9 th Annual IMHO Convention Women’s Health Issues & Current Needs DR. A. RAMANATHAN Medical Consultant POPULATION SERVICES – LANKA (AFFILIATE OF MARIE STOPES INTERNATIONAL - LONDON) April 2012 Canada -/sg

Population- 21 million Birth Rate- 18 Death Rate- 6.0 Maternal Mortality Rate- 36 – (Unsafe Abortion)- 11.7% – Post Partum Bleeding- 13% Infant Mortality Rate- 19 Contraceptive Prevalence Rate- 69% CPR (Modern Methods)- 54% Total Fertility Rate Mean Age – Marriage of Females- 24 Urban Population- 26% Adult Literacy- 92% Life Expectancy - Males Females- 76 Suicide Rate Estimated National Prevalence, STI- 60,000 Estimated National Prevalence, HIV/AIDS- 7,000 Abortion Prevalence - 950/day SRI LANKA

IDP CENTRES STERI CENTRE SRI LANKA HATTON WELLAWAYUA SOCIAL FRANCHISE CENTRES

Components of Women's Health SAFE MOTHERHOOD FAMILY PLANNING AND OTHER REPRODUCTIVE HEALTH SERVICES PREVENTION AND TREATMENT OF SEXUALLY TRANSMITTED INFECTIONS, HIV/AIDS SAFE ABORTION SERVICES EMERGENCY OBSTETRICS PREVENTION OF SEXUAL VIOLENCE AND ASSISTANCE TO VICTIMS ADOLESCENCE SEXUAL REPRODUCTIVE HEALTH SUB-FERTILITY PSYCHOLOGICAL CARE AND SUPPORT/COUNSELLING - THERAPY

FUNDAMENTAL RIGHTS ARE ROOTED IN THE NATION’S LEGAL AND POLITICAL FRAMEWORK BY ITS CONSTITUTION WHICH UPHOLDS EQUALITY, LIBERTY AND SOCIAL JUSTICE ENSURING WOMEN’S HUMAN RIGHTS INCLUDING REPRODUCTIVE RIGHTS LEGAL POLITICAL FRAMEWORK

MARKETING CHALLENGE SOCIAL PROBLEM/ SOCIAL NEED I E & C TARGET AUDIENCE WOMEN, COMMUNITY, PROMOTERS AND PROVIDERS. MUST HAVE ACCESS TO INFORMATION ABOUT SRH TRAINING DOCTORS MID-LEVEL PROVIDERS MOTIVATION INFORMATION, EDUCATION & COUNSELLING FOR CLIENTS SUPPLIES ENSURE SUPPLIES ARE AVAILABLE AFFORDABLE AND RELIABLE PHARMACY CBD WOR- KERS SOCIAL MARKETING PSL IDP CENTRES SOCIAL FRANCHISING OUTRREACH, CHOICE MOBILE PROGRAMME ENSURE SERVICES ARE ACCESSIBLE, AFFORDABLE, AVAILABLE & RELIABLE POPULATION SERVICES LANKA SOCIAL FRANCHISED CENTRE - WELLAWAUYA In order to provide sexual reproductive health services to underserved and vulnerable women and couples, partnership with General Practitioners in 22 districts is vital to complement and supplement unmet RH needs. ENSURE SUPPLIES, DISPENSES ON PRESCRIPTIONS PRIVATE PARTNERSHIPS

The incidence of teenage pregnancy is very high in the country Many attempts to legalize abortion has failed – 1978 and 1998 – Fear of ethnic imbalance – Pressure from Catholic Church – Currently Govt is having discussions with the relevant bodies in collaboration with the College of Obs&Gyn to legalize abortion in the event of Rape, Incest & Severe Faetal Abnormalities – Bill will be submitted in Parliament before the end of the year Challenges Faced

IDENTIFY THE RIGHT SERVICE PROVIDERS IN AN IDEAL LOCATION; – RECRUIT THEM AND PROVIDE APPROPRIATE ORIENTATION AND TRAINING TO ENSURE QUALITY SERVICES – ENSURE REGULAR QUALITY SUPPLIES – SUPPORTIVE SUPERVISION – THESE ACTIVITIES WOULD LEAD TO OPERATIONAL EXCELLENCE Program Management

Execute PSL business in an excellent manner; – Efficiently – Effectively – More Cost Effective – Regularly Look Into; Client Needs Provider Needs Program Needs – Ensuring Client Satisfaction Provider Satisfaction Programme Satisfaction -/sg ADMINISTRATION

IMHO HAS A ROLE TO PLAY IN SRI LANKA TO SUPPLEMENT AND COMPLEMENT THE UNMET SEXUAL REPRODUCTIVE HEALTH NEEDS OF THE UNDERSERVED AND VULNERABLE POPULATION AT THE PRIMARY HEALTH CARE LEVEL. THERE ARE ABOUT 2,000 QUALIFIED AYURVEDIC PHYSICANS IN SRI LANKA. THEY ARE CAPABLE OF DISTRIBUTING CONDOMS AND CONTRACEPTIVES TO THE PROSPECTIVE CLIENTS IN UNDERSERVED AREAS. THEY NEED TRAINING, SIGN BOARDS AND SUPPLIES AT SUBSIDIZED RATES. IMHO - LANKA