Anuradhapura District Research Articles

Prevalence and abundance of plant-parasitic nematodes associated with corn (Zea mays L.) in Anuradhapura, Sri Lanka  

Plant parasitic nematodes (PPN) are important pests of corn (Zea mays L.) Globally, while corn production has recently expanded in Sri Lanka. The population abundance, distribution, and pathological effects of nematodes that adversely affect corn production in Sri Lanka are poorly understood. This study was conducted to identify the prevalence of major PPN genera, population abundance, and their reproduction associated with corn fields in the Anuradhapura district. Over 92% of the corn fields were positive for PPN from the fields sampled in February 2021. Major PPN genera identified were Pratylenchus (71.4%) Helicotylenchus (28.6%), Meloidogyne (21.4%), Criconemella (21.4%), and Hoplolaimus (35.7%). The mean population of the Pratylenchus was 2020 kg-1 of soil, which was above the threshold level (1000 Pratylenchus kg-1 of soil), while other genera were lower than the threshold. All genera, except Meloidogyne, were observed from the intensive sampling from the selected fields during the next cropping season from November 2021 (seedling stage) to February 2022 (harvesting stage). Pratylenchus abundance in all the fields was lower than the threshold at the seedling stage and it was 2 to 10 times higher during the harvesting stage, except in Kelenikawewa where the initial Pratylenchus population (1865 kg-1 of soil) was also above the threshold. According to our results, Pratylenchus have the potential to impact corn yield in Anuradhapura. Future field experiments will determine the impact of PPN on corn production in Sri Lanka.

Assessment of the productivity loss due to leading maternal ill-health conditions: a follow-up study of a prospective pregnancy cohort in rural Sri Lanka.

This study aimed to assess the productivity loss and cost due to maternal ill-health conditions and its associated factors throughout pregnancy in rural Sri Lanka. A follow-up study of women registered in the Rajarata Pregnancy Cohort (RaPCo). Anuradhapura district, Sri Lanka. 1573 pregnant women who were followed up from pregnancy identification to termination. The primary outcome measures of this study are productivity loss due to maternal ill-health conditions expressed by days/month and productivity cost due to maternal ill-health conditions expressed in monetary terms (US$)/month. Data were collected monthly, and all pregnant women were asked to report the leading cause of maternal ill-health condition and the associated loss due to absenteeism and presenteeism. During the pregnancy follow-up, 3595 (81.5%) months had at least one episode of maternal ill-health condition. Of these, only 1729 (48.1%) episodes sought medical care. Assistance for lost routine work was reported in 1281 (35.6%) episodes. The absenteeism, presenteeism and gross and net productivity loss per month were 3.6, 4.5, 8.1 and 5.5 days/month, respectively. The corresponding productivity cost was US$15.26/month. Nausea and vomiting (NVP) reported the highest prevalence (n=1599, 44.5%) until the second month of the third trimester, presenteeism (5.5 days/month) and gross productivity loss (9.5 days/month). Pregnant women with vaginal bleeding reported the highest absenteeism (6.2 days/month) and net productivity loss (6.8 days/month). Pregnant women diagnosed with anaemia reported the highest productivity cost (US$26.98/month). Monthly household expenditure, poverty and receiving assistance were the associated factors of productivity loss (p<0.05). Maternal ill-health conditions during pregnancy lead to productivity loss in rural Sri Lanka. NVP, vaginal bleeding and anaemia are the leading causes of productivity loss. Hence, controlling and preventing the leading causes are the recommended priorities.

An application of the remote sensing derived indices for drought monitoring in a dry zone district, in tropical island

