Sri Lankan Journal of Medical Administration最新文献

{"title":"Project to Reduce the Teenage Pregnancies Through Health Education at MOH Level","authors":"C. Gajanayake, S. Withanage, W. D. S. Lakshima, A. Karunanayake","doi":"10.4038/sljma.v24i2.5430","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5430","url":null,"abstract":"Background: Teenage pregnancy represents a persistent public health challenge with far-reaching consequences, particularly in regions like the Egodauyana MOH area within the Colombo RDHS. This highlights the urgent need for effective interventions to address this issue.Objective: To evaluate the effectiveness of school sexual and reproductive health education (SSRHE) as a public health awareness tool at the MOH level in reducing teenage pregnancies.Methods: This study involved the implementation of SSRHE programs in 12 high-risk schools. The target population consisted of students in grades 10 and above.Results: Result in 2021, a total of 75 teenage mothers had registered; 34 individuals (45.3%) belonged to Group 1, comprising teenage mothers attending school and residing in the area, while the remaining 41 individuals (54.7%) were classified under Group 2, encompassing non-resident teenage mothers. The age distribution revealed that 44 teenage mothers were aged 18–19 years, 28 were in the 16–17 age group, and three were under 16 years. In 2022, registered teenage pregnancies decreased to 68. Within this cohort, 17 individuals (26.5%) were classified as belonging to Group 1, while 51 individuals (73.5%) were categorized under Group 2. The age distribution revealed that 48 teenage mothers were aged 18–19 years, 16 were in the 16–17 age range, and four were under 16 years old. There was a statistically significant reduction in teenage pregnancies within Group 1 when compared to 2021 (p = 0.014). Conversely, Group 2 experienced a substantial increase (p = 0.0000) in teenage pregnancies.Conclusion: This study highlights the value of inclusive SSRHE programs in reducing teen pregnancies at the MOH level as a public health education tool.","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to Improve the Performance of Health Work Assistants at District General Hospital Kalutara","authors":"M. P. Jayalath","doi":"10.4038/sljma.v24i2.5419","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5419","url":null,"abstract":"Background: A high level of performance of the employees is mandatory to improve the quality of healthcare service rendered to the patients. Performance is a function of the interaction between an individual’s motivation, ability, and environment. It was highlighted that the Health Work Assistants (HWA) working at District General Hospital (DGH) Kalutara are poorly motivated leading to underperformance.Objective: To identify strategies to improve the performance of HWAs working at DGH Kalutara.Methods: Issues related to underperformance were identified using a problem tree analysis. The underlying causes were tabulated against a set of criteria. Prioritization was done based on; the technical feasibility of the alternative interventions, and the impact of the issue on the institution and the patients. Poor employee motivation was selected for further analysis based on the prioritized value.Results: Absenteeism, unavailability of streamlined induction training and regular in-service training, poor attitudes, poor employee motivation and family and social issues were identified as the main issues related to the poor performance of HWAs working at DGH Kalutara. “Intrinsic factors” and supervisor-related factors were selected to plan interventions based on the prioritized value.Conclusion: Providing opportunities for achievements, advancements, and personal growth, through recognition for HWAs’ hard work, dedication, and achievements. Improving their sense of responsibility by improving their relationship with supervisors and improving the quality of supervision.","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"45 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141010524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of the incinerator to prevent the emission of toxic air pollutant in biomedical waste incineration process at Base Hospital Udugama","authors":"G. H. S. Fernando, K. M. Somarathne, P. B. W. Dineshi, P. P. A. P. Pathirana, A. Senevirathna","doi":"10.4038/sljma.v24i2.5421","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5421","url":null,"abstract":"Background: Medical waste incinerators emit toxic air pollutants and toxic ash residues that are the major sources of dioxins and furan. However, Incineration is the best available option for treating clinical waste. The harm can be minimized by designing an incinerator according to the composition of components of the clinical waste generated at the hospital. The incinerator at Base Hospital Udugama has been emitting polluted air causing environmental pollution.Objective: To identify the cause of emitting polluted air and modify the incinerator to prevent environmental pollution.Methods: A survey was conducted on similar incinerators in other institutions to see the efficiency and working conditions and followed an audit to identify the composition of the clinical waste generated in the hospital setting. The incinerator was modified according to the composition of waste to tolerate high calorific value.Results: Survey proved that all other similar incinerators emit polluted air during the incinerating process. The audit showed the rubber and plastic composition of waste is around 50% against the recommended value of 10%. The existing machine was modified to tolerate high volumes of rubber and plastic by increasing the calorific value.Conclusion: Existing incinerator at BH. Udugama emits polluted air due to the incompatible composition of clinical waste with the machine specification. This can be prevented by modifying the incinerator by increasing the Calorific value.Recommendations: It is recommended to re-evaluate the existing incinerators and modify them up to the standard to prevent environmental harm considering 50% of rubber and plastics in clinical waste.","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"60 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141009654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sub-fertility and life style