Generating Evidence for Ending Preventable Maternal Deaths

GEEPMD posts and NEWS…

Publications and dissemination of results

Journal articles
  1. Agampodi, T. C., Wickramasinghe, N. D., Prasanna, R. I. R., Irangani, M. K. L., Banda, J. M. S., Jayathilake, P. M. B., … & Agampodi, S. B. (2020). The Rajarata pregnancy cohort (RaPCo): study protocol. BMC pregnancy and childbirth20(1), 1-13. 
  2. Agampodi, T. C., Wickramasinghe, N. D., Jayakodi, H. G., Amarasinghe, G. S., Warnasekara, J. N., Hettiarachchi, A. U., … & Agampodi, S. B. (2021). The hidden burden of adolescent pregnancies in rural Sri Lanka; findings of the Rajarata Pregnancy Cohort. BMC Pregnancy and Childbirth21(1), 1-10.
  3. Agampodi, T. C., Hromi‐Fiedler, A., Agampodi, S. B., Amarasinghe, G. S., Wickramasinghe, N. D., Jayasinghe, I. U., … & Perez‐Escamilla, R. (2021). A self‐applied valid scale for rapid tracking of household food insecurity among pregnant women in Sri Lanka. Maternal & child nutrition, 17(3), e13165.
  4. Amarasinghe, G., Agampodi, T., Mendis, V., & Agampodi, S. B. (2021). The need for standard definitions in global data comparison: lessons from studying the prevalence of anaemia during pregnancy in Sri Lanka. BMJ Global Health, 6(5), e005737.
  5. Amarasinghe, G., Mendis, V., Agampodi, T., & Agampodi, S. (2021). A cross-sectional study to assess aetiology and associated factors for anaemia during first trimester of pregnancy in Anuradhapura district, Sri Lanka: a protocol. F1000Research10, 223. 
  6. Agampodi, S., Hettiarachchi, A., & Agampodi, T. (2021). Making miscarriage matter. The Lancet398(10302), 745.
  7. Gunarathne, S.P., Wickramasinghe, N.D., Agampodi, T.C. et al. How costly is the first prenatal clinic visit? Analysis of out-of-pocket expenditure in rural Sri Lanka – a country with free maternal health care. BMC Health Serv Res 21, 974 (2021).
  8. Hettiarachchi, A., Lokunarangoda, N., Agampodi, T., & Agampodi, S. (2021). Disease burden and adverse pregnancy outcomes due to cardiovascular conditions complicating pregnancy in Sri Lanka: a protocol. F1000Research10(1028), 1028.
  9. Jayasinghe, I. U., Agampodi, T. C., Dissanayake, A. K., Srimantha, S. M., & Agampodi, S. B. (2022). Comparison of global definitions of metabolic syndrome in early pregnancy among the Rajarata Pregnancy Cohort participants in Sri Lanka. Scientific Reports12(1), 1-11.
  10. Jayasinghe, I., Wickramasinghe, Y., Dilanka, M. K., Samarakoon, N., Rupasinghe, I., Ponmalay, P., & Agampodi, S. B. (2022). Feasibility of using telephone interviews and internet-based message services during the COVID-19 pandemic in rural Sri Lanka: experiences of the Rajarata Pregnancy Cohort. Rural and Remote Health22(2).
  11. Koralegedara, I. S., Warnasekara, J. N., Dayaratne, K. G., De Silva, F. N., Premadasa, J. K., & Agampodi, S. B. (2022). Non-alcoholic fatty liver disease (NAFLD): a significant predictor of gestational diabetes mellitus (GDM) and early pregnancy miscarriages—prospective study in Rajarata Pregnancy Cohort (RaPCo). BMJ Open Gastroenterology9(1), e000831.
  12. Koralegedara, I. S., Warnasekara, J. N., Rathnayake, A., Dayaratne, K. G., & Agampodi, S. B. (2022). Fatty Liver Index is a valid predictor of non-alcoholic fatty liver disease (NAFLD) in pregnancy. BMJ open gastroenterology9(1), e000913.
  13. Amarasinghe, G. S., Agampodi, T. C., Mendis, V., Malawanage, K., Kappagoda, C., & Agampodi, S. B. (2022). Prevalence and aetiologies of anaemia among first trimester pregnant women in Sri Lanka; the need for revisiting the current control strategies. BMC Pregnancy and Childbirth22(1), 1-12.
  14. Gunarathne, S. P., Wickramasinghe, N. D., Agampodi, T. C., Prasanna, I. R., & Agampodi, S. B. (2021). Economic burden of out-of-pocket expenditure, productivity cost during pregnancy and COVID-19 impact on household economy in a cohort of pregnant women in Anuradhapura District, Sri Lanka; A study protocol. F1000Research10.
  15. Rajapakse, S., Wickramasinghe, N., Warnasekara, J., Abeyrathna, P., Amarasinghe, G., Hettiarachchi, A. U., … & Agampodi, S. B. (2022). Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period. PloS one17(7), e0269888.
  16. Gunarathne, S. P., Wickramasinghe, N. D., Agampodi, T. C., Prasanna, I. R., & Agampodi, S. B. (2022). The magnitude of out‐of‐pocket expenditure for antenatal care in low and middle‐income countries: A systematic review and meta‐analysis. The International Journal of Health Planning and Management.