Recent research has shown that droughts have intensified in South Asia over the past two decades. As a natural disaster, this has severely impacted people’s livelihoods, especially in the dry zones of Sri Lanka. Thus, to ensure human well-being, security of water resources, and ecosystem health, it is essential to minimize the impacts of droughts using reliable information. Remote sensing (RS) data and techniques help bridge the gap by enabling the analysis of drought phenomena through a diverse array of indices developed in the fields. However, until now, there has been a lack of systematic monitoring and reliable data for accurately characterizing droughts in the study area. As the first comprehensive analysis, we tried to evaluate the spatial–temporal dynamics of drought conditions in two Divisional Secretariat Divisions of the Anuradhapura district, Sri Lanka using eight standardized remote sensing-derived indices over a decade (2013–2023) including the Standardized Precipitation Index (SPI). SPI values indicated that the region has experienced notably below-average precipitation. According to SPI results, a significant portion of the Medawchchiya area experienced arid conditions in 2023. All other indices proved that 2018 was the driest year and 2013 was the wettest year among the three time points, as reflected by their low and high index values. However, according to NVSMI and LST, the wettest year is 2023, with only 1.78 % of areas experiencing severe drought and a maximum LST of 31.4 °C. LULC change detection revealed that 14.3 % of agricultural lands and 5.1 % of forest areas were converted into barren lands over a decade. Overall, this conversion may be another leading factor contributing to increased LST and dryness in the area during the concerned period while increasing the mean LST of barren land by around 4.7 °C per decade. Land surface-related and vegetation-related indices, such as NDWI, NDMI, LST, and NDVI, exhibited a more pronounced impact on short-term drought occurrences. The findings revealed that average precipitation coincides with short-term drought episodes in the area, with 2018 standing out as having the least rainfall and the driest year. The study’s findings may provide additional insights for planning authorities, supporting environmental protection and enhancing agricultural production by mitigating droughts’ impacts through short- and long-term strategies. Although, the study focused on a small area, a similar approach could be extended to other areas by incorporating advanced machine learning techniques and additional drought indices in the future.

Prevalence, symptomatology and factors associated with asthma in adolescents aged 13–14 years from rural Sri Lanka: an analytical cross-sectional study

BackgroundAsthma is the most common chronic disease affecting children. However, the epidemiology of asthma in adolescents from rural geographies is lacking.MethodsAn analytical cross-sectional study was conducted in secondary schools located...

Electrodialysis reversal (EDR) technology: a viable solution for addressing water quality challenges in the dry zone, Sri Lanka

ABSTRACT Chronic Kidney Disease of Unknown Etiology (CKDu) affects rural Sri Lankan agricultural populations, with poor-quality ground and surface water suspected as the root cause. Hence, we conducted this study to explore the effectiveness of Electrodialysis Reversal (EDR) technology in treating water quality issues related to CKDu in dry zone of Sri Lanka. The EDR plant in Kahatagasdigiliya, Anuradhapura district, managed by the National Water Supply and Drainage Board (NWS&amp;DB) was selected. We measured both physical (colour, turbidity, pH) and chemical (electrical conductivity, total dissolved solids, chloride, alkalinity, hardness, nitrate, nitrite, sulfate, fluoride, total phosphate, iron, manganese) parameters of the EDR process. The parameters of the permeate stage of the EDR plant were validated by comparison with data from SLS 614:2013, and removal efficiencies were assessed. The results revealed that all parameters consistently fell within the permissible limits in the permeate stage of the EDR plant. Turbidity (62.65%), sulfate and manganese (50%), colour (47.37%), fluoride (44.19%), and hardness (35.71%) showed high removal efficiencies in the EDR process. The study demonstrated the effectiveness of EDR technology in addressing water quality challenges, validating its potential for groundwater treatment and this contributes to the improvement of groundwater quality in CKDu-prevalent areas.

Behavioral Intention of Paddy Farmers Towards Adoption of Organic Sources for Soil Nutrient Management Consequent to Policy Decision to Ban Agro-chemicals in Sri Lanka: A Case Study

This stu dy was aimed at investigating the behavioral intention towards and factors influencing adoption of organic soil nutrient management by paddy farmers, consequent to the banning of agro-chemicals in April 2021 in Sri Lank a. A questionnaire survey, supplemented by key informant discussions was used to collect the primary data after six months of the banning when farmers were preparing for the next Maha season (starting from Novemb er 2021). Paddy farmers (N=120) from the Mahaillu ppallama irrigation block of the Mahaweli system H in Anuradhapura district were randomly selected as the respond ents. The Theory of Planned Behavior (TPB) was used as the conceptual framework of the study. The study revealed that the majority (85%) of farmers did not agree with the sudden decision of the government to ban agro-chemicals to enable a complete transformation of agriculture to one that is totally organic. Only 11% of the farmers preferred a fully organic paddy production system. The majority (58%) preferred to use both organic and inorganic fertilizers. However, 31% of the farmers preferred conventional farming as usual. Perceived difficulties were the major barriers for farmers to use organic f ertilizers. Attitude on production, age, perceived knowledge of organic agriculture, and farming income significant ly affected (P &lt; 0.1) paddy farmers’ intention to adopt organic fertilizers. It is concluded that a scientifically designed gradual transition would be more appropriate for nutrient management in paddy cultivation.

