Dayasiri Kavinda, Gunarathna Gihan
Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
BMJ Paediatr Open. 2025 Aug 6;9(1):e003750. doi: 10.1136/bmjpo-2025-003750.
Children of incarcerated substance-abusing mothers represent a profoundly vulnerable yet under-researched population in low- and middle-income countries (LMICs). In Sri Lanka, the intersection of maternal addiction, incarceration and poverty poses complex threats to child health and development. This study explores the lived experiences of such mothers and the perceived risks their children face.
A qualitative, phenomenological study was conducted using 10 focus group discussions (FGDs) with 48 incarcerated mothers in Sri Lanka's largest female correctional facility. Participants were purposively sampled to ensure diversity in age, drug use history and caregiving experience. Data were collected through structured, audio-recorded FGDs conducted in Sinhala, transcribed, translated and thematically analysed using Braun and Clarke's framework. A second-order analysis was performed to interpret systemic drivers.
Five major themes emerged: (1) barriers to healthcare access, (2) intergenerational substance use, (3) social stigma and marginalisation, (4) maternal guilt and psychological burden and (5) coping strategies and resilience. Many mothers described how stigma, fear of withdrawal and trauma hindered timely healthcare for themselves and their children. Substance use was often normalised in their families and workplaces, particularly in contexts of poverty, exploitation and domestic violence. Despite adversity, many participants expressed hope for recovery, supported by kinship networks, particularly maternal figures.
Substance use among incarcerated mothers in Sri Lanka is deeply entwined with structural violence, gendered labour exploitation and intergenerational trauma. Child health interventions must be trauma-informed, gender-responsive and family-centred, promoting rehabilitation while safeguarding child development.
在低收入和中等收入国家（LMICs），被监禁的吸毒母亲的子女是一个极其脆弱但研究不足的群体。在斯里兰卡，母亲成瘾、被监禁和贫困相互交织，对儿童的健康和发展构成了复杂的威胁。本研究探讨了这类母亲的生活经历以及她们认为自己孩子所面临的风险。
采用定性的现象学研究方法，在斯里兰卡最大的女子惩教设施中，与48名被监禁的母亲进行了10次焦点小组讨论（FGD）。目的抽样选取参与者，以确保年龄、吸毒史和照顾经验的多样性。通过用僧伽罗语进行的结构化、录音的焦点小组讨论收集数据，进行转录、翻译，并使用布劳恩和克拉克的框架进行主题分析。进行二阶分析以解释系统性驱动因素。
出现了五个主要主题：（1）获得医疗保健的障碍；（2）代际物质使用；（3）社会耻辱和边缘化；（4）母亲的内疚和心理负担；（5）应对策略和恢复力。许多母亲描述了耻辱感、对戒毒反应的恐惧和创伤如何阻碍了她们自己和孩子及时获得医疗保健。在她们的家庭和工作场所，物质使用往往被正常化，特别是在贫困、剥削和家庭暴力的情况下。尽管面临逆境，但许多参与者在亲属网络，特别是母亲角色的支持下，表达了对康复的希望。
斯里兰卡被监禁母亲中的物质使用与结构性暴力、性别化的劳动剥削和代际创伤紧密相连。儿童健康干预必须考虑到创伤因素、对性别问题有敏感认识并以家庭为中心，在促进康复的同时保障儿童的发展。
