Investigator(s)
| WHO Technical Officer |
Thirupathy Suveendran WHO Thirupathy Suveendran 
|
| Principal Investigator |
Inoka Kamalinie Suraweera Consultant Community Physician Environmental and Occupational Health Unit, Ministry of Health, Sri Lanka Inoka Kamalinie Suraweera
|
| Co-Investigator(s) |
Chandanee Withana Director Directorate of Environmental and Occupational Health and Food Safety, Ministry of Health, Sri Lanka Chandanee Withana
|
| Co-Investigator(s) |
Gayan Lakmal Padmashantha Ariyadasa Senior Registar in Commuinty Medicine, Environmental and Occupational Health and Food Safety Directorate, Ministry of Health, Sri Lanka Gayan Lakmal Padmashantha Ariyadasa
|
| Co-Investigator(s) |
Kanchana Erandi Jayamana Registar in Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka Kanchana Erandi Jayamana
|
| Co-Investigator(s) |
MAHESH PRIYADARSHANA KUMBUKAGE Acting Consultant Community Physician, Directorate of Environment Health, Occupational Health and Food Safety, Ministry of Health, Sri Lanka MAHESH PRIYADARSHANA KUMBUKAGE
|
Title(s) and abstract
| Scientific title | Prevalence, Associated Factors, Perceptions, Drivers and Barriers of Skin‑Lightening Products Usage Among Hospital Health Assistants in Selected Tertiary Care Hospitals in Sri Lanka |
| Public title | Prevalence, Associated Factors, Perceptions, Drivers and Barriers of Skin‑Lightening Products Usage Among Hospital Health Assistants in Selected Tertiary Care Hospitals in Sri Lanka |
| Background | Skin lightening is a widespread practice influenced by historical, cultural, and psychological factors. Fair skin has long been linked to beauty, privilege, and social status, with evidence of ancient cosmetic traditions where toxic substances such as arsenic and lead were used to achieve lighter complexions. Today, the skin-lightening industry is a multibillion-dollar global market, with the Asia-Pacific region alone generating more than half of global revenue in 2018. However, many widely available products contain harmful ingredients including mercury, hydroquinone, and corticosteroids, which can cause serious health problems such as kidney and neurological damage. In Sri Lanka, misuse of unregulated skin-lightening products raises concerns about rising skin cancer rates. This study investigates prevalence, perceptions, drivers, and barriers of use among hospital workers, contextualizing findings with local and international evidence to guide effective interventions. |
| Objectives | Objective: To determine the prevalence, associated factors, perceptions, drivers and barriers of Skin‑Lightening Products usage among hospital health assistants in selected tertiary care hospitals in Sri Lanka Specific Objective: 1. To assess the prevalence of Skin‑Lightening product usage among hospital health assistants in selected tertiary care hospitals in Sri Lanka 2. To determine the associated factors of Skin‑Lightening Products usage among hospital health assistants in selected tertiary care hospitals in Sri Lanka 3. To explore the perceptions, drivers and barriers of Skin‑Lightening Products usage among hospital health assistants in selected tertiary care hospitals in Sri Lanka |
| Study Methods | This study uses a convergent parallel mixed-methods design, combining a quantitative cross-sectional survey and a qualitative exploratory study, conducted simultaneously to analyze the prevalence, drivers, and barriers of skin-lightening product (SLP) use among hospital health assistants in Sri Lanka. The research will take place in four randomly selected tertiary care hospitals in Gampaha, Polonnaruwa, Nuwara Eliya, and Matale. The target population includes hospital health assistants aged 18–60 years, with O/L qualifications, short in-service training, and responsibilities supporting clinical staff in workflow and hygiene maintenance. Quantitative Component: The survey aims to determine prevalence and associated socio-demographic and behavioral factors. With a 50% assumed prevalence and 95% confidence, the required sample size is 461, sampled proportionally across hospitals. Data will be collected via a pre-tested structured questionnaire covering socio-demographics, usage patterns, perceptions, drivers, barriers, and adverse effects. The tool will be translated into Sinhala and Tamil and validated. Pre-intern doctors will administer the survey, and data will be analyzed using SPSS 28, applying descriptive statistics, univariate tests, and logistic regression. Qualitative Component: Focus Group Discussions (4–6 groups) with health assistants and Key Informant Interviews (≈4) with dermatologists, pharmacists, GPs, and beauticians will explore motivations, enablers, and barriers. Sessions will be conducted in local languages, transcribed, translated, and analyzed thematically using NVivo. Ethical approval will be obtained, participation will be voluntary, and confidentiality assured. Findings will be shared with hospital authorities and the MoH to inform interventions |
| Expected outcomes and use of results | The study is expected to generate a comprehensive report for the World Health Organization, providing evidence on the prevalence, perceptions, and drivers of skin-lightening product use among hospital health assistants in Sri Lanka. A summary of findings will be submitted to the Ministry of Health and other relevant government bodies to inform the development of occupational health policies and targeted awareness programs for healthcare professionals. Beyond national use, the results will contribute to global understanding of skin-lightening practices and their health implications. To ensure wider dissemination, the findings will also be published in peer-reviewed journals and presented at both national and international conferences, supporting knowledge exchange and policy dialogue at multiple levels. |
| Keywords | Skin Lihtening Products, Behaviour |
Research Details
| Student research | No |
| Start Date | 01-Oct-2025 |
| End Date | 15-Dec-2025 |
| Key Implementing Institution | Enviromental and Occupational Health Unit, Ministry of Health and Mass Media, Sri Lanka |
| Multi-country research | No |
| Nationwide research | Yes, with randomly selected geographical areas |
| Sri Lanka, Sri Lanka, Sri Lanka, Sri Lanka | |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | |
| Involves human subjects | Yes |
| Qualitative Study | |
| Data Collection | Primary and secondary data |
| Proposal reviewed by other Committee | Under Review |