Eye Health Care Services Research Articles

Pattern of Eye Health Care Services in a Tertiary Specialized Eye Hospital in Bangladesh

A retrospective study was conducted in Sheikh Fazilatunnesa Mujib Eye Hospital and Training Institute, Gopalganj, Bangladesh, to analyze the trends of eye diseases in Bangladesh and surgical treatments provided by a tertiary eye hospital to manage them. A total of eighty-eight thousand nine hundred fifty-eight subjects attended the hospital for their ophthalmic checkup from the southern part of Bangladesh. Patience was evaluated according to their complaints; patient demographic data and medical history were retrospectively collected. Complete ophthalmic examination was performed. The study included 44,187 males and 44,771 females. Most of the patients were above 50 years while the toddlers were the least. The highest performed minor procedure was sac patency test and incision and curettage for chalazion was the minimum. regarding the major surgeries, cataract surgeries take the lead followed by DCR, DCT and intravitreal retinal injections. Cataract surgery and retinal injections were performed more in males whereas larger number of female patients underwent DCR and DCT. Most of the patients took their service from outpatient department. In a developing country like Bangladesh, mostly occurring ocular conditions like cataract and lacrimal apparatus diseases should be of utmost importance and National resources should be aimed at the management of such diseases. At the same time, care has to be taken to identify pediatric eye conditions at earlier age by raising awareness among parents. CBMJ 2024 July: vol. 13 no. 02 P: 235-242

Barriers to Eye Care for Adults in the United States and Solutions for It: A Literature Review.

Vision loss and blindness is a significant public health concern that has had a profound impact on various communities in the United States. Both anticipated and unforeseen barriers have been linked to the rising rates of vision loss and blindness in the country. Extensive research has identified numerous barriers that put many Americans at a disadvantage when trying to seek high-quality eye care services. Not only do the barriers to eye care services create problems for eye health, but also create a poor quality of life. Therefore, understanding and identifying barriers to eye healthcare services is incredibly important. In addition to understanding and identifying barriers, it is also important to identify solutions to the problems created by these barriers. A systematic review of articles characterizing the barriers to eye care was completed which resulted in the identification of the major barriers that affect Americans. The review of previous research was also used to identify available solutions for problems associated with the barriers to eye care services. The major barriers identified were cost, insurance, transport and accessibility, eye health care literacy, and communication. Because of the identification of the major barriers, solutions were also identified. Health education and increased vision screenings were found to be the most used forms of solutions by healthcare professionals promoting good eye health. Telemedicine has also been cited as a possible solution to the growing problem of visual impairment and blindness within the American population.

Eye Banking a Boon in Eye Health Care Services and Vision Restoration and Corneal Tattooing for Aesthetic Purposes

Eye donation and eye banking are a boon in eye health care services for visual rehabilitation and corneal tattooing aesthetic purpose in post-trauma corneal opacities. A young female reported to our hospital with a complaint of corneal opacity and difficulty in closing her left eye. On examination, she was diagnosed with a “Corneal scar with an Inadvertent bleb”. The patient reported a history of corneoscleral injury for more than four years. A slit lamp examination showed a corneal scar with a micro leak at the inferotemporal scleral region.

Relationship between the Prevalence of Glaucoma (Estimated Through Prescribed Antiglaucomatous Medication) and Access to Ophthalmologists in Norway

Purpose The relationship between supply and demand in health-care is a challenge. The purpose of the present study is to evaluate to what extent glaucoma prevalence is influenced by local access to eye health-care service in Norway. Methods Population-based cross-sectional study. Data from The Norwegian Prescription Database was used to find the number of users of topical glaucoma medication, grouped by age and county, giving an estimate of glaucoma prevalence. The number of registered ophthalmologists and opticians was obtained from The Norwegian Society of Ophthalmologists and The Norwegian Directorate of Health. Results In total, 75733 persons were treated with IOP-lowering drugs in Norway in 2018, suggesting an overall glaucoma prevalence of 1.43%. In the age group 70-89 years, the nationwide prevalence was 7.60%, the lowest prevalence being in Oppland (5.98%) and highest in Aust-Agder (9.28%) counties. The number of ophthalmologists per 100000 inhabitants varied from 2.63 to 14.65 in the various counties. A statistically significant correlation was found between glaucoma prevalence in the age group 70-89 years and access to ophthalmological services. Furthermore, the increase in glaucoma prevalence plateaus at roughly 10 ophthalmologists per 100000 inhabitants, indicating that this could cover population demands. This relationship did not apply for opticians. Conclusions There is a clear correlation between glaucoma prevalence and availability of ophthalmologists in various counties in Norway. Our study indicates a direct relationship between the number of ophthalmologists in the area and the number of people being treated for glaucoma, with prevalence plateauing once a threshold of approximately 10 ophthalmologists per 100000 inhabitants is reached. This finding suggests that low glaucoma prevalence in some regions could be due to limited access to ophthalmological services.

