Maternal care and Midwifery Service in Rural Sri Lanka

Abstract

The decrease of infant mortality rates (IMR) and maternal mortality rates (MMR) in Sri Lanka has shown a remarkable improvement of healthcare over recent decades. This attainment is almost equivalent to that of some developed countries. Since Sri Lanka is still in the developing status, usually the credit of this success goes to the established medical system of the country and welfare based economy. Although there is no argument on this over emphasized assessment, this research attempts to reveal the role of midwifery service which has been the key stakeholder behind this success. This paper is a part of a research on infant mortality trends in Sri Lanka that has been conducted covering five districts namely: Anuradhapura, Badulla, Hambantota, Kandy and Ratnapura. Relevant primary data were generated through the process of interviewing 80 mothers who have given birth to mortal infants during the period of 2016 to 2018. Some useful information was carried out from informal interviews with 10 midwives representing relevant districts. Personal observations on visual anthropological sources were also utilized as primary data sources. Previous researches, journal articles and published statistical documents of government organizations were used as secondary facts. This research reveals that the most important relationship at pre delivery, delivery and post delivery periods for mothers as, Midwife 48.3 %, Doctor 31.7 %, Family members 18.3 % and others 1.7 %. Moreover, the sample figures show that receiving basic knowledge of hygiene, nutrition and family planning were obtained highly from doctor or midwife 71.7 %, digital media 32.6 %, Printed media 27.3 %, friends or neighbors 19.4 %, formal education 15.2 % and 22.2 % from other sources. Based on these figures this research continued with scrutinizing the history of midwifery service in Sri Lanka. Although, the health care service appeared in Sri Lanka from kings' age up to now in different stands of the process of institutionalizing, it does not say all these facilities equally catered to all remote areas of the Island. This paper also argues that, even though a number of development programmes have been introduced, a seldom of their outcomes have effectively reached to the less developed areas. However, with the implementation of the systematic midwifery service throughout every administrative division it has shown a remarkable attainment even in the remote geographical destinations reporting such low rates of IMR and MMR cases in Sri Lanka.