Antenatal Care Utilization in a Conflict‐Affected District of Northern Sri Lanka

Sivaganesh, S.; Senarath, Upul

doi:10.1111/j.1525-1446.2009.00809.x

Cited by 7 publications

(9 citation statements)

References 6 publications

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“…This study also highlighted that women in conflict areas faced a higher risk of sexual and physical abuse, and faced various barriers in receiving adequate health care and services [ 20 ]. Furthermore, antenatal care utilization was shown to be significantly poor for women whose families were affected by conflict in Northern Sri Lanka or living in an active conflict zone in a study conducted in 2009 [ 21 ].…”

Section: Physical Health Impactmentioning

confidence: 99%

Conflict, forced displacement and health in Sri Lanka: a review of the research landscape

Siriwardhana

Wickramage²

2014

Confl Health

100

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Sri Lanka has recently emerged from nearly three decades of protracted conflict, which came to an end five years ago in 2009. A number of researchers have explored the devastating effect the conflict has had on public health, and its impact on Sri Lanka’s health system - hailed as a success story in the South Asian region. Remarkably, no attempt has been made to synthesize the findings of such studies in order to build an evidence-informed research platform. This review aims to map the ‘research landscape’ on the impact of conflict on health in Sri Lanka. Findings highlight health status in select groups within affected communities and unmet needs of health systems in post-conflict regions. We contend that Sri Lanka’s post-conflict research landscape requires exploration of individual, community and health system resilience, to provide better evidence for health programs and interventions after 26 years of conflict.

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Section: Physical Health Impactmentioning

confidence: 99%

Conflict, forced displacement and health in Sri Lanka: a review of the research landscape

Siriwardhana

Wickramage²

2014

Confl Health

100

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“…Unlike recent trends in Egypt, the odds of maternal care increased during conflict as maternal age increased. Research from Nepal, Sri Lanka and Yemen indicated a negative association of conflict with age, while Iraq reported lower use of SBA (22%) among women under 25 [ 14 , 43 – 49 ]. Also contrary to recent trends in Egypt, and evidence elsewhere, odds of maternal care use during conflict did not increase with increased educational attainment [ 2 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Evidence from conflict-affected countries shows that conflicts adversely affect population health and maternal care by restricting timely availability and access to quality care [ 12 – 14 ]. Addressing equity in maternal care is challenging in conflict-affected settings, particularly during acute conflict [ 4 , 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Associations of acute conflict with equity in maternal healthcare: an uncontrolled before-and-after analysis of Egypt demographic and health survey data

Gopalan

Silverwood

Howard

2018

Int J Equity Health

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BackgroundEquity of usage of maternal services during conflict is considered key to reducing maternal health risks globally. However, evidence showing how conflict affects maternal care use among different population groups is minimal. This study examined how the Egyptian acute conflict of 2011–2012 affected maternal care use among different socioeconomic, demographic, and geographic groups.MethodsAn ‘uncontrolled before-and-after’ study design was used to perform multi-level modelling regression analysis on 2014 Egypt Demographic and Health Survey data. The pre-conflict sample included 2569 births occurring from January 2009 to January 2011 and the peri-conflict sample included 4641 births from February 2011 to December 2012.ResultsInteraction analysis indicated that the effect of conflict on some aspects of maternal care differed by mother’s age, residential status, employment, education level and household wealth. In the stratum-specific analysis, increased odds of skilled delivery during conflict was relatively greater among women who were rural (odds ratio [OR] 1.02; 95%CI 1.02–1.03), educated to primary level (OR 1.04; 95%CI 1.01–1.07), employed (OR 1.04; 95%CI 1.01–1.07), less poor (OR 1.03; 95%CI 1.02–1.05) or middle-income (OR 1.02; 95%CI 1.01–1.04), than pre-conflict. Similarly, increased odds of physician-assisted delivery during conflict was relatively greater for women who were rural (OR 1.03; 95%CI 1.02–1.04), educated to primary level (OR 1.05; 95% CI 1.01–1.10), employed (OR 1.07; 95%CI 1.02–1.11), or from less poor/middle-income (OR 1.03; 95%CI 1.01–1.05 each), and richest quintiles (OR 1.02; 95%CI 1.00–1.03). Decreased odds of postnatal care during conflict was relatively greater among women aged 25–29 (OR 0.92; 95%CI 0.88–0.96) compared to older women.ConclusionsThe association between acute conflict and maternal services usage indicated some vertical equity, as equity patterns during conflict differed from recent trends in Egypt. The association between conflict and maternal care usage among potentially marginalised groups was minimal and not notably inequitable. Specific strategies should be included in maternal health policies to mitigate the unpredictable effect of conflict on maternal care equity. Further research is needed to determine how conflict affects out-of-pocket expenditures and quality-of-care among different socioeconomic groups.

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“…Pregnant women in South Sudan often experience considerable time delays when trying to reach a health facility for treatment (Karoshi & Keith, 2009;Sivaganesh & Senarath, 2009). Geographic barriers impede women with obstetric complications from accessing emergency obstetric care (Borghi, Ensor, Somanathan, Lissner, & Mills, 2006).…”

Section: Geographicalmentioning

confidence: 99%

Maternal and Child Health in South Sudan

et al. 2015

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The Republic of South Sudan continues to face considerable challenges in meeting maternal, newborn and child health (MNCH) care needs and improving health outcomes. Ongoing instability and population displacement undermine scope for development, and damaged infrastructure, low coverage of health services, and limited government capacity and a human resource base have resulted in a fragmented health system. Despite considerable attention, effort and support, the issues and challenges facing South Sudan remain deep and sustained, and urban-rural disparities are considerable. There is a need to maintain investments in MNCH care and to support developing systems, institutions, and programs. This review of the literature offers a commentary and appraisal of the current MNCH situation in South Sudan. It explores the barriers and challenges of promoting MNCH gains, and identifies priorities that will contribute to addressing the Millennium Development Goals and the emerging health priorities for the post-2015 development agenda.

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Antenatal Care Utilization in a Conflict‐Affected District of Northern Sri Lanka

Abstract: Provision of field antenatal clinics, early entry to ANC, and domiciliary care by PHM need improvement.

Cited by 7 publications

References 6 publications

Conflict, forced displacement and health in Sri Lanka: a review of the research landscape

Conflict, forced displacement and health in Sri Lanka: a review of the research landscape

Associations of acute conflict with equity in maternal healthcare: an uncontrolled before-and-after analysis of Egypt demographic and health survey data

Maternal and Child Health in South Sudan

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