BackgroundBirth defects (BD) are considered a leading cause of childhood morbidity and mortality. Personal, cultural, and health care system barriers may increase the incidence of BD in low and middle income countries. In this study we assessed the knowledge of antenatal mothers on BD, associated factors, and prevention and management.MethodsThree hundred and fifty (350) antenatal mothers were surveyed using a pretested, self-administered questionnaire. The knowledge on BD was evaluated under 3 categories; knowledge on BD, knowledge on associated factors, and knowledge on prevention and management. The total scores were calculated for each category and converted into percentages. A higher percentage score indicates a high level of knowledge. Descriptive statistics and regression models were used for data analysis. Level of significance was considered as p < 0.05.ResultsMean age of the participants was 28.7 years (SD = 5.2). The age range was 17–44 years. Most of the participants (79%) had studied up to secondary or tertiary education. The average scores of knowledge on BD, associated factors, and prevention and management of BD were 57.6% (95% CI = 52.3–62.9%), 55.1% (95% CI = 49.8–60.4%) and 58.8% (95% CI = 53.5–64.1%) respectively. The average score on the overall total knowledge was 56.4% (95% CI = 51.1–61.7%). Mother’s level of education, monthly income of the family and number of clinic visits made by the mother were found to be positively associated with the overall knowledge. About 62% of the participants had taken folic acid (FA) preconceptionally, a major preventive factor of BD associated with the nervous system. Folic acid intake was positively associated with age and educational level, but negatively associated with parity. Media (36.9%) and Public Health Midwives (PHMs) (20%) were found to be the major sources of knowledge on BD, associated factors and prevention in this target group.ConclusionsThe average overall knowledge on BD in this group of antenatal mothers was moderate. Thus, there is a need to improve the knowledge in eligible women to reduce the occurrence of BD, ideally before they become pregnant. Media and PHMs were seem to be the effective and possible resources that can be used to educate the community on BD, associated factors and prevention of BD in Sri Lanka.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2163-9) contains supplementary material, which is available to authorized users.

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Female foreign domestic workers (FDWs) are an important and growing occupational group, especially in the Middle East. Although Sri Lankan female FDWs comprise a significant percentage of those employed in this region, little is known about the health issues this population experiences during their employment. Prompted by this dearth in the extant literature, this study aimed to explore self-reported health problems and perceived causes, as well as health behaviors, beliefs, coping, and concerns of Sri Lankan female FDWs through the narratives of returnees formerly employed in the Middle East. Implementing a multi-faceted qualitative approach, focus group discussions and in-depth interviews were utilized to investigate FDWs’ health problems, behaviors, and coping mechanisms. Participants’ health beliefs and concerns were explored through free listing and pile sorting. Data was analyzed using thematic analysis and descriptive statistics. Headaches, backache, irregular meals and symptoms of depression were the most frequently self-reported health issues, most commonly attributed to overwork. Cleanliness was the most commonly adopted health maintaining behavior. The presence of cultural health beliefs in terms of illness causation was revealed, and FDWs’ spoke of the perceived health benefits of social interaction and religious practice as coping strategies. Findings of this study have several implications for policy and future research. FDWs’ concerns and recommendations prompt the need for greater accountability, legal enforcement of policies, and strengthened training and health monitoring. Policy, prevention and intervention measures may be more effective if they consider FDWs’ self-reported health problems, health belief models, health maintaining behaviors, concerns and coping strategies