An Assessment of the Level of Awareness of Eye Health Care Services Provided by Onesight in the Gambia

The objective of the Scorecard study was to assess the intervention of OneSight with respect to Awareness of their services in The Gambia and the perception of Gambians on eye care in The Gambia. More specifically in this paper, the scorecard assesses the level at which people are aware of the existence, the activities and the services offered by OneSight in The Gambia. The research employed both quantitative and qualitative methods. The study revealed that the majority of the sampled respondents are aware of refractive error i.e., about 90%. Their major source of information about eye care issues was through radio however, they gather important information from other sources such as healthcare workers and television. Most of the respondents who are aware of eyesight-related problems, typically obtained information through Government clinics, only 2.8% got their information from OneSight. It was also discovered that 94.6% of the respondents sought eye care treatment from health facilities as opposed to a home or local treatments. Based on the findings, practical implications and an agenda for future research are suggested. For instance, it is recommended that OneSight should strengthen community outreach programs, improve its communication strategies, create more visibility, and conduct more publicity events for more awareness about its programme and activities.

Vision Bus Aotearoa: a platform for strengthening eye health teaching, research and community partnership

ABSTRACT Clinical Relevance Vision Bus Aotearoa is a fully equipped mobile eye health clinic designed to provide a novel platform for undergraduate optometry clinical training, community eye health research and deliver services to underserved communities. Background Aotearoa New Zealand has inequitable access to eye health care. Vision Bus Aotearoa aims to work in partnership with communities to provide comprehensive mobile primary eye health care services while training optometry students, and integrating community eye health research. Methods A description is provided of the governance model which has been involved throughout the project. Results The process of vehicle manufacture, clinical set-up, funding models and service delivery are described. The aims of the project are detailed in terms of optometry teaching, clinical services in partnership with communities, and research integration and implementation. Conclusion Vision Bus Aotearoa represents a valuable opportunity to deliver mobile eye health care to historically underserved communities, enhance undergraduate optometry teaching and to provide a unique platform for community eye health research.

Prevalence of visual impairment and associated factors among children in Ethiopia: Systematic review and meta-analysis.

Visual impairment is a major public health problem in developing countries where there is no enough health-care service. It has a significant impact on the affected child's psychological, educational and socioeconomic experiences, during childhood and beyond. Therefore, the aim of this review was to estimate the pooled prevalence of visual impairment and its associated factors among children in Ethiopia. This systematic review and meta-analysis was designed based on the PRISMA guidelines. Relevant published articles in Ethiopia from 2011-2021 were searched in PubMed/Medline, HINARI, Google scholar, and conference paper and thesis or research final reports were accessed from Ethiopian Universities' repositories. Data was extracted in Microsoft excel by using JBI data extraction checklist. The pooled prevalence and odds ratio of associated factors with their 95% CI was computed by using STATA 14/SE software. A fixed effect meta-analysis model was employed for a Cochrane Q test statistic and I2 test showed there was no heterogeneity in the included studies. A total of 7,647 children from nine studies were included in this study. The overall prevalence of visual impairment among children in Ethiopia was 7% (95% CI: 6, 7%). The pooled prevalence of visual impairment by region was almost similar in Ethiopia. However, there was no significant association between the identified factors and visual impairment among children. But the result showed that being males (AOR 0.642, 95% CI: 0.357-1.156), Children in the age of 10-13 years (AOR 0.224, 95% CI: 0.046-1.102) and 14-18 years (AOR 0.508, 95% CI: 0.102-2.534) were found to be less likely to have visual impairment. On the other hand, children of parents with visual impairment (AOR 1.820, 95% CI: 0.381-8.698) more likely to have visual impairment. Visual impairment among children in Ethiopia is still a public health problem one year later to VISION 2020, a global initiative aimed to eliminate avoidable blindness. All most one out of fourteen children in Ethiopia had visual impairment. Therefore, the government of Ethiopia should focus on effective, efficient, comprehensive eye health care services by integrating with the national health system to prevent avoidable visual impairment among children.

