Bansara Eye Care: Growing Affordable Eye Care for the Rural Population

Bansara eye care (BEC) is one of the first eye care providers in the state of Meghalaya, NE India and has brought many innovations in process and reduced cost of eye care treatment in the region. BEC has been trying to penetrate the rural markets, to educate and provide eye care services to the rural poor. The case deals with the challenges and poor acceptance of eye care services especially in the rural areas of the region. Lack of awareness and superstitious belief towards eye surgery was the main reason for poor penetration in the rural areas. The case highlights the key decisions that is required to be taken to be able to penetrate the rural markets and determine the expansion strategy.

Download Full-text

Health seeking behaviour and health awareness among rural and urban adolescents in Dehradun District, Uttarakhand, India

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2015-0046 ◽

2017 ◽

Vol 29 (2) ◽

Cited By ~ 4

Author(s):

Tuhin Kumar ◽

Piyalee Pal ◽

Prabhdeep Kaur

Keyword(s):

Health Care ◽

Public Sector ◽

Health Care Providers ◽

Rural Areas ◽

Health Care Services ◽

Health Issues ◽

Care Providers ◽

Health Seeking ◽

Care Services ◽

Public Sector Health

Abstract Background: Adolescents constituted 19% population of India in 2011. Adolescents have health seeking behaviour different from that of adults. We estimated the utilisation of available health care services by adolescents and awareness regarding various health issues in the urban and rural Dehradun District, Uttarakhand, India. We also described knowledge and practices of public sector health care providers. Methodology: We conducted a cross-sectional survey among adolescents 10–19 years in the urban Dehradun and rural Chakrata block of the Dehradun District. We used cluster sampling with sample size 680 each in urban and rural areas. We collected data from adolescents using semi structured questionnaire on health awareness and utilisation of health care services. Public sector health care providers were surveyed about their knowledge and practices regarding adolescents health. Results: We surveyed 1463 adolescents. The overall mean age was 14.4 (2.6) years, about half being females. Half of the adolescents who had any illness used the public sector. Awareness about anaemia was 48% in urban and 12% in rural areas. A higher proportion of females (Rural: 89%, Urban: 76%) were aware of condoms as contraceptives than males (Rural: 68%, Urban: 12%). Only 62% of doctors and 49% of paramedical staff had knowledge regarding services under Adolescents Reproductive and Sexual Health (ARSH). Conclusion: Awareness regarding various health issues was low among males as compared to females, especially in rural areas. School based health promotion programs should be carried out to increase awareness among adolescents. Health facilities should be strengthened to provide adolescent friendly health services to enhance utilisation.

Download Full-text

Co morbidities among cataract- operated patients in Rural Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v9i2.19260 ◽

2018 ◽

Vol 9 (2) ◽

pp. 156-159

Author(s):

Eliya Shrestha ◽

Hari Bikram Adhikari ◽

Indra Man Maharjan ◽

Babita Gurung

Keyword(s):

Back Pain ◽

Rural Area ◽

Rural Areas ◽

English Language ◽

Medical Terminology ◽

Eye Care ◽

Interventional Study ◽

Care Services ◽

Total Burden ◽

Rural Nepal

Introduction: Himalaya Eye Hospital (HEH), established in 1993, is providing eye care services in Gandaki, Dhaulagiri and Karnali zones. It has been providing surgical and nonsurgical eye camps in rural areas of Gandaki, Dhaulagiri and Karnali zones. The aim of this study was to determine the prevalence of ocular and systemic co morbidities among the persons treated in rural Asian setting.Method: This is the prospective non-interventional study. Patients who came to take services in surgical eye camp in rural area of Nepal were included. Data were collected by interviewing the patients. They were interviewed by local volunteers with he questionnaires prepared in English language. The volunteers were explained about the medical terminology and they interviewed the patients in native language.Result: Out of 675 patients 401(59%) had systemic co morbidities. Back pain and arthritis being the most common with 321(48%) and 260(38%) respectively.Conclusion: This study shows the systemic co morbidities among the patients who came to seek ocular treatment in eye camp in rural area of Nepal. We should do this kind of studies in different area of Nepal. These kinds of study give us total burden of systemic morbidity and help to treat accordingly.

