The maternal healthcare problem in Sri Lanka is justified by the fact that, for many years, mothers have been losing their lives due to malnutrition and complications during delivery. The problem spans through pregnancy all the way to post-delivery; hence, making the problem worth for research and determination of possible solutions. Most deliveries in the country occur in a health facility supported by skilled midwives. This makes it necessary for the study to be conducted because a third of the population is said to be way below the nation's line of poverty. However, the country has made efforts to ensure that the maternal mortality ratio is among the lowest in the third world fraternity (Datt & Gunewardena, 1997).
The government in this country should be commended for the good job they are doing in improving health care and education standards. This is justified in that there is a high degree of female literacy; hence, raising the female status. However, being a low income country, exceedingly many women here still have no access to decent medical care and nutrition during their expectancy period (Datt & Gunewardena, 1997).
The study's target population is all mothers in Sri Lanka who are in their active reproductive years. This means that even the mothers who get into motherhood prematurely are also captured. The target population also includes mothers who graduate into motherhood against their will like in cases of rape or forced marriages. This population will also include mothers who are educated, elite and have first class healthcare services, as well as the women who are not educated and they have poor healthcare services (Domestic violence, 2012). The population will also include first time mothers and women who have been mothers before. This will be done to capture the element of experience and exposure to maternal health care.
There are also rural dwellers and the urban dwellers in this population. The mothers who live in urban areas have an upper hand in terms of better distribution of healthcare facilities and better quality of services, and they hardly have to worry about access and quality problems. On the other hand, mothers in the rural setting have to worry about access and quality owing to the sparse distribution of healthcare facilities in the rural areas. The other demographic of this population is those mothers who are in correctional facilities. This is also applicable to mothers who go to correctional facilities during pregnancy, who need to exercise their prenatal care under the supervision of the officials at the correctional facilities (Gunetilleke, 2008).
The Sri Lankan government is involved in finding ways to improve the health services in rural settings through a rural health network. Also, offering effective public investment in fundamental health services, improvement of basic living standards and the increase in the level of female education. Kramarae & Spender (2000) argue that this health focus is crucial to the target population because; the health of a mother significantly affects the health of her child. In case of negative effects to the child, the country will be less productive because of the emergence of less productive generations.
The maternal health problem should be thoroughly addressed to create awareness for the mothers. This is so that they can have a frequency of pregnancy that is healthy to them, good for planning for care of children, and also gives them time to engage in fruitful economic activities. More importantly, the mothers will have better quality of life in which they have control of their maternal health and nutrition issues (Kramarae & Spender, 2000).
A survey on the subject matter should be used so as to conduct an effective assessment of the health condition. The survey is necessary so that a clear image of the condition is drawn to the public’s attention. Also, to draw attention to the donors for grants and any party willing to support the maternal health program is another importance. This can be done by the surveyor having an open mind and; hence, engage the target population in order to understand what actually matters to them rather than the proposed subject matter. It is necessary to determine the main causes of the poor health condition from lack of finances, lack of education or even lack of adequate government intervention (UNICEF, 2008). In general, the survey should be focused on interaction with the target population.
The primary stakeholders will be the respondents. For this survey, the target population will be pregnant Sri Lankan women aged between 18- 45 years. There will be significant attention to the group of women from the rural sections of Sri Lanka. The secondary stakeholders will be community volunteers and professional midwives who will be charged with the responsibility of maternal health sensitization for the women (Medical Statistics Unit, 2008). This area requires more funds; hence, the help from donors will be of considerable impact on the positive side.
The key stakeholders will be the donors, the ministry of public health, and the media. The ministry of public health will have the final word on whether or not the proposals on regulations are passed and applied (Medical Statistics Unit, 2008). The media would be a useful tool in the promotion of the program. This will enhance publicity and create more awareness as the media penetration in Sri Lanka is fairly good. The doctors and nurses will be useful in the provision of medical services as the donors help with the financial needs of the process.
The reduction of negative maternal outcomes will be the key objective of this process. The people who are expected to change are the priority population, and the expected improvement is about the maternal health. The pregnant woman in the priority population will be more valuable for change monitoring. Another aspect of this case that will be beneficial is the extent of change or how much is expected to change. The maternal health should be seen to improve by at least 50% courtesy of this program. The time frame of this change is also a vital factor placing the end of the year 2015 as with time the changes will take effect (Brin & Pillay, 2009). This gives the program over two years for implementation and evaluation. This is also enough time for any changes as seen necessary.
The SMART objective of this process is to see that the negative maternal outcomes among the Sri Lankan women are reduced by half at the end of the year 2015. Some of the negative maternal outcomes that the program seeks to address are malnutrition for the expectant mother, lack of proper prenatal care, and lack of professional midwifes or doctors for the delivery process. In addition, it also seeks to address poor post-natal conditions including malnutrition of mother and child, lack of adequate post-natal care, and high frequency of births that make the mothers unable to have quality time for their babies and families. The use of contraceptives like condoms both male and female and the adoption of family planning would reduce the number of pregnancies (Brin & Pillay, 2009).
