Health Impact Assessment (HIA): a comparative case study of Sri Lanka and Wales: what can a developing country learn From the Welsh HIA system?

The health impact assessment (HIA) is increasingly recognized around the world as an effective governance tool to incorporate Health in All Policies to address the wider determinants of health. However, it is still poorly recognized and practiced in many developing countries, including Sri Lanka, where its applicability is most appropriate considering the complexity of social determinants of health and inequalities. This comparative case study aimed to explore the barriers for implementation of HIA in Sri Lanka in the areas of supportive policy framework, institutional infrastructure, capacity-building, and multi-sectoral collaboration and to compare them with a successful HIA system in a developed country (Wales) with a view toward identifying the “best practices” applicable in a developing country context. The case study revealed that there is an emerging government commitment in Sri Lanka to embrace the Health in All Policies approach and much potential in the health system to develop a centrally dedicated expert team with peripheral counterparts and multi-sectoral collaboration, which were the primary pillars of success in the Welsh system. However, there is a great need for capacity-building and for development of country-specific tools, which would facilitate the establishment and sustainability of HIA processes in Sri Lanka

High resilience leads to better work performance in nurses: evidence from South Asia

Aim To find out how resilience level is related to work performance of nurses. Background Resilience is a developable and teachable skill which helps to recover from adversities and continue functioning above the norm. Though combating negative effects at work such as burnout is widely researched, harnessing positive organisational effects such as work performance through resilience is yet to be well‐established. Methods Cross‐sectional study enrolled 230 nurses from Sri Lanka. The level of resilience at work and performance were assessed using culturally adapted and validated tools. How each resilience subscale predicted the nursing performance was assessed using bivariate correlation and linear regression analysis using ordinary least squares method. Results The total resilience scale score demonstrated significant and strong positive correlations with all subdomains of nursing performance, as well as with overall performance (p < .05). In linear regression model, six out of seven subscales in resilience scale predicted 70.5% of variance of work performance. Conclusion Higher resilience level at work is associated with better working performance among nurses

Staff wellbeing and retention in children’s social work : systematic review of interventions

Objective: To systematically review international evidence on the effectiveness and cost-effectiveness of interventions targeting the mental health, wellbeing, and retention of child and family social workers and their impact on child and family outcomes. Method:Systematic review and narrative synthesis of quantitative comparative studies. Published or unpublished research was sought via 12 bibliographic databases, websites, contact with experts, and citation tracking. Studies in any language were eligible for inclusion. Quality was assessed using Cochrane appraisal tools. Results: Fifteen studies were identified from 24 papers. Three studies considered individual-level interventions, with mixed and inconclusive findings. Eleven considered organisational interventions, with mixed but more promising findings. One study considered community-level interventions, with positive findings but a serious risk of bias. Only one study considered costs. Conclusion: The quality of evidence overall does not warrant clear recommendations for services. Organisation-level interventions show some promise. Robust, high-quality interventional studies are needed

Physiotherapy training and education prior to elective Caesarean section and its impact on post-natal quality of life: a secondary analysis of a randomized controlled trial

Abstract Background Caesarean section (CS) is associated with numerous complications that lead to the delayed return to functional activities that have a negative influence on the post-natal quality of life (QOL). It is evident that providing regular evidence-based physiotherapy training and education prior to elective CS helps to enhance the post-natal QOL by improving physical, mental, social, and general well-being. The purpose of this study was to examine the effectiveness of physiotherapy training and education prior to elective CS on post-natal QOL. Methods This single-blind parallel randomized controlled study was carried out at De Soysa Hospital for Women (DSHW), Colombo. The study enrolled 54 women who were scheduled to undergo elective CS. The intervention group (n = 27) of women received physiotherapy training and education, while the control group (n = 27) received standard nursing care. In addition to the primary outcome measures, post-natal QOL was measured. The results were examined using descriptive statistics and the independent samples t-test in IBM SPSS 20. Results The intervention group showed a higher post-natal QOL for the domains of physical function, role limitation due to physical health, energy/fatigue, and pain than the control group (p < 0.05). Conclusion Physiotherapy training and education prior to elective CS play a pivotal role in improving the physical health-related domains of QOL following CS. Trial Registration The Sri Lanka Clinical Trials Registry ( https://www.slctr.lk ). Registration number: SLCTR/2019/029-APPL/2019/028; Registration date: 6th of September 2019

The burden of hospital admissions for skeletal dysplasias in Sri Lanka: a population-based study

Abstract Background Skeletal dysplasias are a diverse group of rare disorders in the chondro-osseous tissue that can have a significant impact on patient’s functionality. The worldwide prevalence of skeletal dysplasias at birth is approximately 1:5000 births. To date, disease burden and trends of skeletal dysplasias in the Sri Lankan population have not been described in any epidemiological study. Our aim was to evaluate the burden and the current trends in hospital admissions for skeletal dysplasias in the Sri Lankan population. A retrospective evaluation of hospital admissions for skeletal dysplasia during 2017–2020 was performed using population-based data from the eIMMR database which covers government hospitals in the entire country. The trends in hospital admissions for skeletal dysplasias by calendar year, age, and types of skeletal dysplasia were described using appropriate summary statistics. Results Respective crude admission rates of skeletal dysplasias in the years 2017, 2018, 2019 and 2020 were 5.2, 8.1, 8.0, and 6.5 per million population. A female predominance (1.4:1) was noted during the studied period. Of all reported cases the majority (n = 268; 44.2%) were children less than 4 years. Each year, 0–4 years age group represented 40–47% of the total hospital admissions. More than half of the cases were reported from Colombo (28.1%) and Kandy (25.4%) districts combined. 60% of cases were diagnosed as osteogenesis imperfecta (OI). Rising trends were observed in the hospital admissions for osteogenesis imperfecta, achondroplasia and osteopetrosis, while other skeletal dysplasia types collectively showed a relatively stable trend. Conclusion This preliminary study revealed a female predominance of skeletal dysplasias and a relatively high admission rate of osteogenesis imperfecta in the Sri Lankan population. A distinct trend was not visible in the studied years probably due to the impact on hospital services due to COVID- Pandemic. Future research on the healthcare burden on families affected by skeletal dysplasia is required to better understand the overall cost of care and identify therapies that reduce admission rates. This study highlights the value of analysing population-based data on rare diseases to improve healthcare in low-resource countries