9th Annual IMHO Convention Women’s Health Issues & Current Needs DR. A. RAMANATHAN Medical Consultant POPULATION SERVICES – LANKA (AFFILIATE OF MARIE STOPES INTERNATIONAL - LONDON)
April 2012 Canada
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SRI LANKA •
Population - 21 million
•
Birth Rate
•
Death Rate - 6.0
•
Maternal Mortality Rate - 36
- 18
– (Unsafe Abortion)
- 11.7%
– Post Partum Bleeding- 13%
•
Infant Mortality Rate - 19
•
Contraceptive Prevalence Rate
- 69%
– CPR (Modern Methods) - 54%
•
Total Fertility Rate
•
Mean Age – Marriage of Females - 24
•
Urban Population
•
Adult Literacy
•
Life Expectancy
- 2.31 - 26%
- 92% - Males - 72 - Females
-
76
•
Suicide Rate - 63.4
•
Estimated National Prevalence, STI
•
Estimated National Prevalence, HIV/AIDS- 7,000
•
Abortion Prevalence - 950/day
- 60,000
SRI LANKA IDP CENTRES STERI CENTRE SOCIAL FRANCHISE CENTRES
HATTON
WELLAWAYUA
Components of Women's Health •SAFE MOTHERHOOD •FAMILY PLANNING AND OTHER REPRODUCTIVE HEALTH SERVICES •PREVENTION AND TREATMENT OF SEXUALLY TRANSMITTED INFECTIONS, HIV/AIDS •SAFE ABORTION SERVICES •EMERGENCY OBSTETRICS •PREVENTION OF SEXUAL VIOLENCE AND ASSISTANCE TO VICTIMS •ADOLESCENCE SEXUAL REPRODUCTIVE HEALTH •SUB-FERTILITY •PSYCHOLOGICAL CARE AND SUPPORT/COUNSELLING - THERAPY
LEGAL POLITICAL FRAMEWORK FUNDAMENTAL RIGHTS ARE ROOTED IN THE NATION’S LEGAL AND POLITICAL FRAMEWORK BY ITS CONSTITUTION WHICH UPHOLDS EQUALITY, LIBERTY AND SOCIAL JUSTICE ENSURING WOMEN’S HUMAN RIGHTS INCLUDING REPRODUCTIVE RIGHTS
POPULATION SERVICES LANKA In order to provide sexual reproductive health services to underserved and vulnerable women and couples, partnership with General Practitioners in 22 districts is vital to complement and supplement unmet RH needs. SOCIAL FRANCHISED CENTRE - WELLAWAUYA
MARKETING CHALLENGE SOCIAL PROBLEM/ SOCIAL NEED
IE&C
TRAINING DOCTORS MID-LEVEL PROVIDERS
TARGET AUDIENCE WOMEN, COMMUNITY, PROMOTERS AND PROVIDERS. MUST HAVE ACCESS TO INFORMATION ABOUT SRH
MOTIVATION
INFORMATION , EDUCATION & COUNSELLING FOR CLIENTS
SUPPLIES ENSURE SERVICES ARE ACCESSIBLE, AFFORDABLE, AVAILABLE & RELIABLE
AFFORDABLE AND RELIABLE
PSL IDP CENTRES
PHARMACY
CBD WORKERS
ENSURE SUPPLIES ARE AVAILABLE
SOCIAL FRANCHISING
SOCIAL MARKETING
PRIVATE PARTNERSHIPS
ENSURE SUPPLIES, DISPENSES ON PRESCRIPTIONS
OUTRREACH , CHOICE MOBILE PROGRAMME
Challenges Faced •The incidence of teenage pregnancy is very high in the country •Many attempts to legalize abortion has failed – 1978 and 1998 –Fear of ethnic imbalance –Pressure from Catholic Church –Currently Govt is having discussions with the relevant bodies in collaboration with the College of Obs&Gyn to legalize abortion in the event of Rape, Incest & Severe Faetal Abnormalities –Bill will be submitted in Parliament before the end of the year
Program Management • IDENTIFY THE RIGHT SERVICE PROVIDERS IN AN IDEAL LOCATION; – RECRUIT THEM AND PROVIDE APPROPRIATE ORIENTATION AND TRAINING TO ENSURE QUALITY SERVICES – ENSURE REGULAR QUALITY SUPPLIES – SUPPORTIVE SUPERVISION – THESE ACTIVITIES WOULD LEAD TO OPERATIONAL EXCELLENCE
ADMINISTRATION Execute PSL business in an excellent manner; – Efficiently – Effectively – More Cost Effective – Regularly Look Into; – Client Needs – Provider Needs – Program Needs
– Ensuring – Client Satisfaction – Provider Satisfaction – Programme Satisfaction
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IMHO - LANKA
IMHO HAS A ROLE TO PLAY IN SRI LANKA TO SUPPLEMENT AND COMPLEMENT THE UNMET SEXUAL REPRODUCTIVE HEALTH NEEDS OF THE UNDERSERVED AND VULNERABLE POPULATION AT THE PRIMARY HEALTH CARE LEVEL. THERE ARE ABOUT 2,000 QUALIFIED AYURVEDIC PHYSICANS IN SRI LANKA. THEY ARE CAPABLE OF DISTRIBUTING CONDOMS AND CONTRACEPTIVES TO THE PROSPECTIVE CLIENTS IN UNDERSERVED AREAS. THEY NEED TRAINING, SIGN BOARDS AND SUPPLIES AT SUBSIDIZED RATES.