Integrating Indicators in Agricultural Vulnerability Assessment to Climate Change

AbstractClimate change stands as one of the most pressing challenges confronting global ecosystems and human livelihoods. The agriculture sector of Anuradhapura district, Sri Lanka, well renowned for its pivotal role in the nation’s food production, faces an increasing threat from the changing climate. This study aims to incorporate the indicator system method which uses a set of indicators to assess the agricultural vulnerability (AV) to climate change in Anuradhapura district. The AV assessment used in this study involves three principal components exposure, sensitivity, and adaptive capacity. The indicators are normalized to allow spatial analysis and smooth integration within a geographic information system (GIS) framework. The AV of Anuradhapura district ranged from 0.32 to 0.67 and was divided among five levels very low, low, moderate, high, and very high. The findings suggest that Anuradhapura’s agricultural sector was significantly impacted by climate change as the majority of the total area was found to have very high, high, and moderate levels of AV with 25, 28, and 24%, respectively. The results obtained from this study are essential for formulating plans to improve Anuradhapura’s agricultural sector resilience and adaptability to ensure food security and livelihood sustainability considering the ever-changing climate.

Prevalence and associated factors of burnout among doctors working in hospitals with COVID-19 treatment units in Anuradhapura district, Sri Lanka during COVID-19 pandemic: a descriptive cross-sectional study

Prevalence and associated factors of burnout among doctors working in hospitals with COVID-19 treatment units in Anuradhapura district, Sri Lanka during COVID-19 pandemic: a descriptive cross-sectional study

Stigma associated with cutaneous leishmaniasis in rural Sri Lanka: development of a conceptual framework.

There is limited knowledge about the stigma associated with cutaneous leishmaniasis (CL) in Sri Lanka. To ensure that leishmaniasis researchers focus on CL-associated stigma, we provide an evidence-based framework that can be used in future research. We conducted a systematic review on CL-associated stigma using international evidence and carried out a multimethod qualitative study in the Anuradhapura district in Sri Lanka. Based on that, we identified manifestations of stigma, drivers and facilitators that we synthesised to develop a conceptual framework on CL-associated stigma. Our framework consists of drivers, facilitators and self-stigma experienced by people with CL. Stigma drivers included fear, misbeliefs and misconceptions about CL; the belief that wounds are disfiguring; the treatment burden and implied blame. Facilitators that reduced stigma included knowledge of the curability of CL and awareness that CL is not contagious. The nature of social interactions in rural communities enhanced stigma formation. We identified various enacted, felt and internalised stigma experiences of people with CL. We developed a conceptual framework of the stigma associated with CL that can be used to develop targeted interventions to increase CL awareness, address stigma and improve the quality of life for CL patients.

Decreasing incidence of hospital diagnosed CKD/CKDu in North Central Province of Sri Lanka: is it related to provision of drinking water reverse osmosis plants?

BackgroundWe assessed the possible impact of provision of reverse osmosis (RO) water on the incidence of hospital diagnosed CKD/CKDu in North Central Province (NCP) of Sri Lanka.MethodsAn ecological study was conducted on data from 2010–2020 on the incidence of hospital diagnosed CKD/CKDu, CKD/CKDu screening and provision of drinking water RO plants in NCP. Analysis was conducted using descriptive statistics, ANOVA and chi-square test.ResultsThe annual incidence of hospital diagnosed CKD/CKDu (per 100 000 population) in 2010–2013, 2014–2016 and 2017–2020 periods in Anuradhapura district were 129.07, 331.06 and 185.57 (p = 0.002) while in Polonnaruwa district these were 149.29, 326.12 and 296.73 (p = 0.04) respectively. In NCP provision of RO plants commenced after 2011 and the decline in the incidence of hospital diagnosed CKD/CKDu was seen in 25 of the 29 Divisional Secretary Divisions when more than 20% of the families received access to drinking RO water projects.ConclusionsThe annual incidence of hospital diagnosed CKD/CKDu increased in NCP from 2010 to 2016 and continuously decreased thereafter. Continuous declining of CKD/CKDu incidence was seen after more than 20% of the families received access to drinking water RO plants.