Download Full-text

Understanding the role of lady health workers in improving access to eye health services in rural Pakistan – findings from a qualitative study

Archives of Public Health ◽

10.1186/s13690-021-00541-3 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Stevens Bechange ◽

Elena Schmidt ◽

Anna Ruddock ◽

Itfaq Khaliq Khan ◽

Munazza Gillani ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Workers ◽

Negative Impact ◽

Care Providers ◽

Eye Care ◽

Care Services ◽

Eye Health ◽

Wide Range

Abstract Background In 1994, the Lady Health Workers (LHWs) Programme was established in Pakistan to increase access to essential primary care services and support health systems at the household and community levels. In Khyber Pakhtunkhwa (KPK) province in northern Pakistan, eye care is among the many unmet needs that LHWs were trained to address, including screening and referral of people with eye conditions to health facilities. However, despite an increase in referrals by LHWs, compliance with referrals in KPK has been very low. We explored the role of LHWs in patient referral and the barriers to patient compliance with referrals. Methods Qualitative methodology was adopted. Between April and June 2019, we conducted eight focus group discussions and nine in-depth interviews with 73 participants including patients, LHWs and their supervisors, district managers and other stakeholders. Data were analysed thematically using NVivo software version 12. Results LHWs have a broad understanding of basic health care and are responsible for a wide range of activities at the community level. LHWs felt that the training in primary eye care had equipped them with the skills to identify and refer eye patients. However, they reported that access to care was hampered when referred patients reached hospitals, where disorganised services and poor quality of care discouraged uptake of referrals. LHWs felt that this had a negative impact on their credibility and on the trust and respect they received from the community, which, coupled with low eye health awareness, influenced patients’ decisions about whether to comply with a referral. There was a lack of trust in the health care services provided by public sector hospitals. Poverty, deep-rooted gender inequities and transportation were the other reported main drivers of non-adherence to referrals. Conclusions Results from this study have shown that the training of LHWs in eye care was well received. However, training alone is not enough and does not result in improved access for patients to specialist services if other parts of the health system are not strengthened. Pathways for referrals should be agreed and explicitly communicated to both the health care providers and the patients.

Download Full-text

Ocular Status, Health Seeking Behaviours and Barriers to Uptake Eye Care Services among Children of Slum Community in Chittagong, Bangladesh

Journal of Ophthalmology & Clinical Research ◽

10.33140/jocr/01/02/00007 ◽

2017 ◽

Vol 1 (2) ◽

Keyword(s):

Rural Areas ◽

Care Center ◽

Health Seeking ◽

Eye Care ◽

General Measure ◽

Ocular Abnormalities ◽

Care Services ◽

Health Seeking Behaviors ◽

Very High ◽

Slum Community

Purpose: The purpose of this study was to find out the ocular status, ocular health seeking behaviors and barriers to uptake eye care services among children of slum community in Chittagong, Bangladesh. Methods: The study was conducted in several urban slums in Chittagong city, which is home of slum children. A total of 410 children aged 5 to 16 years were clinically examined. Their accompanying guardians were also interviewed for collecting data about health seeking behaviors and identifying the barriers, if any, to uptake eye care services. Three focus group discussions were also held with guardians. Results: About 47.3% of the sampled children were male and 52.7% female. About 40% of the children had some complain where we found 36.6% having some ocular abnormalities. Among the respondents (n=410), related with ocular abnormalities (n=150), the diagnosed problems were; Refractive Error (26.7%), Allergic Conjunctivitis (21.3%), Blepharitis (16.0%), Squint (7.3%), Convergence Insufficiency (6.6%), Meibomian Gland Dysfunction (8.7%), Dacryocystitis (3.3%), Conjunctivitis (4.0%), Congenital Cataract (2.7%), Corneal scar 2.0%, Pseudophakia 2.0%, Xerophthalmia (1.3%). Infrequently Entropin, Ptosis, Corneal Opacities, Retrobulbar Neuritis, Retinal Detachment, Episcleritis, Scleritis, Microphthalmos, Ocular FB, Chalazion, Stye, Nystagmus and Proptosis were also present in limited percentage. However 25.70% were referred to tertiary eye care center, 39.60% were treated with medicine, 22.20% were given optical correction, and 25.70% were given general measure. Most of them (73%) never went to an eye care specialist. The main reasons assigned for not going to a doctor were: financial constraints (16.30%), didn’t feel necessary (33.70%), lack of escort (3.4%), lack of time (3.7%), traditional belief (0.3%) and not aware of hospital doctor (4.5%). The Guardians consider recent cost of treatment is very high. They want low cost treatment, provide free spectacle, increase more hospital facilities and hold free eye camps. Conclusion: This study found very high ocular morbidities among slum children, the vast majority of the guardians’ cannot afford medical treatment for lack of money, awareness, escort, time and indifference to eyes. Though adequate eye care facilities are available in Chittagong city compared to many other urban and rural areas in Bangladesh, most of the slum dwellers can’t take advantage of it for financial reason and lack of knowledge.

