Iam engaged in social science research in a nearly 50 year old research institute. additionally I take some sessions in a masters course. Iam in management as well.
An unusual feature of Sri Lanka’s development during the four decades after independence has been... more An unusual feature of Sri Lanka’s development during the four decades after independence has been the relatively slow growth of the urban sector. According to census data, the share of the urban population in the total population increased from 15.4 per cent in 1946 to 21.4 per cent in 1981. These data, which are based on the administrative definition of what is urban, tend to underestimate the actual extent of urbanization. But even after making corrections for this, the level of urbanization remains low. The slow expansion of the urban sector has been the result of a combination of economic, social and political factors…
Using the limited data available regarding the female sector in Sri l.anka, the paper seeks to sp... more Using the limited data available regarding the female sector in Sri l.anka, the paper seeks to spell out the impact of Western style modernization on the role of the female hitherto hedged around by heterogeneous norms and perceptions. It explores the role conflict, stresses and disabilities of the female, areas of change, in social attitude and activities as well as in the administra tive and legal spheres, and, what is more important, areas which are still largely traditional. It is suggested that, as yet, the pull of tradition is stronger than the 'push' of modernization in many aspects of social organization. It makes the point that the social transformation would have to take place in the relationship between men and women rather than in a change in the status of women alone, and that this would have to evolve in a pattern of development which pre serves the positive elements of tradition, while it absorbs the benefits of modernization.
in collaboration with the World Health Organization: Daily vs. weekly iron supplementation effect... more in collaboration with the World Health Organization: Daily vs. weekly iron supplementation effects on adolescent school girls 1997/98.
... When she fell ill recently, the kovil priest sent her to the government hospital. ... Bank ac... more ... When she fell ill recently, the kovil priest sent her to the government hospital. ... Bank accounts of low income householders were mainly deposits that were compulsory from the Samurdhi allowance, or from their membership in Savings and Thrift Cooperatives in which they could ...
Chapter 1 CARE OF THE AGED IN ASIA AND EUROPE S Irudaya Rajan Carla Risseeuw Myrtle Perera Introd... more Chapter 1 CARE OF THE AGED IN ASIA AND EUROPE S Irudaya Rajan Carla Risseeuw Myrtle Perera Introduction The ageing of population is an outcome of successful demographic transition. One of the unprecedented achievements in the medical history of the twentieth ...
Background: Lymphatic filariasis (LF) is a so-called neglected tropical disease, currently oversh... more Background: Lymphatic filariasis (LF) is a so-called neglected tropical disease, currently overshadowed by higher-profile efforts to address malaria, tuberculosis, and HIV/AIDS. Despite recent successes in arresting transmission, some 40 million people who already have the disease have been largely neglected. This study aims to increase understanding of how this vulnerable, neglected group can be helped. Methods: We used purposive sampling to select 60 men and women with filarial lymphoedema (45 with filarial elephantiasis and 15 men with filarial hydrocoele) from the south of Sri Lanka in 2004-2005. Participants were selected to give a balance of men and women and poor and nonpoor, and a range of stages of the disease. Participants' experiences and the consequences of their disease for the household were explored with in-depth qualitative, semistructured interviews. Findings: LF was extremely debilitating to participants over long periods of time. The stigma attached to the condition caused social isolation and emotional distress, and delayed diagnosis and treatment, resulting in undue advancement of the disease. Free treatment services at government clinics were avoided because the participants' condition would be identifiable in public. Loss of income due to the condition was reported by all households in the sample, not just the poorest. Households that were already on low incomes were pushed into near destitution, from which it was almost impossible to escape. Affected members of low-income households also had less opportunity to obtain appropriate treatment from distant clinics, and had living and working conditions that made hygiene and compliance difficult. Significance: This highly vulnerable category of patients has low visibility, thus becoming marginalized and forgotten. With an estimated 300,000 total cases of elephantiasis and/or oedema in Sri Lanka, and around 300,000 men with filarial hydrocoele, the affected households will need help and support for many years to come. These individuals should be specially targeted for identification, outreach, and care. The global strategy for elimination is aimed at the cessation of transmission, but there will remain some 40 million individuals with clinical manifestations whose needs and problems are illustrated in this study.
