Aims: Limited knowledge exists on pregnancy outcome among COVID-19 positive pregnant women despite relatively better understanding on disease severity in pregnancy. Objective of this assessment is to describe the maternal characteristics and factors associated with disease severity and pregnancy outcome of COVID-19 positive pregnant women in Sri Lanka. Study Design: Secondary descriptive analysis was conducted using data reported in the National COVID-19 positive pregnant women surveillance, Sri Lanka. Place and Duration of Study: All pregnant women who were tested positive either by RT-PCR or by Rapid Antigen Test for SARS CoV-2 virus and their pregnancy and neonatal outcomes reported from 1st March 2020 to 31st October 2021 in the National surveillance in Sri Lanka, were included in the study. Methodology: Sri Lankan country-level pregnant women characteristics were compared with COVID-19 positive pregnant women using Z test. Associated factors for disease severity and pregnancy outcome was calculated using univariate and multivariate Odds ratios. Results: Details of pregnancy and neonatal outcomes were reported for 2493 COVID-19 positive pregnant women. Less cases of severe COVID-19 infection were observed among pregnant women with no co-morbidities compared with women having at least single co-morbidity (AOR=0.508, CI=0.293-0.879, P=0.04). Pregnant women with mild to moderate infection reported better pregnancy outcome compared to women with severe infection (AOR=7.376, CI=3.557-15.292, P<0.001).  In contrast, COVID-19 diagnosis in 1st and 2nd trimesters significantly reduced the good pregnancy outcome compared to pregnant women with diagnosis of COVID-19 in 3rd trimester of the pregnancy (AOR=0.009, CI=0.005-0.015, P<0.001 and AOR=0.113, CI=0.072-0.179, P<0.001 respectively). Conclusion: Our study showed poor pregnancy outcome among severe vs mild to moderate infection and diagnosis in 1st and 2nd trimesters vs 3rd trimester among COVID-19 positive women. Further, increased severity of COVID-19 infection among pregnant women with co-morbidities vs no comorbidities.

Introduction: Biomedical Informatics is a rapidly growing discipline, which intersects the fields of Information Communication Technology, Medicine and Biology. Given the multidisciplinary and rapidly evolving nature of this field of study, trainees and graduates may possess a variety of academic and research interests, complicating the task of training and curriculum development. The aim of this study is to identify the key interest areas among the trainees of existing post graduate programmes in Biomedical and Health Informatics, conducted by the Post Graduate Institute of Medicine (PGIM), Sri Lanka in view of identifying their key learning needs. Methods: A web-based survey was conducted among current MSc trainees of Biomedical Informatics and MD

Introduction: Reproductive, Maternal, Newborn , Child, Adolescent and Youth Health (RMNCAYH) programme in Sri Lanka is an exemplary model in the region. Family Health Bureau (FHB) conducts numerous training programmes for different levels of public health staff involved in RMNCAYH services. Even though these training programmes are proven a success for many years, there are numerous challenges from both FHB and trainee's perspective due to resource limitation. The aim of this project was to assess the needs and to design & develop an electronic learning management system to train public health medical officers in maternal and child health services. Methods: The project contained two main components. The first component was a need assessment for a Learning Management System (LMS) for courses conducted by the Family Health Bureau among end-users. It was a cross-sectional descriptive study, using a self-administrated questionnaire among all Medical Officers of Health (MOH), Additional Medical Officers of Health (AMOH) and Medical Officers of Maternal and Child Health (MO-MCH) distributed in electronic format. Email addresses were obtained from the official email database available at FHB. Associations were analysed using Kruskal-Wallis statistics-H. The second component was the designing and development of electronic LMS by customising free and open-source Moodle platform according to a custom-made development model. Pre-test conducted within the FHB among Medical Officers. Results: Responses given to the questionnaire show that participants prefer courses with a shorter duration for conventional training programmes (60.30%). The majority preferred blended training models over conventional methods (68.84%). The preferred model (from online training, conventional, or blended training model) is significantly associated with previous participation in web-based training (Ha = 12.04, DF = 1, P = 0.001), knowledge of using internet/web surfing(Ha = 10.73, DF = 1, P = 0.001), and how often participants using computer for office work (Ha= 23.88, DF = 2, P = 0.000) respectively. LMS was developed by customising Moodle version 3.7.2, and the Theme selected was the 'Trending'. Alternations to the system were done according to the comments received. The final product was named as eBridge since the LSM is bridging the gap between the trainers and trainees. Conclusions: Majority prefer blended training programmes in contrast to conventional programmes conducted by the FHB. Study variables related to computer and digital literacy of MOHs and AMOHs were significantly associated with the preferred method of training. The final product of the electronic learning management system to train Medical Officers of Health, Medical Officer of Maternal and Child Health was developed according to the needs. Post-implementation assessment needed to be carried on eBridge-LMS to assess the effectiveness and cost-benefit.

Telehealth is the delivery of health-related services and information using electronic information and communication technologies. Telehealth enables the health service providers to connect with a remote patient to provide care, advice, reminders, education, intervention, monitoring and facilitates remote admissions. Due to COVID-19 related travel restrictions, disruptions in access to healthcare were observed in Sri Lanka. Therefore, a telehealth solution to connect patients where specialist medical doctors were inaccessible or unavailable, was planned and implemented in the North Central province of Sri Lanka in 2020. The objective of this case study is to describe the experience during the planning and implementation of the telehealth intervention. Issues faced during planning and implementation were securing adequate funds, limited knowledge of information technology among the health staff, the reluctance of patients to explain and show the signs through video consultation, and difficulties faced during the allocation of responsibility at each step of the telehealth services and provision of network facilities to peripheral hospitals. These issues were overcome by creating awareness among the key stakeholders on telehealth and its advantages, addressing concerns of the patients and conducting awareness campaigns on telehealth, streamlining the maintenance of equipment and most importantly, addressing concerns of the administrators, including health officials, and obtaining their consensus for the implementation of telehealth services. If these key issues can be forecasted and addressed timely, telehealth services could be successfully implemented in a resource-limited country like Sri Lanka.

Emotional support and services provided by Public Health Midwives (PHMs) play a crucial role  in identification and management of maternal mental health disorders as they are the first line  contact in maternal and child-care and the focal field health members in caring for the antepartum  and postpartum mothers. Aim of this study was to describe the Sri Lankan PHMs’ knowledge on  maternal mental health disorders. Cross-sectional descriptive study was conducted using  probability proportionate sampling, covering PHMs of all districts in Sri Lanka. Total of 434  PHMs were recruited with 99.1% response rate. A content-validated pre-tested questionnaire was  administered. Univariate and multivariate analysis was used to assess the knowledge of each  component with selected study variables. Respondents’ mean age was 40.6 years. Out of the 430  PHMs, 36% of them were unaware, that symptoms of Depression and anxiety could be  commonly seen during antenatal and postpartum period. It was found that only 21.8% of the  respondents knew the average number of maternal deaths due to suicides in Sri Lanka. Forty seven percentage of the respondents did not know, that providing understanding, empathy and  support was the most appropriate step in managing mothers with Postpartum Blues. This study  findings highlight major deficiencies in basic knowledge of PHMs in identifying and initial  management of common maternal mental health disorders. Therefore, focus on continuous  professional development of PHMs should be prioritized.