Evaluating eye health care services progress towards VISION 2020 goals in Gurage Zone, Ethiopia

BackgroundEthiopia signed the VISION 2020 Global Declaration and launched its eye health program in 2002. Since then, there has been limited systematic and comprehensive evaluation of the progress towards VISION 2020 goals in Ethiopia.ObjectiveTo evaluate Gurage Zone progress towards VISION 2020 targets and process indicators.MethodAn institutional-based cross-sectional study was conducted among all public and private eye health care facilities in the Gurage Zone within the Southern Nations, Nationalities, and People Region of Ethiopia. The evaluation protocol was adopted from the VISION 2020 situational analysis data collection tool. We used this structure to evaluate progress in terms of human resources for eye health, infrastructure, and service delivery at the zonal health office and health facilities. At the time of the study, Gurage Zone had a 1.7 million catchment area population. There were a total of five eye care centers, one of which was established by a non-governmental organization. Three of these facilities were secondary eye care centers with an operating theatre and two facilities were primary eye care centers. At the zonal level, there was no survey data available on the prevalence of blindness.ResultThere was no systemic evaluation of VISION 2020 process indicators. The budget allocation specific to eye health care was less than 0.7% of the total budget of the zonal health office. The human resources for eye health (HReH) in the catchment area were: one ophthalmologist, two cataract surgeons, five optometrists, and 12 ophthalmic nurses, which is below the VISION 2020 targets for HReH. In terms of equipment, neither primary eye care center had a slit lamp biomicroscope, and two of the three secondary eye care centers did not have intraocular pressure measuring equipment. Only one secondary eye care center was providing glaucoma surgical services, and no center provided emergency and elective pediatric surgery. The cataract surgical rate determined by the study was 1967.ConclusionGurage Zone showed significant improvement in terms of cataract surgical rate. But it had not achieved VISION 2020 goals in terms of critical HReH and service delivery. We recommend that the zonal health office carries out a focused and baseline evaluation of eye health care service achievements.

Eye health promotion-oriented policy statements in various national and provincial health policy documents in South Africa

Background: There are many fragmented public health policies that give directives towards various aspects of healthcare needs and implementation. However, none of these policies make specific reference to eye health promotion (EHP) as an enabler for individuals to take control of the determinants of their eye health (EH) needs.Aim: The current study sought to identify EHP messages in the various available policy documents at both national and provincial health department levels with a view to assessing awareness on the available gaps for the development of an integrated EHP policy in South Africa.Setting: The study used documents provided by the National Department of Health and those that were available online from various other provincial Departments of Health in the country.Methods: Content analysis of EH policies requested from the Directorate of Chronic Diseases, Disabilities and Geriatrics was conducted. Various other health policies that were enacted post-1994 and endorsed by the National and Provincial Departments of Health were also considered for analysis.Results: Twenty-four documents were considered for content analysis. The national guidelines on eye healthcare made reference to EH activities such as immunisation of children, vision screening of the elderly, vitamin A supplementation and maternal services to detect sexually transmitted diseases, amongst others. Of the 20 national and provincial health documents analysed, only four made reference to EH. None of these documents made any specific reference to EHP.Conclusion: Although four national guidelines contain content related to EHP, the fragmentation and lack of integration with other health policy documents may lead to eye healthcare messages not being prioritised for dissemination even where they are highly required. Also, public eye healthcare services in general will continue to lag behind as is the case in most provinces in South Africa.

Prevalence of Eye Conditions, Utilization of Eye Health Care Services, and Ophthalmic Medications After Entering Residential Aged Care in Australia.