Invited Speeches
  1. Untold Stories of Maternal Morbidity and Mortality in the Pandemic. Annual Academic sessions of Perinatal Society of Sri Lanka 2021. 12th-14th of November 2021, Shangri-La Hotel, Colombo, Sri Lanka
  2. An experience in integrating maternal mental health into the pregnancy care programme. Annual Academic sessions of Perinatal Society of Sri Lanka 2020. 14th-16th of December 2020, Waters Edge, Battaramulla, Sri Lanka
  3. CKD and Renal functions in Pregnancy: Experience from Rajarata Pregnancy Cohort (RaPCo). 53rd Annual Scientific Congress Sri Lanka College of Obstetricians and Gynaecologists. 12th – 13th December 2020, Hotel Galadari, Colombo, Sri Lanka

Introduction to GEEPMD by project partners


Public health midwives (PHMs) in Anuradhapura district register around 17,000 pregnant mothers every year with around 14,000 deliveries.
The public health information system data in 2017-18 shows that 30-50% of these mothers (up to 8000) are having low hemoglobin levels.
Our previous studies shows that pregnant mothers in Anuradhapura undergo various ill health conditions;
1. High blood glucose level during pregnancy 10.6% (~1700 mothers annually)
2. Anxiety and depression during pregnancy 16% (~2720 mothers)
3. Depression after child birth 27% (~4500 mothers)

Reanalysis of maternal deaths in the province shows that suicide is the leading cause of death among pregnant and postpartum mothers. During a three year period from 2013-16, are than 150 pregnant and breastfeeding mothers were hospitalized in one area, due to intentional self-hram.

In addition to these leading issues, heart disease in pregnancy, non communicable diseases, weight gain during pregnancy, low birth weight and related neonatal complications are also major health issues related to the maternal care programme in Anuradhapura.

What are we going to do?

We want to improve the lives of pregnant mothers and newborn children in Anuradhapura through evidence based interventions and policy changes.

Our work will include, health promotion, investigation and treating the underlying causes of anemia, early identification of heart diseases, gestational diabetes, liver diseases, metabolic syndrome, hypertension and mental health problems during pregnancy.

Our in-depth exploration of maternal ill health will provide us evidence for policy changes in maternal care. The collaboration with the provincial health department will ensure that the policy changes will take place.

Our collaborators

We have multiple project partners involved in this work. Academics, practitioners, funding agencies and individual contributors. The lead institute is the Maternal and Child Health Research Unit, DoCM, FMAS, RUSL. All planning and implementations are done with the medcial officer maternal and child health (MOMCH) and the consultant community physician (CCP) of Anuradhapura district.
The reserch component of the project is funded through the AHEAD grant of UGC, World Bank. We also received funding support from other organizations and individuals.

Rajarata University of Sri Lanka (RUSL) project staff

DoCM is leading the project and six other departments from FMAS are collaborating with us. Faculty of Social Sciences is the main collaborator from The RUSL.


GEEPMD is funded by the Accelerating Higher Education Expansion and Development (AHEAD) Operation of the Ministry of Higher Education, Sri Lanka.(

Under the Results Area 3 of AHEAD, GEEPMD has received a funding for Development- Oriented Research (DOR) in universities and non-state HEIs.
AHEAD is a World Bank funded Sri Lankan government operation to support the higher education sector