Download Full-text

CATARACT & OTHER CO MORBIDITIES – STUDY FROM NORTH INDIA.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i10.667 ◽

2019 ◽

Vol 3 (10) ◽

Author(s):

Rakesh Kumar ◽

Angli Manhas ◽

Rameshwar S Manhas ◽

Dinesh Gupta ◽

Aditi Gupta ◽

...

Keyword(s):

Rural Areas ◽

North India ◽

Eye Care ◽

Care Services ◽

Number Of Patients ◽

Co Morbidity ◽

Department Of Ophthalmology ◽

Medical Facilities ◽

Systemic Examination ◽

Eye Camps

Background: Rural areas are away from medical facilities & these areas catters more than 3/4th of Indian populations. Thus, eye care services need to be planned & executed in these areas. Aim: To determine the prevalence of other ocular and systemic co-morbidities among the camp selected cataract patients in rural areas. Methodology: The present observational study was conducted at postgraduate department of Ophthalmology of GMC Jammu & involved patients from various eye camps selected for ECCE (SICS with PC-IOL implantation surgery). Total of 84 patients were participated in the study. Detailed history was taken from the patient & relevant ocular & systemic examination was done.Routine investigations were also done. Results: The most frequently occuring systemic co-morbidities was hypertension i.e.36.9% followed by back pain in 32.1% in the present study. The ocular co-morbities other than cataract were diabetic retinopathy in 4.8%, glaucoma in 3.6% etc. Among other ocular co morbidity, optic atrophy, amblyopia, chorioretinal atrophy, macular scar etc were noted. Conclusion: From present study it has been concluded that large number of patients who came to seek ocular treatment in eye camps has systemic co morbidities also. Thus, other specialities should also be part of team of eye camp so that along with eye other comorbidities should also be treated. Key words: Cataract, Ocular co-morbidities, Systemic co-morbidities.

Download Full-text

Utilization of Secondary Eye Care Services in Western Kenya

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183371 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3371

Author(s):

Hillary K Rono MMed ◽

David Macleod ◽

Andrew Bastawrous ◽

Emmanuel Wanjala ◽

Michael Gichangi ◽

...

Keyword(s):

Incidence Rate ◽

Age Groups ◽

Unmet Need ◽

The Elderly ◽

Vulnerable Groups ◽

Age Group ◽

Attendance Rates ◽

Care Providers ◽

Eye Care ◽

Care Services

Background: Eye care provision is currently insufficient to meet the population’s eye health needs in Kenya. Many people remain unnecessarily visually impaired or at risk of becoming so due to treatable or preventable conditions. A lack of access and awareness of services are key barriers, in large part due to their being too few eye care providers in the health system for this unmet need. Methods: A hospital-based, retrospective analysis of patients who attended Kitale eye unit, Trans Nzoia County, Kenya from 1st January 2013 to 31st December 2015. Age and sex standardized hospital attendance rates by residence, age group, and sex were calculated for Trans Nzoia county and each subcounty. The changing trends in attendance rates were estimated by calculating the difference between base year and last year. Incidence rate ratios for attendance for each age-group, sex, and residence were estimated using a multivariable regression model. Results: 20,695 patients from the county were seen in Kitale Eye Unit in 2013, 2014 and 2015. In that period, 8.3% had either uncorrected refractive error, cataracts or glaucoma, the priority VISION2020 diseases, and 61.0% had allergic or other conjunctivitis or normal eyes, which could potentially be managed at primary eye care. During the study period, overall average annual attendance rate increased from 609 to 792 per 100, 000 population, incidence rate ratio (IRR) 1.30 (95% confidence interval (CI) 1.26–1.35). Attendance rates increased more in females than males (34.7% vs. 25.1%, respectively), IRR 1.07 (1.04–1.10). Attendance rates increased with increasing age, (highest among the elderly compared to the young). We found that in extreme age groups (>75 years and <15years) females were less likely to attend than males and there was reduced utilization from those based furthest from the hospital. Conclusion: Specialist eye services are heavily utilized by people with conditions that could be managed at the primary health care level. Barriers to accessing eye services were distance and gender, especially among the most vulnerable groups (young and the elderly). Integration of primary and secondary eye care services could lower barriers to essential eye care services to the population whilst lowering pressure on the limited specialist services by ensuring more appropriate utilization.

