Establishing a school-based vision screening program in Myanmar: a qualitative study on the perspectives of school children with refractive error, teachers, optometrists and ophthalmologists

Abstract

Background: Refractive error (RE) is one of the global leading causes of vision impairment among children. The World Health Organization outlined the school-based vision care program aided by school teachers as one solution. In Myanmar, although the prevalence of RE among school children is expected at about two million, a regular eye check-up program has not been established. This study aimed to explore the barriers, feasibility, and limitations of the children with RE and service providers to establish a program.Methods: This qualitative study was conducted in eight public schools,that have been involved in the pilot school-based vision screening program, in Yangon. Focus group discussions with school children and teachers from these schools, key informant interviews with optometrists and ophthalmologists, involved in the program, and working at Yangon Eye Hospital and North Okala General Hospital, were carried out from January to August 2020. Qualitative data analysis was manually performed using the grounded theory according to the pre-defined themes.Results: Almost all school children showed positive perspectives but they expressed their psychosocial barriers of the cost, time, and care given by their parents on the next vision examination. All teachers mentioned optimism to be volunteers. The optometrist and ophthalmologists revealed the feasibility to establish the program despite having limitations in human resources, logistic requirements, and low awareness level on visual impairment of the children by parents.Conclusions: This study highlighted that a school-based vision care program can be initiated in Myanmar despite having some barriers and limitations.