PurposeThis study aims to evaluate the burden and trends of eye diseases, utilisation of eye health care services, and ophthalmic medications among older people living in residential aged care facilities in Australia.MethodsA cross-sectional study was conducted using data from the Registry of Senior Australians. Individuals aged ≥65 years who entered permanent residential aged care facilities between 2008 and 2015 were included. The prevalence (95% confidence interval [CI]) of eye diseases by year, eye health care services, and ophthalmic medication use within a year of entry into the service were evaluated. Poisson regression models estimated adjusted rate of change using prevalence ratio (PR) by age, sex, state, and frailty scores.ResultsOf the 409,186 people studied, 43.6% (N = 178,367) had an eye condition. Of the total cohort, 32.9% (N = 134,566) had chronic eye conditions and 19.7% (N = 80,661) had an acute eye condition. Common chronic eye conditions were glaucoma (13.6%, N = 55,830), cataract (8%, (N = 32,779), blindness (4.5%, N = 18,856), and poor vision (10.3%, N = 42,245). Prevalence of any eye condition (2008: 42.7%, 95% CI = 42.2%–43.2% and 2015: 41.2%, 95% CI = 40.8–41.6%, PR = 0.99, 95% CI = 0.99–0.99, P < 0.001), acute eye conditions (2008: 19.8%, 95% CI = 19.4%–20.2% and 2015: 17.4%, 95% CI = 17.1%–17.6%, PR = 0.97, 95% CI = 0.97–0.98, P < 0.001), and blindness (2008: 5.2%, 95% CI = 5.0%–5.4% and 2015: 3.7%, 95% CI = 3.5%–3.9%, PR = 0.93, 95% CI = 0.93–0.94, p < 0.001). decreased over the study period. The prevalence of glaucoma (2008: 13.5%, 95% CI = 13.2%–13.8% and 2015: 13.8%, 95% CI = 13.5%–13.7%; PR = 1.01, 95% CI = 0.99–1.10, P < 0.001) and cataract (2008: 7.4%, 95% CI = 7.2%–7.7% and 2015: 8.5%, 95% CI = 8.3%–8.7%, PR = 1.00, 95% CI = 1.00–1.01, P < 0.001) remained stable or slightly increased. Overall, 46.4% (N = 82,769) of individuals with eye conditions, accessed at least one eye health service within the first year of entering residential care and 70.5% (N = 125,673) used at least one ophthalmic medication. Optometric services (41.7%, N = 74,358) were the most used eye health care services and anti-infective eye drops (37.2%, N = 66,331) were the most commonly dispensed medications.ConclusionsThe prevalence of blindness among older Australian using residential aged care services decreased over the study period. However, the burden of eye diseases remained high between 2008 and 2015, whereas the use of eye health care services was disproportionately low. This study provides evidence of a significant need for eye health care services for older people with an eye disease in residential aged care facilities.Translational RelevanceFour in ten long term aged care residents in Australia had at least one eye condition over the study period, indicating potential for a high eye health care needs in aged care settings.

Eye health promotion-oriented policy statements in various national and provincial health policy documents in South Africa

Background: There are many fragmented public health policies that give directives towards various aspects of healthcare needs and implementation. However, none of these policies make specific reference to eye health promotion (EHP) as an enabler for individuals to take control of the determinants of their eye health (EH) needs. Aim: The current study sought to identify EHP messages in the various available policy documents at both national and provincial health department levels with a view to assessing awareness on the available gaps for the development of an integrated EHP policy in South Africa. Setting: The study used documents provided by the National Department of Health and those that were available online from various other provincial Departments of Health in the country. Methods: Content analysis of EH policies requested from the Directorate of Chronic Diseases, Disabilities and Geriatrics was conducted. Various other health policies that were enacted post-1994 and endorsed by the National and Provincial Departments of Health were also considered for analysis. Results: Twenty-four documents were considered for content analysis. The national guidelines on eye healthcare made reference to EH activities such as immunisation of children, vision screening of the elderly, vitamin A supplementation and maternal services to detect sexually transmitted diseases, amongst others. Of the 20 national and provincial health documents analysed, only four made reference to EH. None of these documents made any specific reference to EHP. Conclusion: Although four national guidelines contain content related to EHP, the fragmentation and lack of integration with other health policy documents may lead to eye healthcare messages not being prioritised for dissemination even where they are highly required. Also, public eye healthcare services in general will continue to lag behind as is the case in most provinces in South Africa.

