Maternal Care in Private Sector, Colombo District, Sri Lanka; Profile and Factors associated with key Newborn Care Practices

Abstract

Aims: Limited information is available on private sector contribution for maternal care in Sri Lanka. The main objective of this assessment is to describe the maternal and newborn characteristics of deliveries in private sector in Colombo District, Sri Lanka. Secondly, the assessment of the factors associated with key newborn care practices using the National Maternal and Newborn Health Management Information System of Private Health Institutions (NMNMIS-PHI)-Phase 1 was conducted. Study design: Secondary descriptive analysis was performed using data reported in the NMNMIS-PHI-Phase 1, Sri Lanka. Place and Duration of Study: All deliveries in private health institutions in Colombo District which were reported in the NMNMIS-PHI-Phase 1 was included in the study. The time period was from 1st January 2021 to 31st December 2021. Methodology: Maternal, delivery and newborn characteristics of national vs. private sector in Colombo District were compared using Z test. Associated factors for key newborn care practices was calculated using univariate and multivariate Odds ratios. Results: Incidence of Gestational DM was higher among pregnant women delivered at private sector, Colombo compared to national rate (17.9% vs. 7.1%, p<0.001). Further, the reported caesarean section rate in private sector was close to twofold that of the national rate (76.5% vs. 41.9%, p<0.001). Stillbirth rate of private sector in Colombo was comparatively low than the national rate (0.2% vs. 0.7%). Similarly, reduced number of low-birth-weight newborns was reported in private sector in comparison to national figure (12.4% vs. 13.9%). Significantly more newborns of primi-pregnant women received skin-to-skin contact (SSC) immediately after birth compared to newborns of multi-parous women (AOR=0.814, CI=0.735-0.900, p<0.001). Conclusion: Maternal and neonatal characteristics of pregnant women delivered in private sector in Colombo was significantly different from the national profile of pregnant women. Promotion of immediate SSC and reduction in unnecessary caesarean sections should be considered in private sector deliveries in Sri Lanka to further enhance the positive maternal and newborn outcomes.