Karra Publishes Journal Article on Postpartum IUD Counseling in Sri Lanka
Mahesh Karra, Assistant Professor of Global Development Policy at the Frederick S. Pardee School of Global Studies at Boston University, co-wrote a recently published journal article in International Perspectives on Sexual and Reproductive Health.
Karra’s article, entitled “Ethnolinguistic Concordance and the Receipt of Postpartum IUD Counseling Services in Sri Lanka,” was published in International Perspectives on Sexual and Reproductive Health.
From the text of the article:
Context
Ethnic and linguistic concordance are important dimensions of the patient-physician relationship, and are linked to health care disparities. However, evidence on the associations between health behavior and outcomes and patient-provider concordance is limited, especially in low- and middle-income settings.
Methods
To examine how concordance between women and their primary health midwife is associated with women’s receipt of postpartum IUD counseling, observational data from a cluster-randomized trial assessing an intervention to increase postpartum IUD counseling were used. Data on 4,497 women who delivered at six hospitals in Sri Lanka between September 2015 and March 2017 were merged with data on 245 primary health midwives, and indicators of linguistic concordance, ethnic concordance and their interaction were generated. Multivariate logistic regression analyses were used to assess the associations between concordance and women’s receipt of counseling.
Results
Women from non-Sinhalese groups in Sri Lanka face disparities in the receipt of postpartum IUD counseling. Compared with the ethnolinguistic majority (Sinhalese women who speak only Sinhala), non-Sinhalese women have lower odds of having received postpartum IUD counseling, whether they speak both Sinhala and Tamil (odds ratio, 0.6) or only Tamil (0.5). Ethnic discordance— rather than linguistic discordance—is the primary driver of this disparity.
Conclusions
The findings highlight the need for interventions that aim to bridge the sociocultural gaps between providers and patients. Matching women and their providers on ethnolinguistic background may help to reduce disparities in care.
Karra’s academic and research interests are broadly in development economics, health economics, quantitative methods, and applied demography. His research utilizes experimental and non-experimental methods to investigate the relationships between population, health, and economic development in low- and middle-income countries.