title: Productivity cost due to maternal ill health in Sri Lanka.
abstract: BACKGROUND
  The global impact of maternal ill health on economic productivity is estimated to be over 15 billion USD per year. Global data on productivity cost associated with maternal ill health are limited to estimations based on secondary data. Purpose of our study was to determine the productivity cost due to maternal ill health during pregnancy in Sri Lanka.
  
  
  RESULTS
  We studied 466 pregnant women, aged 24 to 36 weeks, residing in Anuradhapura, Sri Lanka. A two stage cluster sampling procedure was used in a cross sectional design and all pregnant women were interviewed at clinic centers, using the culturally adapted Immpact tool kit for productivity cost assessment. Of the 466 pregnant women studied, 421 (90.3%) reported at least one ill health condition during the pregnancy period, and 353 (83.8%) of them had conditions affecting their daily life. Total incapacitation requiring another person to carry out all their routine activities was reported by 122 (26.1%) of the women. In this study sample, during the last episode of ill health, total number of days lost due to absenteeism was 3,356 (32.9% of total loss) and the days lost due to presenteeism was 6,832.8 (67.1% of the total loss). Of the 353 women with ill health conditions affecting their daily life, 280 (60%) had coping strategies to recover loss of productivity. Of the coping strategies used to recover productivity loss during maternal ill health, 76.8% (n = 215) was an intra-household adaptation, and 22.8% (n = 64) was through social networks. Loss of productivity was 28.9 days per episode of maternal ill health. The mean productivity cost due to last episode of ill health in this sample was Rs.8,444.26 (95% CI-Rs.6888.74-Rs.9999.78).
  
  
  CONCLUSIONS
  Maternal ill health has a major impact on household productivity and economy. The major impact is due to, generally ignored minor ailments during pregnancy.
authors.affiliation: Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka. sunethagampodi@yahoo.com
authors.forename: Suneth
authors.initials: S
authors.lastname: Agampodi
authors.forename: Thilini
authors.initials: T
authors.lastname: Agampodi
authors.forename: Nuwan
authors.initials: N
authors.lastname: Wickramasinghe
authors.forename: Santhushya
authors.initials: S
authors.lastname: Fernando
authors.forename: Umanga
authors.initials: U
authors.lastname: Chathurani
authors.forename: Wathsala
authors.initials: W
authors.lastname: Adhikari
authors.forename: Ishani
authors.initials: I
authors.lastname: Dharshika
authors.forename: Dhanaseela
authors.initials: D
authors.lastname: Nugegoda
authors.forename: Samath
authors.initials: S
authors.lastname: Dharmaratne
authors.forename: David
authors.initials: D
authors.lastname: Newlands
mesh_terms: D000328:Adult; D017281:Cost of Illness; D004526:Efficiency; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008429:Maternal Welfare / Q000191:economics*; D011247:Pregnancy; D013188:Sri Lanka