Housing and home-making in low-income urban settlements: Sri Lanka and Colombia

2008 ◽  
Vol 23 (1) ◽  
pp. 53-70 ◽  
Author(s):  
Ranjith Dayaratne ◽  
Peter Kellett
2021 ◽  
pp. 1-24
Author(s):  
Renuka Jayatissa ◽  
Himali Herath ◽  
Amila Gayan Perera ◽  
Thulasika Thejani Dayaratne ◽  
Nawmali Dhanuska De Alwis ◽  
...  

Abstract Objectives: To determine changes and factors associated with child malnutrition, obesity in women and household food insecurity before and after the first wave of COVID-19 pandemic. Design: A prospective follow up study. Setting: In 2019, the baseline Urban Health and Nutrition Study (UHNS-2019) was conducted in 603 households, which were selected randomly from 30 clusters to represent underserved urban settlements in Colombo. In the present study, 35% of households from the UHNS-2019 cohort were randomly selected for repeat interviews, one year after the baseline study and 6 months after COVID-19 pandemic in Sri Lanka. Height/length and weight of children and women were re-measured, household food insecurity was reassessed, and associated factors were gathered through interviewer administered questionnaires. Differences in measurements at baseline and follow-up studies were compared. Participants: A total of 207 households, comprising 127 women and 109 children were included. Results: The current prevalence of children with wasting and overweight was higher in the follow-up study than at baseline UHNS-2019 (18.3%vs13.7%;p=0.26 and 8.3%vs3.7%;p=0.12 respectively). There was a decrease in prevalence of child stunting (14.7%vs11.9%;p=0.37). A change was not observed in overall obesity in women, which was around 30.7%. Repeated lockdown was associated with a significant reduction in food security from 57% in UHNS-2019 to 30% in the current study (p<0.001). Conclusions: There was an increase in wasting and overweight among children while women had a persistent high prevalence of obesity. This population needs suitable interventions to improve nutrition status of children and women to minimise susceptibility to COVID-19.


Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 94
Author(s):  
Carolyn Tarrant ◽  
Andrew M. Colman ◽  
David R. Jenkins ◽  
Edmund Chattoe-Brown ◽  
Nelun Perera ◽  
...  

Antimicrobial stewardship programs focus on reducing overuse of broad-spectrum antibiotics (BSAs), primarily through interventions to change prescribing behavior. This study aims to identify multi-level influences on BSA overuse across diverse high and low income, and public and private, healthcare contexts. Semi-structured interviews were conducted with 46 prescribers from hospitals in the UK, Sri Lanka, and South Africa, including public and private providers. Interviews explored decision making about prescribing BSAs, drivers of the use of BSAs, and benefits of BSAs to various stakeholders, and were analyzed using a constant comparative approach. Analysis identified drivers of BSA overuse at the individual, social and structural levels. Structural drivers of overuse varied significantly across contexts and included: system-level factors generating tensions with stewardship goals; limited material resources within hospitals; and patient poverty, lack of infrastructure and resources in local communities. Antimicrobial stewardship needs to encompass efforts to reduce the reliance on BSAs as a solution to context-specific structural conditions.


2021 ◽  
Vol 9 (3) ◽  
pp. 658
Author(s):  
Inga Böge ◽  
Martin Pfeffer ◽  
Nyo M. Htwe ◽  
Pyai P. Maw ◽  
Siriwardana Rampalage Sarathchandra ◽  
...  

(1) Background: Bartonella spp. are zoonotic bacteria with small mammals as main reservoirs. Bartonella spp. prevalence in small mammals from Myanmar and Sri Lanka are yet unknown. (2) Methods: Small mammals were snap trapped in Sri Lanka and Myanmar in urban surroundings. Spleens-derived DNA was screened for Bartonella spp. using conventional PCR based on three target genes. Positive samples were sequenced. (3) Results: 994 small mammals were collected comprising 6 species: Bandicota bengalensis, Bandicota indica, Rattus exulans, Rattus rattus, Mus booduga, and Suncus murinus. In Myanmar, the Bartonella prevalence in Bandicoot rats (68.47%) was higher than in Rattus rattus (41.67%), Rattus exulans (21.33%), and Suncus murinus (3.64%). Furthermore the prevalence in Myanmar (34%, n = 495) was twice as high as in Sri Lanka (16%, n = 499). In Sri Lanka, Bartonella spp. occurred almost exclusively in R. rattus. In Myanmar, Bartonella kosoyi was mainly detected (56%), followed by Bartonella sp. KM2529 (15%), Bartonella sp. SE-Bart D (12%) and Bartonella henselae (1%). In Sri Lanka, B. phoceensis (60%) and Bartonella sp. KM2581 (33%) were predominant. (4) Conclusions: Bartonella spp. were detected in all investigated small mammal species from Myanmar and Sri Lanka for the first time. Bartonella kosoyi and B. henselae are zoonotic. As these small mammals originated from urban settlements, human bartonellosis seems likely to occur.