Disease burden of cardiovascular conditions complicating pregnancy in Sri Lanka: a protocol

Background Cardiovascular diseases (CVD) are the commonest indirect medical cause of maternal deaths worldwide, both in high-income and low and middle-income countries. To minimize the effects of CVD in pregnancy, proper risk assessment and appropriate referral is required. In Sri Lanka, cardiovascular disease complicating pregnancy is a significant cause of maternal mortality, second only to postpartum hemorrhage. Screening for CVD in pregnancy in Sri Lanka is limited to a routine clinical assessment. Evidence-based guidelines are yet to be developed, and this deficit may have resulted in a substantial underestimation of the CVD burden. This study aims to determine the burden of CVD in early pregnancy and develop a risk prediction model to be used in field pregnancy clinics in Sri Lanka to reduce CVD effects in pregnancy. Methods A prospective cohort study was carried out in the Anuradhapura district, Sri Lanka. Following registration to the antenatal care, pregnant women fulfilling the eligibility criteria were invited to attend a special clinic at their relevant Medical Officer of Health (MOH) area. Risk assessment was done through history and a clinical examination, and suspected/probable cases were referred for an echocardiogram by a consultant cardiologist. All the recruited participants in the first trimester were prospectively followed up and screened again between 24–28 weeks of the period of amenorrhoea (POA). Antenatal ward admissions with CVD complicating pregnancy will be extracted, and a telephone interview will be carried out between 6–12 weeks after the expected delivery date to cover postpartum morbidities. Discussion This proposed study will be the largest of its kind carried out in the local setting. The study's findings will be beneficial for policymakers to develop guidelines to reduce maternal cardiovascular disease morbidities and mortalities in Sri Lanka.

What Does a KAP Survey Reveal about the Awareness Regarding Leishmaniasis among the Community of an Endemic Area in Sri Lanka?

Leishmaniasis is one of the neglected tropical diseases. Studies show that the poor knowledge about epidemiological aspects of leishmaniasis within communities causes the collapse of existing disease control programs. Therefore, the present study focuses on a detailed survey of the existing awareness among the threatened population in the Medawachchiya Public Health Inspector's (PHI) Area in the Anuradhapura District, Sri Lanka, aiming to assist the health staff to organize community-based vector control programs effectively in the future. Assessment of the awareness of residents of two hundred and seventy households (n = 270) from 10 Grama Niladhari Divisions (GNDs) was carried out by using a structured questionnaire. Among 143 females and 134 males, only 75.1% had knowledge about the disease, 5.8% (n = 16) of the participants knew only about the vector, and 28.9% (n = 80) knew about control methods. The study showed a considerable lack of awareness about the disease among the studied population. The study found that age and education levels had significant impacts on knowledge, attitudes, and practices. However, factors like gender, marital status, occupation, income, and expenses did not show significant correlations. The present study suggests huge scope for greater achievements in community-related vector control methods by implementing a continuous educational program.

Evaluation of the Quality of the Groundwater used for Domestic Purposes in the Anuradhapura District of the Dry Zone and the Efficacy of Laterite Soil-based Household Water Filters as Adsorbents

