MATERNAL HEALTH CARE (MHC) SERVICES AVAILABLE TO PLANTATION COMMUNITIES IN SRI LANKA: ITS CHARACTERISTICS AND EMERGING CHALLENGES

Abstract

ABSTRACT

Background:

Sri Lanka is held out as a model for maternity care in non-industrialized countries. The latest MMR for Sri Lanka is 32.5 per 100 000 live births in 2013. It is also reported that most maternal deaths are preventable. The MMR for estate sector has been always 2-3 folds greater than the national figure. For last ten years there were many efforts to reduce MMR of estate sector and which has ended up with disappointing results. The objective of the present study was to analyze the current situation of the Maternal Health Care (MHC) services available to the estate communities in Sri Lanka.

Materials and Methods: Published literature and administrative reports published by line agencies and reconnaissance visits to the area were made to analyze and interpret the information.  Maternal Mortality Ratio (MMR) was used as the main indicator of MHC.

Result: The situation has been analyzed using “three delay model”. The results show that delays in seeking medical care and treating at the hospital are responsible for more than 90% of the deaths indicating that the estate communities have largely overcome the difficulties in reaching the hospitals.

This indicates that at least two major causes are responsible for this situation. First is the socio-cultural environment which they live including living conditions, working norms, food habits, family bonds and gender relations. However second and the major cause seems to be the knowledge gaps with preventive and curative maternal health care providers and receivers.

Keywords: Tea Estate Communities in Sri Lanka, Maternal Health, Maternal Mortality Ratio