Abstract
The Inclusive System for Effective Eye-care (I-SEE) is a pilot project for disability inclusion in eye health in Bandung district of Indonesia. The aim of this research was to investigate factors influencing the introduction, i.e., adoption, implementation and continuation of I-SEE. A qualitative exploratory study was conducted by interviewing relevant stakeholders (n = 27) and users with disabilities (n = 12). A theoretical framework on the introduction of innovations in health care was used to guide data collection and thematic analysis. Factors related to the characteristics of the innovation (I-SEE) (e.g., infrastructure, equipment, engagement of people with disabilities, inclusive communication), service provider characteristics (e.g., motivation, attitudes, training), organizational characteristics (e.g., supervision, indicators, data), and the socio-political context of I-SEE (policy, motivation of users, family support, costs, transport) were essential for supporting the introduction process. Additionally, stakeholders proposed strategies for enhancing the introduction of I-SEE (e.g., awareness, collaborations). While there are specific disability related factors, most factors influencing the introduction of disability inclusive eye health were similar to introducing any innovation in general health care. Strategies for disability inclusion should be included from the planning phase of an eye health program and are reasonably simple to adapt.
Highlights
They reported that engagement of people with disabilities, accessible health service infrastructure, accessible methods of communication, the availability of human resources and equipment were all important characteristics of a disability inclusive eye health program
As a pilot project in Bandung district, it provided the opportunity to learn what is feasible for a disability inclusive eye health system
This study identified that the majority of the factors perceived to be influencing the introduction of Inclusive System for Effective Eye-care (I-SEE) pilot project were related to implementation and continuations stages
Summary
The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) defines disability as an outcome of an interaction between an individual’s health condition and the contextual (environmental and personal) factors the individual lives in [1]. People with disabilities have similar health care needs as others but often face barriers in accessing health care, in low and middle income countries [2]. These barriers include geographic location of services, inadequate transportation facilities, costs of getting to care, inadequate referrals, and negative attitudes of service providers and the community [3,4].
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