National community health worker (CHW) programmes supported by Ministries of Health have been int... more National community health worker (CHW) programmes supported by Ministries of Health have been introduced in a number of countries as part of their primary health care policy. Although in many of these programmes the CHWs are salaried or receive an honorarium, there are a number of large-scale programmes in which CHWs work as unpaid volunteers. This paper looks at one such programme in Sri Lanka, in order to understand the motivation of such volunteers and to consider the feasibility of relying on volunteers to support primary health care policies. The lessons from the Sri Lanka case are generalized to other studies. The conclusion is that large-scale community level volunteer programmes will be characterized by high attrition and low activity rates and will only be sustainable under particular enabling conditions.
Sri Lanka's public health care system is free at the point of use and maintains a focus on eq... more Sri Lanka's public health care system is free at the point of use and maintains a focus on equity. However, noncommunicable diseases, such as diabetes, are rapidly increasing in prevalence and posing new challenges to the system and to patients and households. In-depth interviews and focus group discussions were conducted in four districts of Sri Lanka to investigate the care-seeking experiences of diabetes patients from households at different income levels. Although health care is free, other direct and indirect costs served as deterrents to care seeking before and after diagnosis, and placed a high burden on households. The need for frequent visits to clinics with appropriate facilities for diagnosis and management of diabetes, often far from rural communities, posed high costs, in particular due to income foregone. Households employed coping strategies, but the need for frequent clinic visits posed repeated costs, which made it difficult for households to recover their econo...
This article is based on a collaborative research study of policy and practice in national commun... more This article is based on a collaborative research study of policy and practice in national community health worker (CHW) programs in developing countries. The study involved a review of the relevant literature, case studies in Botswana, Colombia and Sri Lanka, and an international ...
National community health worker (CHW) programmes supported by Ministries of Health have been int... more National community health worker (CHW) programmes supported by Ministries of Health have been introduced in a number of countries as part of their primary health care policy. Although in many of these programmes the CHWs are salaried or receive an honorarium, there are a number of large-scale programmes in which CHWs work as unpaid volunteers. This paper looks at one such programme in Sri Lanka, in order to understand the motivation of such volunteers and to consider the feasibility of relying on volunteers to support primary health care policies. The lessons from the Sri Lanka case are generalized to other studies. The conclusion is that large-scale community level volunteer programmes will be characterized by high attrition and low activity rates and will only be sustainable under particular enabling conditions.
An unusual feature of Sri Lanka’s development during the four decades after independence has been... more An unusual feature of Sri Lanka’s development during the four decades after independence has been the relatively slow growth of the urban sector. According to census data, the share of the urban population in the total population increased from 15.4 per cent in 1946 to 21.4 per cent in 1981. These data, which are based on the administrative definition of what is urban, tend to underestimate the actual extent of urbanization. But even after making corrections for this, the level of urbanization remains low. The slow expansion of the urban sector has been the result of a combination of economic, social and political factors…
Using the limited data available regarding the female sector in Sri l.anka, the paper seeks to sp... more Using the limited data available regarding the female sector in Sri l.anka, the paper seeks to spell out the impact of Western style modernization on the role of the female hitherto hedged around by heterogeneous norms and perceptions. It explores the role conflict, stresses and disabilities of the female, areas of change, in social attitude and activities as well as in the administra tive and legal spheres, and, what is more important, areas which are still largely traditional. It is suggested that, as yet, the pull of tradition is stronger than the 'push' of modernization in many aspects of social organization. It makes the point that the social transformation would have to take place in the relationship between men and women rather than in a change in the status of women alone, and that this would have to evolve in a pattern of development which pre serves the positive elements of tradition, while it absorbs the benefits of modernization.
in collaboration with the World Health Organization: Daily vs. weekly iron supplementation effect... more in collaboration with the World Health Organization: Daily vs. weekly iron supplementation effects on adolescent school girls 1997/98.
... When she fell ill recently, the kovil priest sent her to the government hospital. ... Bank ac... more ... When she fell ill recently, the kovil priest sent her to the government hospital. ... Bank accounts of low income householders were mainly deposits that were compulsory from the Samurdhi allowance, or from their membership in Savings and Thrift Cooperatives in which they could ...
Chapter 1 CARE OF THE AGED IN ASIA AND EUROPE S Irudaya Rajan Carla Risseeuw Myrtle Perera Introd... more Chapter 1 CARE OF THE AGED IN ASIA AND EUROPE S Irudaya Rajan Carla Risseeuw Myrtle Perera Introduction The ageing of population is an outcome of successful demographic transition. One of the unprecedented achievements in the medical history of the twentieth ...