The condition of inequality in the maternal health care program is caused by several environmental determinants, which include housing, sanitation, work place, the quality of air among other determinants. In this study, the main factors of focus are sanitation, the quality of air and the work place of mothers. In Sri Lanka, maternal health care has had challenges. This is due to the different and poor environmental conditions in which expectant mothers and post-delivery mothers live. Being a developing country; these cases are rampant because of the big number of women living poorly. In the traditional set up, global health policy’s main focus was to fund and provide for medical care, which included maternal health care. It is different in the world today since environmental conditions in which a mother lives in are main factors in determining her health condition (Unies, 2000).
Environmental risk is based on different resources like unclean water, poor sanitation, crowded residential places, and dangerous working conditions (Unies, 2000). These conditions are dangerous to pregnant women given their high requirement for nutrients that may be found unhealthy given such conditions in the environment. The health of children is at risk because, their growth require more energy, which is compromised by poor nutrition due to unfit environmental conditions.
There are different ways in which maternal health care in Sri Lanka can be addressed. This helps in reducing the dangers associated with this health problem. One of the strategies that can be used to reduce dangers in maternal health is by improving the utilization of health care facilities. This implies that all expectant mothers in the country, irrespective of their location should be encouraged to be in constant communication with the health care providers (Skolink, 2012). This is necessary so that they can get educated on how to take care of pregnancy and also identification of any maternal health complications. The lack of communication which can be due to poor transport services leads to the risk of increasing dangers of maternal healthcare. This is because poor transport is a hindrance to emergency actions of life saving. Communication can be also due to language and cultural challenges or barriers where it is necessary that the respective parties involved should learn to involve their peers in their experiences of maternity.
Another strategy is that education should be provided to all pregnant women. This can be achieved by having pre natal classes during every clinic visit. In these clinics, the women can be reminded of the dangers at their exposure and how they can be averted. This is the best strategy since educated women, in most cases, realize the importance of using maternal health care services.
The maternal health care services should be affordable for every woman so that none of the expectant woman lacks the services; hence, reducing mortality rates due to complications in pregnancy. Being a developing country, infrastructure and communication should be improved so as to help in taking care of any emergencies that arise due to pregnancy (Ricci, 2009). Sri Lanka can reduce mortality rates of pregnancy by improving the infrastructure in the roads, transport and communication, as well in the health sector. Medical facilities should be improved yearly based on the innovations and technology around the globe.
Several intervention programmes are identified so as to help in reducing mortality rates and dangers associated with the maternal heal problem. The intervention programmes should be divided into three stages with respect to the strength they have on the problem. These stages should be primary intervention, which may affect secondary intervention programmes and finally affect the tertiary intervention programmes. These programmes are based on the strategies used to reduce maternal health problems in Sri Lanka. In the course of training women about good maternal care, the service providers should primarily encourage them to avoid any pregnancies when they do not have enough medical facilities in their location. This program should be facilitated by the government to help ensure that all women are exposed to the knowledge about dangers associated with irresponsible pregnancy.
The secondary intervention program should encompass having mothers prevent obstetric complications in the course that pregnancy is unavoidable. This implies that since getting pregnant has no other alternative due to unavoidable circumstances, the woman should ensure that she has medical attention in the course of the pregnancy so that she does not develop problems based on the pregnancy. The final intervention program is based on providers of medical services which is known as tertiary intervention program. In this case the medical specialist will have to ensure that they avoid any mortality cases that arise due to obstetric complications. In this case, after a discovery of pregnancy complications, the medical team in every hospital both in the urban and the rural set up should work towards ensuring that there are no major cases of death. All these intervention programs are possible only if they are based on the strategies to alleviate mortality in pregnancy.
After strategies have been developed and the intervention programmes have been identified, it is important that the administration of the country of hospitals is aware of the plan. This is to help them come up with the best policy to assess the resources required for the program to be successful, and of good and reliable services. The first step for the administration to identify is the assessment of resources which range from time, personnel the setting of the program and the budget required. This can be done by the use of several project management tools like the Gantt chart or the critical path method. These tools help in identifying how long the project will take and how the tasks involved will affect the duration of the project. The resources needed should also be identified in terms of finances, technical support and even instructional resources. Personnel are also important for the general knowledge success of the [program since the team to facilitate the end product should be identified in good time.
The government and all health providers should come up with a plan that will help in the implementation of the successful program. This is done by prioritizing the different strategies to reduce dangers of maternal health. Also, ensuring that a specific time is allocated for the strategy to be complete. This is because one strategy should be able to affect the other. This may only be attained by forming a schedule that is relevant to the program, and a budget that is feasible with respect to the funds available. The government should also formulate a plan that will ensure expansion of medical facilities especially in the villages and rural set up of Sri Lanka so that even the women in the village have access to qualified medical specialists. Bottom line of the whole issue is that education should be embraced as an intervention strategy for improving maternal health care in the country. At the end of the administrative assessment, the government should be able to identify what is important and come up with a budget for the program to succeed.