Vision Screening of Learners by Teachers in Kafue District in Zambia as a Strategy to Address the Challenges of Childhood Blindness

Background: Early detection and treatment of eye diseases in children is critical in combating childhood blindness. Innovative community-based strategies such as training of teachers in vision screening need to be developed for effective utilisation of the available human resources as well as to counter the challenges of inequitable distribution of trained eye health human resourcesas well as the limited access of quality eye health care services to the majority of our population.&#x0D; Aim: To evaluate the effectiveness of using teachers as the first level of vision screeners.Materials and Methods: Teacher training programmes were conducted for schoolteachers to educate them about childhood eye diseases and the significance of their early detection. The teachers trained for the school vision screening were from all government, private and community schools located in Kafue District. The teachers then conducted vision screening of learners in their schools.Subsequently, the mobile eye health teams visited the schools for the re-evaluation of learners identified with poor vision. All learners identified with refractive errors had refraction performed on them and spectacles prescribed. The mobile eye health teams referred learners requiring a further ophthalmic evaluation to the University Teaching Hospitals – Eye Hospital which was the base hospital for the programme. The assessment included calculation of true positives, false positives, true negatives and false negatives.Results: One hundred and fifty-four (154) teachers from 73 primary and secondary schools underwent training in vision screening. The teachers screened 18,713 learners and reported eye diseases in 2,818 (15.1%) children. However, the mobile eye health teams examined 5,958 learners who included 2,818 referrals from teachers and 3,140 rescreened learners. The mobile eye health teams confirmed eye problems in 2,818 learners screened by the teachers and further diagnosed more eye problems in 999 learners giving a total of 3,817 learners with eye problems. Thus, the teachers were able to correctly identify eye problems (true positives) in 100.0% (2,818/2,818) of learners. The teachers could not identify eye problems in 999 learners giving false negatives were 26.2% (999/3,817).Conclusion: Considering the high true positive value and the comprehensive coverage provided by the survey, vision screening in schools by teachers is an effective method of identifying learners with eye problems and poor vision early. This strategy could be valuable in reducing the workload of the eye health care staff.

Vision Screening of Learners (School Children) by Teachers in Kafue District in Zambia as a Strategy to Address the Challenges of Childhood Blindness

Background: Early detection and treatment of eye diseases in children is critical in combating childhood blindness. Innovative community-based strategies such as training of teachers in vision screening need to be developed for effective utilisation of the available human resources as well as to counter the challenges of inequitable distribution of trained eye health human resources as well as the limited access of quality eye health care services to the majority of our population.&#x0D; Aim: To evaluate the effectiveness of using teachers as the first level of vision screeners.&#x0D; Materials and Methods: Teacher training programmes were conducted for schoolteachers to educate them about childhood eye diseases and the significance of their early detection. The teachers trained for the school vision screening were from all government, private and community schools located in Kafue District. The teachers then conducted vision screening of learners in their schools. Subsequently, the mobile eye health teams visited the schools for the re-evaluation of learners identified with poor vision. All learners identified with refractive errors had refraction performed on them and spectacles prescribed. The mobile eye health teams referred learners requiring a further ophthalmic evaluation to the University Teaching Hospitals – Eye Hospital which was the base hospital for the programme. The assessment included calculation of true positives, false positives, true negatives and false negatives.&#x0D; Results: One hundred and fifty-four (154) teachers from 73 primary and secondary schools underwent training in vision screening. The teachers screened 18,713 learners and reported eye diseases in 2,818 (15.1%) children. However, the mobile eye health teams examined 5,958 learners who included 2,818 referrals from teachers and 3,140 rescreened learners. The mobile eye health teams confirmed eye problems in 2,818 learners screened by the teachers and further diagnosed more eye problems in 999 learners giving a total of 3,817 learners with eye problems. Thus, the teachers were able to correctly identify eye problems (true positives) in 100.0% (2,818/2,818) of learners. The teachers could not identify eye problems in 999 learners giving false negatives were 26.2% (999/3,817).&#x0D; Conclusion: Considering the high true positive value and the comprehensive coverage provided by the survey, vision screening in schools by teachers is an effective method of identifying learners with eye problems and poor vision early. This strategy could be valuable in reducing the workload of the eye health care staff.

