January to March 2019 among the adults in a highly dengue-endemic area in Kurunegala District, Sri Lanka. The overall goal of the plan was to contribute to the reduction in morbidity and mortality from dengue disease in the Kurunegala district by improving the dengue prevention behaviours by three months in 2019.ResultsThe plan was developed after finalizing Specific Behaviour Objectives (SBOs) by conducting Situational Market Analysis for Communication Keys (SMACK). The SBOs for the plan were to improve the proper waste management practices according to the ‘3R concept’ (Reduce, Reuse and Recycling) and to improve the dengue prevention practices by 30 minutes of weekly cleaning. The strategies were to conduct a community empowerment program to improve household waste management and weekly practices on dengue prevention by conducting administrative mobilization and public relationship, public advocacy, community mobilization, personal selling, advertising, and point of service promotion during follow up.ConclusionDeveloping a COMBI plan for an area after the identification of specific behavioural objectives would be feasible to implement in order to empower the community to prevent dengue in the area and improve community health services.

Introduction: Sri Lanka remains a low-prevalent country for HIV/ AIDS over last few decades, according to the reported cases to the National STD and AIDS Control Programme. Even among high risk population groups, the HIV prevalence remains low. It is very important to monitor HIV prevalence trends among these population groups as risk behaviours are changing and HIV prevalence might rise in escalating levels needing urgent action. Objective: The objective of the survey is to assess the prevalence of HIV infection among the subpopulation groups at risk for HIV infection and to monitor the trends of the HIV epidemic. Method: As a regular process, 14th round of HIV sentinel surveillance survey was conducted during the period of 3 months starting from 01st October to 31st December 2019. A survey protocol was developed in 2019 including same sentinel sites, modified sentinel groups and testing algorithms. The nine provinces of the country were identified as 9 sentinel sites and sentinel groups include Men who have sex with men (MSM), female sex workers (FSW), Clients of sex workers, Transgender women and people who inject drugs (PWID). Results: Prevalence of HIV was highest among MSM (1.46%) followed by transgender women (1.35%) and clients of sex workers (0.09%). The prevalence among FSW was 0.07%, and there were no HIV positives among the 70 PWID enrolled in the study. Conclusions: MSMs appears to be the highest risk group for contracting HIV and active syphilis in Sri Lanka. This trend should be taken into account when planning interventions to achieve programme objectives.