Ethnolinguistic Concordance and the Provision of Postpartum IUD (PPIUD) Counseling Services in Sri Lanka

Mahesh Karra , Boston University
Erin Pearson, Ipas
David Canning, Harvard University
Iqbal H. Shah, World Health Organization (WHO)
Ranjith de Silva, Sri Lanka College of Obstetricians and Gynaecologists
Arnjali Samarasekera, Sri Lanka College of Obstetricians and Gynaecologists

Ethnic and linguistic concordance are important dimensions of the patient-physician relationship and are linked to health care disparities. This study examines how concordance between women and their Primary Health Midwives (PHMs) in Sri Lanka is associated with women's receipt of postpartum IUD (PPIUD) counseling services. We use data from a cluster-randomized trial, in which women who delivered in six hospitals were offered PPIUD counseling services. Hospitals received an intervention that aimed to increase access to postpartum contraception counseling, with an emphasis on the PPIUD. We link data on women with data on PHMs and generate indicators of linguistic concordance (whether the woman’s spoken language(s) match with her PHM's spoken language(s)), ethnic concordance (whether the woman’s ethnicity matches with her PHM's ethnicity). We find that women from ethnolinguistic minority groups face larger disparities in receiving counseling. We identify ethnic discordance to be the driver of this disparity rather than linguistic discordance.

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 Presented in Session 244. Disparities and Equity in Reproductive Health