scholarly journals Co morbidities among cataract- operated patients in Rural Nepal

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.

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

2018 ◽  
Vol 22 (02) ◽  
pp. 357-384
Author(s):  
Teidorlang Lyngdoh ◽  
G. Sridhar ◽  
Prashant Mishra
Keyword(s):  
Rural Areas ◽  
Rural Population ◽  
Rural Poor ◽  
Care Providers ◽  
Eye Care ◽  
Expansion Strategy ◽  
Rural Markets ◽  
Care Services ◽  
Superstitious Belief ◽  
Ne India

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.

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

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.

scholarly journals CATARACT & OTHER CO MORBIDITIES – STUDY FROM NORTH INDIA.

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.

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

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.

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

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.

Willingness to use follow-up eye care services after vision screening in rural areas surrounding Chennai, India

2014 ◽  
Vol 98 (8) ◽  
pp. 1009-1012 ◽  
Author(s):  
Zhuo Su ◽  
Bing Q Wang ◽  
Jennifer B Staple-Clark ◽  
Yvonne M Buys ◽  
Susan H Forster
Keyword(s):  
Rural Areas ◽  
Vision Screening ◽  
Eye Care ◽  
Care Services ◽  
Willingness To Use

scholarly journals Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review

2021 ◽  
Vol 6 (3) ◽  
pp. e004484
Author(s):  
Helen Burn ◽  
Lisa Hamm ◽  
Joanna Black ◽  
Anthea Burnett ◽  
Matire Harwood ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Service Delivery ◽  
Indigenous Peoples ◽  
Indigenous Communities ◽  
High Income ◽  
Eye Care ◽  
Service Delivery Models ◽  
Care Services ◽  
Delivery Models ◽  
Improve Access

PurposeGlobally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care services. We conducted a scoping review to identify and summarise service delivery models designed to improve access to eye care for Indigenous peoples in high-income countries.MethodsSearches were conducted on MEDLINE, Embase and Global Health in January 2019 and updated in July 2020. All study designs were eligible if they described a model of eye care service delivery aimed at populations with over 50% Indigenous peoples. Two reviewers independently screened titles, abstracts and full-text articles and completed data charting. We extracted data on publication details, study context, service delivery interventions, outcomes and evaluations, engagement with Indigenous peoples and access dimensions targeted. We summarised findings descriptively following thematic analysis.ResultsWe screened 2604 abstracts and 67 studies fulfilled our eligibility criteria. Studies were focused on Indigenous peoples in Australia (n=45), USA (n=11), Canada (n=7), New Zealand (n=2), Taiwan (n=1) and Greenland (n=1). The main disease focus was diabetic retinopathy (n=30, 45%), followed by ‘all eye care’ (n=16, 24%). Most studies focused on targeted interventions to increase availability of services. Fewer than one-third of studies reported involving Indigenous communities when designing the service. 41 studies reflected on whether the model improved access, but none undertook rigorous evaluation or quantitative assessment.ConclusionsThe geographical and clinical scope of service delivery models to improve access to eye care for Indigenous peoples in high-income countries is narrow, with most studies focused on Australia and services for diabetic retinopathy. More and better engagement with Indigenous communities is required to design and implement accessible eye care services.

scholarly journals Facilitating co-production in public services: Empirical evidence from a co-design experience with family caregivers living in a remote and rural area

2020 ◽  
pp. 095148482097145
Author(s):  
Eleonora Gheduzzi ◽  
Niccolò Morelli ◽  
Guendalina Graffigna ◽  
Cristina Masella
Keyword(s):  
Home Care ◽  
Family Caregivers ◽  
Empirical Evidence ◽  
Rural Area ◽  
Public Service ◽  
Rural Areas ◽  
Crucial Role ◽  
Care Agency ◽  
Home Care Agency ◽  
Design Experience

The involvement of vulnerable actors in co-production activities is a debated topic in the current public service literature. While vulnerable actors should have the same opportunities to be involved as other actors, they may not have the needed competences, skills and attitudes to contribute to this process. This paper is part of a broader project on family caregivers’ engagement in remote and rural areas. In particular, it investigates how to facilitate co-production by looking at four co-design workshops with family caregivers, representatives of a local home care agency and researchers. The transcripts of the workshops were coded using NVivo, and the data were analysed based on the existing theory about co-production. Two main findings were identified from the analysis. First, the adoption of co-production by vulnerable actors may occur in conjunction with other forms of engagement. Second, the interactions among facilitators and providers play a crucial role in encouraging the adoption of co-production. We identified at least two strategies that may help facilitators and providers achieve that goal. However, there is a need for an in-depth understanding of how facilitators and providers should interact to enhance implementation of co-production.