An Assessment of the Level of Affordability of Eye Health Care Services and Products in the Gambia – Case Study Onesight

Health care services and in particular eye care in The Gambia is plagued by exorbitant costs both direct (consultation fee, cost of medication/glasses, etc.) and indirect (cost of transportation to and from eye clinic, cost of food/sustenance during eye treatment etc.) making it luxury and barrier for the poor and vulnerable of our societies. It is for those reasons that OneSight decided to commission a survey in The Gambia. The sampling of the study was a multistage stratified cluster sampling. At each stage Probability Proportional to Size and random procedures were applied to arrive at the actual sample population of 3300 households. The study employed both quantitative and qualitative research design techniques to collect and analyze data. The finding of the study illustrated that nearly 70% of the household’s heads are willing to be the one to pay for corrective glasses should the need arise for any member of their household. 80% of the respondents reported in affirmative that there are costs required in making eyesight better. It was also disclosed that respondents are willing to pay for a pair of eye glasses GMD 0 (free eyeglasses) to GMD 20,000. The Focus Group Discussion conducted across The Gambia almost all participants unanimously recommended that the affordable cost for a pair of glasses should be GMD50.

Special Report OSP

This report highlights recent developments in OSP in the field of ophthalmic Medical Education including Professionalism, Research and Development, Publications and Eye Health Care service delivery system. In the year 2016, Prof. Zia ul Islam was elected as the new President of OSP. In the inaugural meeting of the central council, chaired by the newly elected Honorable President, it was observed that despite achieving major milestones since the birth of the country in 1947 and the birth of the Ophthalmological Society in 1957, there are still serious gaps in eye care in Pakistan in terms of equitability, cost, uptake, comprehensiveness, quality and sustainability.

Law Protection on Patients Toward The Health Services Conducted by Social Security Administrator for Health (Ssah) or BPJS in Accordance With The Limitation on Cataract Surgery

Health is a primary right of every individual and must be guaranteed by the state; therefore, the state has regulated the health of its citizens as stipulated in the 1945 Constitution Article 28 Section 3 which is further regulated in law No. 40 Year 2004 concerning the national social security system. One of the concerns of the government is that many Indonesians who have reached the age of 50-60 years who experience vision problems due to cloudy eye lense or cataract. The government concern is can be seen from their attention on health problems by passing Minister of Health Regulation No. 29 Year 2016. Concerning with eye Health Care Services at the Health Care Amanities and the Director of Health Service Security on Health (SSAH) passed a regulationNo. 2 Year 2018 concering with cataract service security service.The Method Used in this study is a normative juridical method, using secondary data consisting of primary, secondary and tertiary legal materials. The end purpose of this study is to get clarity about the legal protection of patients against health services by the Health amenities and SSAH or BPJS with the existence of restrictions on cataract surgery and to find out the claim procedures concerning with this restriction.Keywords: Legal Protection, BPJS or SSAH, Cataract Surger.

Validating a tool to assess eye health knowledge, attitude and practice in Cambodia and Vietnam.

To develop an eye health knowledge, attitude and practice (EH-KAP) field-based assessment tool for use in implementing effective eye health care services. An instrument development and validation study. A Vietnam EH-KAP dataset were used to identify and eliminate redundant questions to develop a standardized tool. Face validity was assessed by the KAP survey team. Internal validity (congruency/criterion) was assessed by comparing descriptive analysis of two datasets (n=531; n=38) collected from the same sampling frame at different time points. Weighted scores were calculated for each construct. Kappa values for test-retest and inter-observer agreement were calculated to check the reliability of responses. The modified version was assessed by analysing the raw and ungrouped data. Responses were weighted and agreement was tested by comparing construct scores. Totally 38 respondents were included in this validation process (mean age 58.5y). Mean scores for knowledge were 9.15 (old questionnaire n=531) and 5.05 (modified version). For attitude, the scores were 2.23 and 2.42, and for practice the scores were 3.33 and 2.21. Test-retest agreement was between 62% to 93% (Kappa 0.24 to 0.86) for the ungrouped raw data, and 55% to 72% (Kappa 0.42 to 0.65) for KAP domain. Inter-observer Kappa value for ungrouped data was 0.37 and 0.45 for the weighted scores. This standardized tool applied at critical time points can assess trends in KAP within the same population and for comparison across groups. If used alongside a Rapid Assessment of Avoidable Blindness (RAAB), this tool provides a comprehensive perspective on eye-health of a population.

