Challenges and adaptations in communications during COVID 19 among midwives of Sri Lanka: Presenter(s): Sembakuttige Amali Chinthika Dalpatadu, General Sir John Kotelawala Defence University, Sri Lanka

INTRODUCTION AND OBJECTIVES: The role of midwives in maternal and childcare is greatly hampered due to challenges in communication during COVID pandemic. This study explores challenges and adaptations for communication. METHODS: This FGD based qualitative study included 12 PHMs from a field clinic and 11 midwives were from a ward setting from Anuradhapura district, Sri Lanka in two separate focus group discussions. The focus group discussions based on a pretested interviewer guide were audio-recorded, transcribed and thematically analysed. RESULTS: Challenges faced and adaptations made were described under twelve sub themes. Disruption of bonding, difficulty in clear comprehension, compromised communication due to lack of non-verbal expressions, limited talk time and lack of “reassuring touch” were the different categories of challenges identified. Using the telephone for inquiry, managing time to accommodate patient care, explaining the limitations of care to mothers beforehand were the common adaptations made. Lack of non-verbal communication was pointed out as the most important barrier in building up a good relationship. The time spent on proactive health education, were compromised and individually modified to according level of knowledge, understanding capacity and available support. Conversations seem to have focused more on COVID advice more than proactive advice on health promotion. CONCLUSIONS: The main challenges were the distance and lack of nonverbal cues. However the care delivery was provided under dire circumstances with minimum interruption to communication. Public health midwives made adaptations in order to communicate efficiently and effectively and went and extra mile to do so. Alternative routes of communication have proven extremely useful under these difficult circumstances. Keywords: Midwives, adaptations, Focus Group Discussion (FGD), communication, Anuradhapura, Sri Lanka