scholarly journals Factors Influencing the Willingness of Palliative Care Utilization among the Older Population with Active Cancers: A Case Study in Mandalay, Myanmar

2021 ◽  
Vol 18 (15) ◽  
pp. 7887
Author(s):  
Aye Tinzar Myint ◽  
Sariyamon Tiraphat ◽  
Isareethika Jayasvasti ◽  
Seo Ah Hong ◽  
Vijj Kasemsup
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Rural Areas ◽  
Psychosocial Support ◽  
Care Utilization ◽  
Severe Illness ◽  
Cross Sectional Survey ◽  
Care Services ◽  
Palliative Care Services ◽  
Older Cancer Patients

Palliative care is an effective, multidisciplinary healthcare service to alleviate severe illness patients from physical, psychological, and spiritual pain. However, global palliative care has been underutilized, especially in developing countries. This cross-sectional survey aimed to examine the factors associated with older cancer patients’ willingness to utilize palliative care services in Myanmar. The final sample was composed of 141 older adults, 50-years of age and above who suffered from cancers at any stage. Simple random sampling was applied to choose the participants by purposively selecting three oncology clinics with daycare chemotherapy centers in Mandalay. We collected data using structured questionnaires composed of five sections. The sections include the participant’s socio-economic information, disease status, knowledge of palliative care, psychosocial and spiritual need, practical need, and willingness to utilize palliative care services. The study found that approximately 85% of older cancer patients are willing to receive palliative care services. The significant predictors of willingness to utilize palliative care services include place of living, better palliative care knowledge, more need for spiritual and psychosocial support, and practical support. This study can guide health policymakers in increasing the rate of palliative care utilization. The suggested policies include developing community-level palliative care services in Myanmar, especially in rural areas, promoting palliative care knowledge, applying appropriate religious and spiritual traditions at palliative treatment, and developing suitable medicines for the critically ill.

scholarly journals Overuse of diagnostic testing in healthcare: a systematic review

2021 ◽  
pp. bmjqs-2020-012576
Author(s):  
Joris L J M Müskens ◽  
Rudolf Bertijn Kool ◽  
Simone A van Dulmen ◽  
Gert P Westert
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Tests ◽  
Patient Population ◽  
English Language ◽  
Diagnostic Testing ◽  
Low Back ◽  
Preoperative Testing ◽  
Healthcare Settings ◽  
Major Variation

BackgroundOveruse of diagnostic testing substantially contributes to healthcare expenses and potentially exposes patients to unnecessary harm. Our objective was to systematically identify and examine studies that assessed the prevalence of diagnostic testing overuse across healthcare settings to estimate the overall prevalence of low-value diagnostic overtesting.MethodsPubMed, Web of Science and Embase were searched from inception until 18 February 2020 to identify articles published in the English language that examined the prevalence of diagnostic testing overuse using database data. Each of the assessments was categorised as using a patient-indication lens, a patient-population lens or a service lens.Results118 assessments of diagnostic testing overuse, extracted from 35 studies, were included in this study. Most included assessments used a patient-indication lens (n=67, 57%), followed by the service lens (n=27, 23%) and patient-population lens (n=24, 20%). Prevalence estimates of diagnostic testing overuse ranged from 0.09% to 97.5% (median prevalence of assessments using a patient-indication lens: 11.0%, patient-population lens: 2.0% and service lens: 30.7%). The majority of assessments (n=85) reported overuse of diagnostic testing to be below 25%. Overuse of diagnostic imaging tests was most often assessed (n=96). Among the 33 assessments reporting high levels of overuse (≥25%), preoperative testing (n=7) and imaging for uncomplicated low back pain (n=6) were most frequently examined. For assessments of similar diagnostic tests, major variation in the prevalence of overuse was observed. Differences in the definitions of low-value tests used, their operationalisation and assessment methods likely contributed to this observed variation.ConclusionOur findings suggest that substantial overuse of diagnostic testing is present with wide variation in overuse. Preoperative testing and imaging for non-specific low back pain are the most frequently identified low-value diagnostic tests. Uniform definitions and assessments are required in order to obtain a more comprehensive understanding of the magnitude of diagnostic testing overuse.

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