Knowledge and practices of eye health professionals about the availability and accessibility of child eye care services in the public sector in Swaziland

Background: International and African rights instruments stipulate that children have the right to access quality general and eye health care. Lack of access to quality eye care can have a significant negative impact on the child, family and society in general.Aim: To determine the knowledge and practices of eye care professionals about the availability and accessibility of child eye care services in the public sector in Swaziland.Setting: The study was conducted in Swaziland.Methods: This was a quantitative study design, and 15 public eye health professionals completed and returned the Questionnaire for Eye Health Professionals (QEHP).Results: Thirteen (86.7%) eye health practitioners reported that both standard practice guidelines and paediatric national guidelines for ophthalmic services were unavailable. The majority (66.7%) identified cost and unawareness of available services by parents as the most common barrier to accessing eye care services. Nine (60%) felt that they were less informed about eye health problems and 6 (40%) reported being well informed. Eight (53.3%) respondents indicated that there were no outreach programmes and 7 (46.7%) reported that their clinics offered these services. Thirteen (86.7%) eye health practitioners indicated that they were not part of teachers’ training for supporting visually impaired children, while 2 (13%) reported that they were.Conclusion: Formulation of guidelines to support eye health care service delivery in Swaziland is essential in order to improve availability, accessibility, affordability and effectiveness in the public health system.

A situational analysis of eye care services in Swaziland.

Compared to other African countries, Swaziland performs the worst in terms of providing eye health care services. A priority goal of the World Health Organization (WHO) is to alleviate childhood blindness, particularly in low-income countries such as Swaziland, where many people live in poverty, which is a contributor to poor health outcomes. A mixed method approach that entailed a document review, key informant interviews and clinical facility assessment questionnaires was used. Hospitals and mission clinics offering ophthalmic services were identified through the website of the Ministry of Health and verified during key informant interviews. A saturated sampling procedure was applied due to the few facilities that offer eye care services. Six framework components from the WHO for analysing health systems were utilised in an eye health care service context: leadership and governance, eye health services, eye health workforce, eye health financing systems, eye health medical supplies and technologies, and eye health information systems. Poor management, lack of accountability, poor monitoring and evaluation mechanisms, weak coordination and ineffective private-public sector regulations were identified as factors that lead to poor eye care in the country. The optometrists indicated that refractive services are the most rendered ophthalmic services. The exodus of healthcare practitioners has contributed to the downfall of the public health sector in the country. Five government eye care facilities, 3 government hospitals, 1 non-governmental organization (NGO) and a church mission clinic were included in this analysis. The eye services distribution favors the more affluent areas, particularly the more urban Hhohho Region, which is also where most of the eye health professionals are located. No campaigns have been conducted to prevent childhood blinding diseases or create awareness about getting children’s eyes tested for refractive correction. The burden of eye diseases among children in Swaziland remains unknown. More eye health care personnel and equipped facilities are needed throughout the country, and the eye health care program needs to be adopted.

Examining Population Structure of Rajasthan with Implications for Public Health Planning and rate Standardization to support Eye and Vision Care Public Health Programming

Introduction: Scientific thinking and methods are necessary in order to make valid comparisons of the distribution of health outcomes within and across populations. To date, no prior report has been identified as examining the population structure of Rajasthan and its implication for public health planning applied to eye health and vision care service utilization. In this report, the population structure of Rajasthan was examined based on official projections. A brief discussion was offered for the use of population structure data in public health planning, specifically to support eye health and vision care public health programming in Rajasthan. Methods: Using an ecological design, secondary data were used to examine the projected population structures of Rajasthan and India from 2016 to 2026. The data were abstracted from publically-available reports and organized by age group and sex for 2016, 2021, and 2026. Population pyramids were constructed for the data from each of the three aforementioned years for both the population of Rajasthan and the corresponding data for the population of India. Results: The projected population of Rajasthan is expected to rise from 2016 to 2026. During this tenyear time span, the proportion of individuals in the younger age groups (birth to 34 years) will represent a sizable number of individuals compared to those in the older age groups. A comparison of the projected population structures, by age-group strata and sex, showed differences in population pyramids. Discussion: These findings suggest that, when making public health planning decisions for Rajasthan, public health planners concerned with eye conditions and vision care service utilization might consider the distribution of population by age grouping. Furthermore, it might be appropriate to establish a “standard reference population” for Rajasthan in order to compare age-standardized rates of eye conditions and vision care utilization through 2026.