2015 ◽  
Vol 11 (2) ◽  
pp. 25
Author(s):  
Nayanthara De Silva ◽  
D.B.D Sampath ◽  
C.R. De Silva

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031773
Author(s):  
Manuja Perera ◽  
Chamini Kanatiwela de Silva ◽  
Saeideh Tavajoh ◽  
Anuradhani Kasturiratne ◽  
Nathathasa Vihangi Luke ◽  
...  

IntroductionUncontrolled hypertension is the leading risk factor for mortality globally, including low-income and middle-income countries (LMICs). However, pathways for seeking hypertension care and patients’ experience with the utilisation of health services for hypertension in LMICs are not well understood.ObjectivesThis study aimed to explore patients’ perspectives on different dimensions of accessibility and availability of healthcare for the management of uncontrolled hypertension in Sri Lanka.SettingPrimary care in rural areas in Sri Lanka.Participants20 patients with hypertension were purposively sampled from an ongoing study of Control of Blood Pressure and Risk Attenuation in rural Bangladesh, Pakistan, Sri Lanka.MethodWe conducted in-depth interviews with patients. Interviews were audio-recorded and transcribed into local language (Sinhala) and translated to English. Thematic analysis was used and patient pathways on their experiences accessing care from government and private clinics are mapped out.ResultsOverall, most patients alluded to the fact that their hypertension was diagnosed accidentally in an unrelated visit to a healthcare provider and revealed lack of adherence and consuming alternatives as barriers to control hypertension. Referring to the theme ‘Accessibility and availability of hypertension care’, patients complained of distance to the hospitals, long waiting time and shortage of medicine supplies at government clinics as the main barriers to accessing health services. They often resorted to private physicians and paid out of pocket when they experienced acute symptoms attributable to hypertension. Considering the theme ‘Approachability and ability to perceive’, the majority of patients mentioned increasing public awareness, training healthcare professionals for effective communication as areas of improvement. Under the theme ‘Appropriateness and ability to engage’, few patients were aware of the names or purpose of their medications and reportedly missed doses frequently. Reminders from family members were considered a major facilitator to adherence to antihypertensive medications. Patients welcomed the idea of outreach services for hypertension and health education closer to home in the theme ‘Things the patients reported to improve the system’.ConclusionPatients identified several barriers to accessing hypertension care in Sri Lanka. Measures recommended improving hypertension management in Sri Lanka including public education on hypertension, better communication between healthcare professionals and patients, and efforts to improve access and understanding of antihypertensive medications.Trial registration numberNCT02657746.


2017 ◽  
Vol 8 (1) ◽  
pp. 100-112 ◽  
Author(s):  
Richard Chunga ◽  
M. W. Jenkins ◽  
Jeroen Ensink ◽  
Joe Brown

Abstract We carried out a stated preference survey in Malawi to examine whether access to microfinance for sanitation would significantly increase the proportion of households upgrading to improved pit latrines or alternative improved sanitation technologies (urine diverting dry toilet, fossa alterna, pour flush). We presented a range of sanitation options at local market prices, initially without and then with a real microfinance option, to 1,300 households sampled across 27 low-income urban settlements in the two largest cities, Lilongwe and Blantyre. When we gave respondents a microfinance option, the proportion of households stating an intention to install improved and unimproved pit latrines decreased significantly, while the proportion stating an intention to upgrade to alternative improved sanitation technologies increased significantly. However, households in the lowest wealth quintile were more likely to state a preference for unimproved pit latrines, suggesting that the benefits of microfinance for sanitation may not accrue equally across wealth strata. Organisations seeking to improve access to safely managed sanitation by promoting alternative sanitation technologies would succeed if households have access to affordable alternative sanitation technologies and microfinance for sanitation. However, poorer households would need more affordable improved sanitation technologies, flexible microfinance options and possibly targeted subsidies to gain access to safely managed sanitation.


2003 ◽  
Vol 47 (12) ◽  
pp. 305-312 ◽  
Author(s):  
N.J.G.J. Bandara

The primary problems concerning water resources in Sri Lanka are the depletion and degradation of the resource caused by various anthropogenic activities. Surface inland waters in urban areas are polluted heavily with domestic sewage and industrial effluents, and in rural areas with agricultural runoff. With regard to ground water in certain areas of the dry zone, there is a high fluoride content and in hard, rocky, alluvial areas, there is a high concentration of iron. In urban over-crowded cities, there is biological contamination of ground water. Over-utilization, particularly through tube wells, is another major problem affecting ground water resources in Sri Lanka. Oil spills, dumping of waste from ships, coral and sand mining, and industrial activities are the main causes of marine pollution in the country. Except for pipe-borne water supply, irrigation and hydropower schemes, in general water resources in Sri Lanka are managed very poorly. Regulations are available to control most water related problems but enforcement of these regulations is lacking. The ultimate result of degradation and depletion of water resources is the increasing health hazards. Water-borne and vector-borne diseases are prevalent, particularly amongst urban low-income communities with poor sanitary facilities and drainage. Despite government initiatives and legislation, very slow progress has been made towards combating water pollution. This paper examines the most significant water and wastewater related issues in Sri Lanka and their controlling mechanisms.


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