High concentrations of hardness, Ca, Mg, NO3-, PO43-, F- and, heavy metals in the groundwater being consumed in Sri Lanka's North Central province are becoming a serious health concern. The current study examined the groundwater quality in the Anuradhapura district as well as the effectiveness of groundwater purification by a laterite soil-based water purification device for Domestic Purposes. Chemical parameters (hardness, Ca, Mg, NO3-, PO43-, F-, Cr, Cd and Pb) were analyzed in randomly collected 35 number of well water samples during the dry season to assess the quality. The range of hardness was (21-1730) mg/l, with an average hardness of 471 mg/l. Anuradhapura had high levels of Ca and Mg, with average concentrations of 122 mg/l, ranges of (5- 429 mg/l) and 40 mg/L (2-160 mg/l), respectively. Phosphate levels ranged from (0.02-0.83 mg/l), with an average of 0.08 mg/l. Whereas nitrate concentrations ranged from (0.05-6.5) mg/l with an average of 0.59 mg/l and, fluoride levels ranged from (1.8-4.0 mg/l), with 2.3 mg/l being the average. Heavy metal concentrations that were below the WHO and Sri Lankan Standard limits had no discernible effect. The laterite soil-based water purification cylinder removed the hardness, Ca, Mg, NO3-, PO43- and, F- by adsorption. It was removed the hardness at an average rate of 89.7%, Ca at 89.32%, Mg at 86.87%, P at 100%, NO3- at 92.6% and F- at 81.6%. The outcomes showed that, well water in Anuradhapura region needs to be treated beforehand so it can be consumed. The laterite soil-based water filter performed well in terms of removing high hardness, Ca, Mg, P, NO3-, and F-.&#x0D; Keywords: Groundwater quality, Laterite, Adsorption, Removal efficiency

Assessment of the Vulnerability of Paddy Cultivation to Impacts of Climate Change in Anuradhapura District in North Central Province, Sri Lanka

Anuradhapura District in Sri Lanka heavily relies on paddy cultivation and plays a significant role in the country's paddy production. Given the grave threat posed by climate change to paddy cultivation in this region, it is crucial to assess its vulnerability. This study aims to fill the gap in sub-national vulnerability assessments by determining the degree of vulnerability and mapping it in the district. A combination of secondary and primary data was employed in this study. Secondary data encompassed the analysis of average annual and monthly rainfall and temperature variations in Anuradhapura District from 2010 to 2020, as well as the occurrence of droughts and floods in the same period. Additionally, the study examined the variations in average annual paddy yield in Anuradhapura District from 2010 to 2020. For primary data collection, Climate Change Vulnerability Indices (CCVI) were employed, which included indicators, exposure, sensitivity, and adaptive capacity. Under the exposure indicator, climate exposure, biophysical exposure, and biological exposure were considered. Sensitivity was assessed through social, financial, and farm sensitivity sub-indicators, while adaptive capacity was evaluated using socio-economic, agricultural, and institutional capacity sub-indicators. The field sampling focused on divisions with significant paddy lands that depend on minor irrigation and rainfed cultivation, such as Thirappane and Kahatagasdigiliya. Nuwaragam Palatha Central which had fewer paddy lands and a population engaged in non-paddy-related activities, was used as a control. Two Grama Niladhari (GN) divisions from each selected Divisional Secretariat (DS) division were randomly chosen for detailed sampling. In each GN division, 50 families were randomly selected to participate in semi- structured questionnaire surveys supplemented with focus group discussions and key informant surveys. The collected data were used to create a vulnerability map for Anuradhapura District through GIS analysis. The study results revealed that the annual rainfall showed a decrease from 2010 to 2020. Other parameters did not show significant variation. In terms of vulnerability, Kahatagasdigiliya DSD exhibited the highest vulnerability followed by Thirappane DSD. The lowest vulnerability was observed in Nuwara Gampalatha Centre DSD.&#x0D; &#x0D; Keywords: Climate change, Paddy cultivation, Adaptation measures, Vulnerability assessment, Anuradhapura&#x0D;

Assessment of Heavy Metal Accumulation in Freshwater Fishes in Irrigation Tanks, Anuradhapura