Download Full-text

Bilateral severe microphthalmos with bilateral colobomatus orbitopalpebral cyst: accessibility of speciality eye-care and rehabilitation services in low and middle-income countries

BMJ Case Reports ◽

10.1136/bcr-2021-241783 ◽

2021 ◽

Vol 14 (5) ◽

pp. e241783

Author(s):

Suwarna Suman ◽

Arushi Kumar ◽

Hement Uttamraw Rathod ◽

Taruna Yadav

Keyword(s):

Rural Areas ◽

Large Mass ◽

Lower Eyelid ◽

Late Presentation ◽

Eye Care ◽

Middle Income ◽

Middle Income Countries ◽

Care Services ◽

The Right ◽

Low And Middle Income

A 12-year-old girl presented with an unusually large mass under the right lower eyelid and a smaller mass under the left lower lid since the last 6 months. The parents had noticed the absence of the right eyeball and a very small left eyeball and no vision in both eyes since birth but did not approach the healthcare system. The patient was diagnosed as a case of bilateral severe microphthalmos with colobomatous cyst with late presentation and was treated surgically. The parents were counselled for education and training of the child in schools for visually impaired. Early treatment and rehabilitation help patients lead a normal life in these cases. In rural areas, patients face challenges in getting access to the specialty eye-care services due to several barriers, including lack of availability and affordability. This case highlights the disparities in essential health services in low and middle-income countries.

Download Full-text

Education as a Gateway to Development: Case of Rural Poor at Thabaneng Village in Lesotho

Journal of Education and Learning ◽

10.5539/jel.v4n4p168 ◽

2015 ◽

Vol 4 (4) ◽

pp. 168

Author(s):

Mokone W. Matsepe

Keyword(s):

Primary Education ◽

Rural Areas ◽

Rural Population ◽

Education For All ◽

Rural Poor ◽

Free Primary Education ◽

The People ◽

Standards Of Living ◽

Purpose Of Education ◽

The Government

<p>The study explores and unfolds the purpose of education in general, its value and the role it plays in helping development of the people in rural areas especially at Thabaneng Village in Lesotho. It reveals that education is the key to development and functions to equip the rural population in Lesotho with knowledge, training and worthwhile skills that are intended to uplift their standards of living in their respective milieus. Education is so vital for the rural poor for it makes them to have critical thinking and reasoning. It further renders them, through participation, to be part and parcel of their own development.</p><p>In conclusion, the paper indicates that the Government of Lesotho launched the Free Primary Education (FPE) to promote the importance and value of Education for All (EFA) that is hoped to promote the development of Basotho especially in the rural areas.</p>

Download Full-text

A systemic review of barriers to accessing paediatric eye care services in African countries

African Health Sciences ◽

10.4314/ahs.v21i4.47 ◽

2021 ◽

Vol 21 (4) ◽

pp. 1887-97

Author(s):

Saif Hassan Alrasheed

Keyword(s):

Visual Impairment ◽

Rural Areas ◽

Negative Impact ◽

Public Health Problem ◽

Systemic Review ◽

Major Public Health Problem ◽

Eye Care ◽

African Countries ◽

Attitudes And Practices ◽

Care Services

Background: Global estimate reported that 1.4 million children are blind of which three-quarters live in developing countries. Childhood Visual Impairment is a major public health problem globally especially in rural areas of developing countries.Objective: To review barriers to accessing paediatric eye care services in African countriesMethods: The studies in this review were searched in online databases (PubMed, Web of Sciences, ProQuest, Scopus, Google Scholar, African Index Medicus and Medline) for studies published between January 2000 and April 2020. The articles included in this review, which was conducted in Africa to assess the barriers for accessing paediatric eye care services with regards availability, accessibility, affordability, socio cultural barriers of parents/caregivers and community.Results: Of 22 705 articles screened, the study found 29 publications from 10 African countries which met the inclusion criteria. The main barriers were non-availability, non-accessibility, and non-affordability of paediatric eye care services. The studies reviewed revealed that there are other factors affecting the utilization of paediatric eye services which include the primary health system, geographic barriers, health beliefs, perception of parents; lack of knowledge, attitudes and practices about paediatric eye care. Furthermore, environmental, demographic barriers and socio-economic status has negative impact on accessing paediatric eye care services in African counties.Conclusion: The main barriers to accessing paediatric eye care services in Africa were affordability, accessibility and availability. There is therefore a need for all relevant stakeholders to play a significant role in addressing barriers to child eye carein African countries. Keywords: Paediatric eye care; Africa; availability; accessibility; affordability; visual impairment; refractive errors.

Download Full-text