factors which affecting sub-fertility among women in Regional Director of Health Service area, Colombo","authors":"C. Gajanayake, P. M. Munasinghe, K. Kalubowila, J. Gunathilake, C. Denawaka, D. Kahangamage","doi":"10.4038/sljma.v24i2.5431","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5431","url":null,"abstract":"Background: Sub-fertility is one of the leading health issues with its economic and social implications in Sri Lanka and changes in lifestyles of the people have a great impact on it.Objective: To determine the association between selected lifestyle factors and sub-fertility among women in the Regional Director of Health Service area, Colombo.Methods: A case control study was conducted among sub-fertile (n=170) and fertile (n=340) women as case and control respectively. A pre-tested, structured interviewer administered questionnaire, which underwent face, content validity and reliability (Cronbach’s alpha= 0.8) was used. Chi-square, Mann-Whitney, two-way ANOVA, independent sample t- test and odds ratio (OR) were performed.Results: The mean age at marriage was 25.1±3.1 years and 26.5±3 years for fertile and sub-fertile women, respectively. Level of education of both groups was not significantly different (p= 0.120, 95% CI). Islamic women have high fertility than others. Vigorous physical activities were significantly high among sub-fertile women (p=0.000; 95%CI 1.08-1.59). OR for passive smoking for fertile women was 1.3, (95%CI). Sub-fertile women experienced a lack of full restful sleep than fertile women (p=0.001, 95%CI) and majority of sub-fertile women (63.8%) recorded high levels of stress.Conclusion: Vigorous physical activities, exposure to passive smoking, lack of full restful sleep, and having high levels of stress have the negative effects on fertility. Therefore, counselling sessions for the sub-fertile couples and a sensitization programme for newly married couples on lifestyle factors by the primary health care staff are recommended.","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"9 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141011183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Basic Training Program at the School of Ophthalmic Technology","authors":"W. K. M. Epa, G. S. Ranasinghe, M. A. S. C. Samarakoon, S. De Alwis","doi":"10.4038/sljma.v24i2.5423","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5423","url":null,"abstract":"Background: Training and development are vital in Human Resource management. The School of Ophthalmic Technology offers diploma-level training in Sri Lanka, and the Ministry of Health collaborates to streamline the program.Objective: To Evaluate ophthalmic technology training at the School of Ophthalmic Technology to improve the quality of eye care and health outcomes.Methods: The study conducted at the National Eye Hospital from December 2023 to January 2024. Both qualitative and quantitative research methods were used. The sample population involved four trainers and 24 trainees. The methodology included assessments from both trainees and trainers, facility surveys, document reviews, and key informant interviews. The data was analysed using SPSS.Results: The study has identified several issues related to trainees, including communication difficulties with non-academic staff, the unavailability of dining room facilities, a lack of hands-on experience with OCT (Ocular Coherence Tomography) and FFA (Fluorescein Fundus Angiography), a lack of clarity about the curriculum/syllabus, unavailability of past papers, and a majority of trainees failing in the main exams.Conclusion: To address trainee issues, it is crucial to update the curriculum to align with the current requirements of the clinical field. The evaluation process for students should also be scrutinized. Moreover, students should have easy access to past papers and curriculum details. The hospital administration must take measures to support the trainees whenever necessary.","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"64 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141008695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience of Health Systems in Sri Lanka: A Comprehensive Assessment and Implications for Future Preparedness","authors":"W. M. N. K. L. Wijesuriya, K. Rahulan, K. W. R. Wimalagunarathne, M. P. Jayalath, A. Jayathilaka, L. Panapitiya","doi":"10.4038/sljma.v24i2.5427","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5427","url":null,"abstract":"Background: The COVID-19 pandemic underscored the critical importance of resilient health systems capable of withstanding and responding to crises. Despite the unprecedented challenges faced globally, Sri Lanka's health system emerged as a success story, maintaining routine healthcare services amidst the pandemic while demonstrating resilience in the face of past crises such as civil war and natural disasters.Objective: To assess the current level of health system resilience and identify gaps for improvement.Methods: Using a customized evaluation tool from the World Health Organization, data was collected through literature review, questionnaires, and expert discussions.Results: The assessment focused on four dimensions: Leadership and Governance, Financing, Resources, and Service Delivery. Results revealed commendable resilience levels across these dimensions, with an overall score of 70%. Critical gaps were identified, including legislative shortcomings, information sharing deficiencies, and disparities in resource distribution.Conclusion: Despite its achievements, Sri Lanka's health system can further enhance resilience by addressing these gaps and pursuing continuous improvement.By prioritizing Universal Health Coverage and Sustainable Development Goals, Sri Lanka can solidify its position as a leader in healthcare resilience, ensuring the health and well-being of its population in the face of future challenges.","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"2 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141011355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Officers Attitudes Toward the implementation of Hospital Health Information Management System in Hospitals in Kalmunai RDHS","authors":"S. Issadeen, I. M. Mujeeb, T. S. R. T. R. Rajab, R. F. Ikrima","doi":"10.4038/sljma.v24i2.5422","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5422","url":null,"abstract":"Background: Transition from paper-based health record systems to comprehensive electronic Hospital Health Information Management System is viewed as a means to improve both the quality of patient care and professional factors related to end-users.Objective: To Evaluate the attitudes and concerns towards implementation of electronic record system among Nursing Officers.Methods: A cross sectional study was conducted at RDHS Kalmunai among 95 nursing officers attached to four Base hospitals from October to November 2023. A pretested self-administered questionnaire was used to collect data related to demography and attitudes of nursing officers. Study analysis was performed using mean and percentages, Mann-Whitney U test and Spearman’s test.Results: 70.5% of the nurses were female and 47.8% of them were >39 years old. All had previous computer exposure and 67.45% of them had 1-2 years electronic system experience. Nurses attitude towards electronic health record system was positive (mean score 62.28, SD=8.79). Majority of nurses agreed that computer has allowed them to become more efficient (73.5%) and reduced paper-based work (54.3%). They disagreed that computer has caused them to decrease interdepartmental communication (58.8%).Nurses perceived that computer usage may cause more legal implications (74.9%), increased healthcare cost (65.2%), increased waiting time of patient and caused less satisfaction to patients (60.8%) and more work load (54.3%). No statistical significant co relation between nurses attitude score and demographic variables (p= > 0.05).Conclusions: Nurses exhibited a positive disposition towards computer-based documentation. As it was an implementing stage frequent awareness programmes might prevent potential misunderstandings and enhance adoptability. Additionally, continuous refresher training program could be suggested to improve speed and proficiency.","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"7 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141005915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holistic Approach in Strengthening of Primary Health Care Service","authors":"L. Panapitiya, S. Ranasinghe, P. Jayakody, S. Amadoru, M. I. Siraj, U. Gunathilaka","doi":"10.4038/sljma.v24i2.5438","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5438","url":null,"abstract":"Sri Lanka is currently facing a demographic and epidemiological transition, which includes the rising burden of non-communicable diseases (NCD), immerging, and re-emerging of communicable diseases. Further, Population ageing in Sri Lanka is accelerating at a faster rate than in other South Asian countries. Primary Health Care, often abbreviated as ‘PHC’, has been defined by World Health Organization as “an approach that in whole society that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment\". Currently, there is a dichotomy in PHC as preventive and curative aspects.Reversing the service utilization pattern would likely yield substantial efficiency gains that maximize the benefit of existing resources as well as maximal utilization of higher-level institution for needy critical patients, while changing PHC as popular first contact points closure to their homes providing comprehensive care package. The Key Result Areas are Strengthening Primary Health Care Service with reforms, Empowering individuals, families and communities, and Facilitating broader determinants of health. The Strategic Objectives are to meet people's health needs throughout their lives; promotive, preventive, curative, rehabilitation and palliative care ensuring availability, coverage, affordability and equitable access to quality health services with appropriate technology and facilities through a team of well-trained staff in adequate number. (Equitable distribution of health care with appropriate technology and developed Health workforce), To empower individuals, families and communities to take charge of their own health through community awareness and participation (Community participation and community engagement), and to address the broader determinants of health through Multisectoral policy and action ensuring the quality of available basic needs of citizens (Multi-sectoral approach). A strategic framework was designed based on above objectives.","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141006213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Pre-analytical Errors in the Laboratory of National Institute of Infectious Diseases, Sri Lanka","authors":"P. D. Koggalage, M. P. G. D. Madhubhashini, D. U. Abeysinghe, G. R. D. M. Abeywickrama","doi":"10.4038/sljma.v24i2.5424","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5424","url":null,"abstract":"Background: Laboratory investigations are the backbone of the diagnosis of diseases. Previous studies have shown that more than 70% of clinical laboratory specimens have to be rejected due to pre-analytical errors.Objective: To determine the sample error rate and identify the causes of sample errors to prevent pre-analytical errors on a laboratory basis.Methods: This is a cross-sectional study. Details were recorded on a data sheet from the received blood samples which were rejected. Sample rejection criteria were described using a formula.Results: The overall sample rejection rate was found to be 71.15%. Incomplete request forms accounted for 54.2% of sample rejections for biochemical samples, while mislabelled blood samples accounted for 35.1% of sample rejections for complete blood counts.Conclusion: According to the study findings, it has shown that relevant healthcare workers should pay more attention to patient investigations relevant to blood samples to provide appropriate patient management with minimal errors in investigation reports.","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"35 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Resilience: Charting the Future of Sri Lanka's Healthcare","authors":"L. Panapitiya","doi":"10.4038/sljma.v24i2.5416","DOIUrl":"https://doi.org/10.4038/sljma.v24i2.5416","url":null,"abstract":"No abstract available","PeriodicalId":197325,"journal":{"name":"Sri Lankan Journal of Medical Administration","volume":"55 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141010031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}