Background: Lymphatic filariasis (LF) is a so-called neglected tropical disease, currently oversh... more Background: Lymphatic filariasis (LF) is a so-called neglected tropical disease, currently overshadowed by higher-profile efforts to address malaria, tuberculosis, and HIV/AIDS. Despite recent successes in arresting transmission, some 40 million people who already have the disease have been largely neglected. This study aims to increase understanding of how this vulnerable, neglected group can be helped. Methods: We used purposive sampling to select 60 men and women with filarial lymphoedema (45 with filarial elephantiasis and 15 men with filarial hydrocoele) from the south of Sri Lanka in 2004-2005. Participants were selected to give a balance of men and women and poor and nonpoor, and a range of stages of the disease. Participants' experiences and the consequences of their disease for the household were explored with in-depth qualitative, semistructured interviews. Findings: LF was extremely debilitating to participants over long periods of time. The stigma attached to the condition caused social isolation and emotional distress, and delayed diagnosis and treatment, resulting in undue advancement of the disease. Free treatment services at government clinics were avoided because the participants' condition would be identifiable in public. Loss of income due to the condition was reported by all households in the sample, not just the poorest. Households that were already on low incomes were pushed into near destitution, from which it was almost impossible to escape. Affected members of low-income households also had less opportunity to obtain appropriate treatment from distant clinics, and had living and working conditions that made hygiene and compliance difficult. Significance: This highly vulnerable category of patients has low visibility, thus becoming marginalized and forgotten. With an estimated 300,000 total cases of elephantiasis and/or oedema in Sri Lanka, and around 300,000 men with filarial hydrocoele, the affected households will need help and support for many years to come. These individuals should be specially targeted for identification, outreach, and care. The global strategy for elimination is aimed at the cessation of transmission, but there will remain some 40 million individuals with clinical manifestations whose needs and problems are illustrated in this study.
National community health worker (CHW) programmes supported by Ministries of Health have been int... more National community health worker (CHW) programmes supported by Ministries of Health have been introduced in a number of countries as part of their primary health care policy. Although in many of these programmes the CHWs are salaried or receive an honorarium, there are a number of large-scale programmes in which CHWs work as unpaid volunteers. This paper looks at one such programme in Sri Lanka, in order to understand the motivation of such volunteers and to consider the feasibility of relying on volunteers to support primary health care policies. The lessons from the Sri Lanka case are generalized to other studies. The conclusion is that large-scale community level volunteer programmes will be characterized by high attrition and low activity rates and will only be sustainable under particular enabling conditions.
Sri Lanka's public health care system is free at the point of use and maintains a focus on eq... more Sri Lanka's public health care system is free at the point of use and maintains a focus on equity. However, noncommunicable diseases, such as diabetes, are rapidly increasing in prevalence and posing new challenges to the system and to patients and households. In-depth interviews and focus group discussions were conducted in four districts of Sri Lanka to investigate the care-seeking experiences of diabetes patients from households at different income levels. Although health care is free, other direct and indirect costs served as deterrents to care seeking before and after diagnosis, and placed a high burden on households. The need for frequent visits to clinics with appropriate facilities for diagnosis and management of diabetes, often far from rural communities, posed high costs, in particular due to income foregone. Households employed coping strategies, but the need for frequent clinic visits posed repeated costs, which made it difficult for households to recover their econo...
This article is based on a collaborative research study of policy and practice in national commun... more This article is based on a collaborative research study of policy and practice in national community health worker (CHW) programs in developing countries. The study involved a review of the relevant literature, case studies in Botswana, Colombia and Sri Lanka, and an international ...
National community health worker (CHW) programmes supported by Ministries of Health have been int... more National community health worker (CHW) programmes supported by Ministries of Health have been introduced in a number of countries as part of their primary health care policy. Although in many of these programmes the CHWs are salaried or receive an honorarium, there are a number of large-scale programmes in which CHWs work as unpaid volunteers. This paper looks at one such programme in Sri Lanka, in order to understand the motivation of such volunteers and to consider the feasibility of relying on volunteers to support primary health care policies. The lessons from the Sri Lanka case are generalized to other studies. The conclusion is that large-scale community level volunteer programmes will be characterized by high attrition and low activity rates and will only be sustainable under particular enabling conditions.
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