&#x0D; Sri Lanka is well known for its dense freshwater irrigation tanks, especially in dry zones, which play an important role in sustaining both the environment and human livelihoods by providing essential resources such as drinking water, irrigation for agriculture, and nutrition through fish proteins. However, heavy metal contamination poses a significant threat to the sustainability of these valuable freshwater irrigation tanks due to their persistence and non-biodegradability. These heavy metals tend to accumulate in living organisms and biomagnified and have harmful effects on high tropic level organisms like humans who rely on aquatic fish species via food chains. This study was carried out to assess the heavy metal accumulation in muscle and liver parts of freshwater fishes, Tilapia (Oreochromis sp.), and striped snakehead; Lula (Channa striata) in Kammalakkulama, Hammillewa, Kirindegama, and Madawalagama tanks in Anuradhapura district, Sri Lanka. The Inductively coupled plasma mass spectrometry (ICP-MS) was used to analyse the randomly collected fish samples for total Cadmium (Cd), Arsenic (As), Lead (Pb), and Mercury (Hg) in the tanks. The results indicated a significant difference (p&lt;0.05) in the detected concentrations of heavy metal levels in tested samples among the four tanks. The highest concentrations of Cd (2.098 mg/kg) and As (0.366 mg/kg) were recorded in the liver of Tilapia in the Kammalakkulama tank. The highest Pb (5.509 mg/kg) and Hg (2.015 mg/kg) concentration was recorded in the Tilapia muscle in the Hammillewa tank and the Lula muscle in the Madawalagama tank respectively exceeding the WHO/FAO standards. The accumulation levels of these heavy metals were higher in the fish liver compared to their muscle in most of the samples. Arsenic (As) showed a significant positive linear relationship (R2=0.531) between their dry body weight and accumulated concentration in the Tilapia muscle. The canonical discriminant analysis showed a significant differentiation among the four tanks concerning heavy metal levels in fish tissues.&#x0D; &#x0D; Keywords: Channa striata, Heavy metals, Irrigation tanks, ICP-MS, Oreochromis sp.

Impact Assessment of Fall armyworm (&lt;em&gt;Spodoptera frugiperda&lt;/em&gt; J.E. Smith) Damage and Control on Smallholder Maize Fields of Anuradhapura District, Sri Lanka

Purpose: Limited information is available on Fall Armyworm (FAW) and its agricultural burden in Sri Lanka. This is the first study conducted aimed at evaluating the level of economic damage caused by FAW in maize fields in the Anuradhapura district during the Maha season 2019-2020, along with the economic impacts on small-scale farmers.Research Method: Five small-scale maize farming sites were selected, along with another maize-cultivated area as the control site. General farming practices were allowed and observed in the sampling sites, while the maize-cultivation at the control site was not treated with any pest management practices. A total of 150 maize plants were monitored. The percentage of damage was calculated for each study site, and the expenditures from the land preparation to harvesting were recorded, along with the final yield. Findings: The highest percentage of mean FAW- damaged plants was reported during the fifth week as 28.5% in farmer fields, while the control site reported a &gt;80% rate of damaged plants. The average dry yield received from the investigated sites was 1,162.2 kg/acre and the average income was Rs. 75,543, along with an average profit of Rs. 31,051 per acre. Meanwhile, the control plots yielded only 224.8 kg of maize/acre. Research Limitation: Collecting information from farmer’s side and unexpected attacks from elephants on the selected corn fields has been the biggest challenge. Originality/value: The study highlights the need for sustainable Integrated Pest Management (IPM) options, along with due attention to biological control methods in controlling FAW.

The Effectiveness of Microfinance Services on Poverty Alleviation: Comparative Analysis of Anuradhapura District and Colombo District in Sri Lanka

Purpose: The purpose of the study is to determine the effectiveness of microfinance services on household income to alleviate poverty in both rural and urban areas of Sri Lanka, and which area has successfully used microfinance services to alleviate poverty.Design/Methodology/Approach: The researcher chose Anuradhapura as the rural area and Colombo as the urban area to conduct the study. In this regard, data was collected from 280 microfinance beneficiaries in the Anuradhapura and Colombo districts using a survey questionnaire. Microfinance services such as micro-credit and micro-entrepreneurship training were employed as the independent variables in this study, with poverty alleviation as the dependent variable. Simple random sampling was used to collect the data then were analyzed using SPSS software.Findings: According to the study's findings, both entrepreneurship training and micro-credit have a statistically significant positive relationship with poverty alleviation in both districts. According to the regression results, entrepreneurship training is more effective in reducing poverty in the Colombo district, but microcredit is more beneficial in the Anuradhapura area.Conclusion: The findings highlighted that microfinance services are more effective in alleviating poverty in urban and rural areas of Sri Lanka. Further, micro-credit services were more effective in urban (Colombo) areas than in rural (Anuradhapura) areas in Sri Lanka. However, the micro-entrepreneurship trainings were more effective in rural areas than in urban areas in Sri Lanka. Therefore, the researcher suggests that microfinance services should be promoted to alleviate poverty in Sri Lanka while more micro-credit services to urban areas and more micro-entrepreneurship training to rural areas.

