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.
BackgroundSwaziland, like many other developing countries, lacks appropriate eye health services, particularly for children.AimTo determine the knowledge and practices of parents about child eye health care in the public sector in Swaziland.SettingThe setting for this study was Swaziland.MethodsA descriptive study involving cross-sectional sampling methodology and quantitative analysis was employed with 173 randomly selected parents whose children attended public schools in Swaziland.ResultsOut of 173 participants, 104 (60.1%) parents reported that they have never taken their children for an eye test and 69 (31.7%) felt that their children’s vision was fine. Ninety-seven (53.1%) parents indicated having no knowledge about child eye conditions and no significant association was found between level of education and knowledge of eye conditions affecting children (p = 0.112). Having an immediate family member who wore spectacles increased the likelihood of a child being taken for eye testing (p = 0.001), but decreased the likelihood of being well informed about eye health (p = 0.218). Of those parents who reported taking their children for eye tests, 34 (49.3%) reported that they were given eye drops and 31 (44.9%) stated that their children were prescribed spectacles. Eighty-seven (50.3%) parents accepted the idea of their children wearing spectacles.ConclusionThe findings of the study suggest the need for parents to be informed about basic child eye health care and the importance of their children having regular eye examinations.
Purpose: To provide epidemiological data on ocular injuries among patients utilising the provincial hospitals eye care clinics in urban KwaZulu-Natal, South Africa. This data can be used in the future planning and intervention for ocular injuries at provincial hospitals.Methods: Record cards of 220 ocular injury patients seen at two selected urban provincial hospitals over a period of four years were reviewed.Results: Male presentation was higher (79.1%) compared to females (20.9%). The Black population (85.9%) experienced more ocular injuries than other race groups. The 21 to 30 age group incurred more injuries (32.3%) than other age groups. Open globe injuries occurred more frequent (56.4%) than closed globe injuries (43.6%). The frequent type of injury was blunt trauma/contusion (32.7%). More than half of the injuries were from solid objects (56.4%) followed by assaults (16.4%). The home was the common place to incur an injury (72.2%). Twenty four patients (10.9%) required surgical intervention at initial presentation. One hundred and fifty eight (71.8%) patients returned for follow up examination. Twenty five percent of the patients remained with poor vision following treatment. Conclusion: Ocular trauma due to burns is usually bilateral while that due to blunt trauma and intra ocular foreign bodies are generally unilateral. Solid objects were the most frequent cause of ocular injury and injuries due to this cause were most often incurred in the home. (S Afr Optom 2013 72(3) 119-126)
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.
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