ArticleReproductive health2022
Social determinants of health pave the path to maternal deaths in rural Sri Lanka: reflections from social autopsies.
Article in Reproductive health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Maternal social determinants of health: the hidden face of perinatal mortality in Mexico.International journal for equity in health · 2025Article
- What do women experiencing domestic violence expect from healthcare professionals? A qualitative study in Sri Lanka.BMJ open · 2024Article
- Article
- Adolescents' Tsunami Exposure and Mental Health Consequences: Protective Role of Cultural Coping Strategies.International journal of environmental research and public health · 2024Article
- Mobilising Communities Prior to Healthcare Interventions: Reflections on the Role of Public Health Midwives Working With Vulnerable Communities of Sri Lanka.Community health equity research & policy · 2024Article
- Out-of-Pocket Expenditure for Antenatal Care Amid Free Health Care Provision: Evidence From a Large Pregnancy Cohort in Rural Sri Lanka.Global health, science and practice · 2023Article
- Incorporating early pregnancy mental health screening and management into routine maternal care: experience from the Rajarata Pregnancy Cohort (RaPCo), Sri Lanka.BMJ global health · 2023Article
- Alcohol use, self-harm and suicide: a scoping review of its portrayal in the Sri Lankan literature.Heliyon · 2023Article
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7 authors at 1 institution in 1 country.
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Abstract
backgroundEnding preventable maternal deaths remains a challenge in low- and middle-income countries (LMICs). Society perceived causes and real-life observations can reveal the intangible causes of maternal deaths irrespective of formal maternal death investigations. This study reports complex patterns in which social determinants act towards paving the path to maternal deaths in a rural Sri Lankan setting.
methodsWe conducted social autopsies for 15/18 maternal deaths (in two consecutive years during the past decade) in district A (pseudonymized). In-depth interviews of 43 respondents and observations were recorded in the same field sites. During thematic analysis, identified themes were further classified according to the World Health Organization framework for social determinants of health (SDH). The patterns between themes and clustering of social determinants based on the type of maternal deaths were analyzed using mixed methods.
resultsDiscernable social causes underpinned 12 out of 15 maternal deaths. Extreme poverty, low educational level, gender inequity, and elementary or below-level occupations of the husband were the characteristic structural determinants of most deceased families. Social isolation was the commonest leading cause manifesting as a reason for many other social factors and resulted in poor social support paving the path to most maternal deaths. A core set of poverty, social isolation, and poor social support acted together with alcohol usage, and violence leading to suicides. These core determinants mediating through neglected self-health care led to delay in health-seeking. Deficits in quality of care and neglect were noted at health institutions and the field.
conclusionSocial autopsies of maternal deaths revealed complex social issues and social determinants of health leading to maternal deaths in Sri Lanka, indicating the need for a socially sensitive health system.
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