Knowledge and attitudes on attention deficit hyperactivity disorder (ADHD) among school teachers in Anuradhapura district, Sri Lanka: a descriptive cross-sectional study

ObjectiveThis study aimed to assess the knowledge and attitude of school teachers from a rural district in a developing country towards children with attention deficit hyperactivity disorder (ADHD).DesignA population-based descriptive...

Exploring drivers of ecosystem-based livelihood diversification engagement: experiences from women in agri-based economy in Sri Lanka

PurposeEcosystem-based livelihood diversification (ESLD) approaches have been identified as one of the best solutions to alleviate poverty and improve living standards in rural communities in developing nations. This study aims to elucidate the motivations that drive Sri Lankan women in rural agri-based community to adopt ESLD activities.Design/methodology/approachThe sustainable livelihood approach (SLA) five pillars were used as a theoretical framework. This study was carried out with women living in farmer families located in Anuradhapura District, Sri Lanka. A purposive sampling technique was used, and semistructured interviews were performed with 46 women in a noncontrived setting. Deductive content analysis approach was used for answering research questions.FindingsMaking handcrafts using different plants, composting and home gardening are the major sources of ESLD of women in the study areas. Under the SLA factors, human resources include family size, education, vocational training, age and attitude. Social resources like participation in community work, family support received and becoming members in cooperatives encourage the women to partake in ESLD. Nonagriculture natural resources were considered as an incentive to engage in ESLD. Satisfaction with the income generated by the livelihood, other income sources and loans from the informal sector were the vital financial resources. Regarding the physical resources, the respondents were profound with infrastructure, marketplaces, training centers and tools/equipment.Practical implicationsKnowing the existing ESLD strategies and pointing out the determinant factors affecting women in practicing ESLD activities are unquestionably important in the provision of information to formulate an appropriate strategy for the development of the rural agri-based community.Originality/valueLittle is known about the ESLD efforts and the extent of adoption of ESLD practices by women in rural communities. The findings based on the SLA framework help to understand what is happening in livelihood diversifications in agri-based community and suggest important implications for the development of ESLD for the future.

Out-of-Pocket Expenditure for Antenatal Care Amid Free Health Care Provision: Evidence From a Large Pregnancy Cohort in Rural Sri Lanka.

Global evidence suggests that high out-of-pocket (OOP) expenditure negatively affects health service utilization and creates an economic burden on households during pregnancy. This study aimed to estimate the magnitude and associated factors of OOP expenditure for antenatal care (ANC) in a rural Sri Lankan setting by following up with a large pregnancy cohort (The Rajarata Pregnancy Cohort [RaPCo]) in Anuradhapura District, Sri Lanka. Data were collected from July 2019 to May 2020. An interviewer-administered questionnaire was used to collect socioeconomic data and OOP expenditures in the first trimester. Self-administered questionnaires were used monthly to collect OOP expenditures in the second and third trimesters. In-depth financial information of 1,558 pregnant women was analyzed using descriptive statistics, nonparametric statistics, and a multiple linear regression model. The majority of participants used both government and private health facilities for ANC. The mean (standard deviation [SD]) OOP expenditure per ANC visit was US$4.18 (US$4.19), and the mean (SD) OOP expenditure for total ANC was US$57.74 (US$80.96). Pregnant women who used only free government health services also spent 28% and 14% of OOP expenditure on medicines and laboratory investigations. Household income (P<.001), household expenditure (P<.1), used health care mode (P<.05), maternal morbidities (P<.05), and the number of previous pregnancies (P<.1) were the statistically significant independent predictors of OOP expenditure. OOP expenditure per visit for ANC equals half of the daily household expenditure. Despite having freely available government health facilities, most pregnant women tend to use both government and private health facilities and incur higher OOP expenditure. Free government health care users also incur a direct medical OOP expenditure for medicines and laboratory investigations. Monthly household income, expenditure, used health care mode, maternal morbidities, and the number of previous pregnancies are independent predictors of OOP expenditure.