Background: Successful refractive error programmes arise from evidence that can be collected cost effectively and timely.Aim: To investigate the prevalence of uncorrected refractive error (URE), presbyopia and spectacle coverage in the Kamuli district, Uganda.Setting: The study was conducted in the Kamuli district in Uganda.Methods: The Rapid Assessment of Refractive Error (RARE) study design is a communitybased cross-sectional study using multistage cluster random sampling to gather information on refractive errors and presbyopia. Subjects aged 15 years and older were selected from the population in Kamuli district in Uganda. Vision impairment due to URE at distance and near and barriers to uptake of refractive error services were investigated.Results: Participants, N = 3281 (57.6% male), with an age range of 15–92 years were enumerated and the response rate was 100%. The prevalence of refractive errors was 4.6% (95% confidence interval [CI]: 3.7 – 5.5) and the spectacle coverage was 5.96% (95% CI 1.74% – 10.18%). The prevalence of uncorrected presbyopia was 50.3% (95% CI 47.6% – 53.0%) and the spectacle coverage was 0%. Thirty-three (or 1%) respondents were current spectacle users. One-hundred fourteen people (3.5%) had previously used spectacles; however, 50.9% of them discontinued spectacle use a year before the study because the spectacles were broken or scratched. The major barriers to spectacle uptake were accessibility of services and affordability of spectacles.Conclusion: The prevalence of URE and the barriers to uptake of refractive services will inform the implementation of refractive services in the study area. Key words: Uncorrected refractive errors; presbyopia and spectacle coverage

Background: In South Africa, there is a paucity of optometrists serving the needs of the larger public sector. KwaZulu-Natal is one of the most densely populated provinces and home to several of the poorest districts. Despite an optometry school in the province, and with a lack of compulsory community service for new graduates, more optometrists are needed to serve the public sector. While studies on the recruitment and retention of medical and allied health professionals have been conducted, limited evidence exists on work trends of public sector optometrists.Methods: A cross-sectional study design using both quantitative and qualitative data collection methods was used. All public sector optometrists and local district health co-ordinators in the province were contacted, with an 80% (41 out of 51) and 75% (9 out of 12) response rate, respectively. Questionnaires containing demographic, recruitment, retention and open-ended questions were distributed by post, fax and email and via an online survey to both groups. Telephonic interviews were also conducted using semi-structured techniques. Frequency distributions, Fisher’s exact test and odds ratios were used to statistically describe the demographic data, while qualitative responses were recorded and analysed for commonly occurring themes.Results: The present public sector optometry workforce comprises mainly young (73%), black (70%), women (66%). They chose to work in the public sector to ‘make a difference’ and were attracted by ‘good working hours’ and ‘job security’. Fifty-three percent of optometrists work in the public sector due to a study bursary, for which there was a statistically significant association for race (p = 0.01), gender (p = 0.05) and background origin (p = 0.05). To aid their retention in public service, improved salaries, career progression, recognition, improved management relations and improved instrumentation were ranked highest by these optometrists.Conclusion: The demographic profile of presently serving public sector optometrists poses many human resource (HR) challenges and opportunities. Universities should pay attention to rural origin of students and provide exposure to rural clinical experiences during study. Departments of Health use study bursary incentives to recruit optometrists, but need to consider financial and non-financial incentives for their retention. At hospital level, a responsive HR management system should be implemented with emphasis on career management, recognition, improving infrastructure and supporting professional development.