title: An investigation into the role of alcohol in self-harm in rural Sri Lanka: a protocol for a multimethod, qualitative study.
abstract: BACKGROUND
  Sri Lanka has one of the highest suicide and self-harm rates in the world and although alcohol has been found to be a risk factor for self-harm in Sri Lanka, we know little about the connection between the two. This paper comprises a protocol for a qualitative study investigating alcohol's role in self-harm in rural Sri Lanka at three levels: the individual, community and policy level. The analysis will bring new understanding of the link between alcohol and self-harm in Sri Lanka, drawing on structural, cultural and social concepts. It will equip researchers, health systems and policy makers with vital information for developing strategies to address alcohol-related problems as they relate to self-harm.
  
  
  METHODS
  To capture the complexity of the link between alcohol and self-harm in the Anuradhapura district in the North Central Province in Sri Lanka, qualitative methods will be utilised. Specifically, the data will consist of serial narrative life-story interviews with up to 20 individuals who have non-fatally self-harmed and where alcohol directly or indirectly was involved in the incidence as well as with their significant others; observations in communities and families; six focus group discussions with community members; and key-informant interviews with 15-25 stakeholders who have a stake in alcohol distribution, marketing, policies, prevention and treatment as they relate to self-harm.
  
  
  BACKGROUND
  The study has received ethical approval from the Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka. A sensitive data collection technique will be used and ethical issues will be considered throughout the study.
  
  
  RESULTS
  The results will be disseminated in scientific peer-reviewed articles in collaboration with Sri Lankan and other international research partners.
authors.affiliation: Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jane Brandt
authors.initials: JB
authors.lastname: Sørensen
authors.affiliation: Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Thilde
authors.initials: T
authors.lastname: Rheinländer
authors.affiliation: Department of Anthropology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Birgitte Refslund
authors.initials: BR
authors.lastname: Sørensen
authors.affiliation: Pharmacology, Toxicology and Therapeutics, University of Edinburgh, UK and South Asian Clinical Toxicology Research Collaboration, Edinburgh, UK.
authors.forename: Melissa
authors.initials: M
authors.lastname: Pearson
authors.affiliation: Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
authors.forename: Thilini
authors.initials: T
authors.lastname: Agampodi
authors.affiliation: Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
authors.forename: Sisira
authors.initials: S
authors.lastname: Siribaddana
authors.affiliation: Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Flemming
authors.initials: F
authors.lastname: Konradsen
mesh_terms: D000428:Alcohol Drinking; D006801:Humans; D036301:Qualitative Research; D012307:Risk Factors; D012424:Rural Population; D016728:Self-Injurious Behavior; D013188:Sri Lanka; D013405:Suicide
keywords: QUALITATIVE RESEARCH