Boosting safe childbirth and obstetric care in Sri Lanka

Dr. Darshana Abeygunawardana (48) heads the obstetrics and gynaecology unit at the Base Hospital Homagama (BHH) – a leading public healthcare facility in western Sri Lanka. With his 20+ years of experience, he guides the unit to create a safe and caring environment for expectant mothers, ensuring a pleasant and healthy journey into motherhood. The unit also provides gynaecology care and is equipped to handle emergencies.

BHH has the second-highest population catchment in the country and Dr. Abeygunawardana’s unit handles over 100 births, cares for over 70 warded pregnant mothers, 300 outpatients and undertakes 50+ major surgeries each month. However, in 2022, as the impacts of the economic crisis began trickling into the health sector, the unit’s capacity was severely curtailed due to shortages of essential drugs.

 “During the economic crises, we faced a shortage of Oxytocin injections, “Dr. Abeygunawardana recalled. Oxytocin is an essential drug that assures effective healthcare for the mother and the baby during obstetrics emergencies and complications such as delayed labour, haemorrhaging after childbirth, and miscarriages. Haemorrhaging after the delivery of the baby, also known as Postpartum Haemorrhage (PPH), is a life-threatening situation that requires prompt action.

“Oxytocin is a naturally occurring hormone in the human body and plays an important role in pregnancy and childbirth ensuring the health of the mother and the child. For specific obstetric complications and emergencies, synthetic Oxytocin is administered to ensure the good health and safety of the mother and the baby,” he explained further.

With a vital drug such as Oxytocin running low, the obstetrics and gynaecology unit was met with the challenge of ensuring a smooth flow of their crucial operations.  “We were faced with a grave concern at the hospital as childbirth and obstetrics care cannot be delayed or postponed. We needed to be ready and equipped to provide for the usual flow of births regardless of the crisis and ensure a safe environment for the mothers and their newborns,” Dr. Abeygunawardana explained.

In August 2022, UNICEF helped sustain the emergency obstetrics services at BHH through the procurement of Oxytocin injections. “The support from UNICEF was a timely intervention; by ensuring the availability of essential drugs we could assure all mothers at this health facility access to effective care to experience a safe birth and a healthy life beyond,” he added.

The procurement of Oxytocin injections by UNICEF, with funding from Rotary International, was part of a supply of essential medicines to the Ministry of Health (MoH) during a critical time when the country faced shortages of medicine supplies. The scarcity of life-saving drugs disrupted the public health system, which covers approximately 95% of the country’s in-patient care and 50% of out-patient care. Ensuring the continuous supply of essential medicines helped the network of base and teaching hospitals across Sri Lanka continue to provide quality healthcare for mothers and their newborns.