Effect of education sessions of a structured school eye screening programme on Indian schoolteachers’ knowledge and responsibility for children’s eye health

Abstract

Objective: To evaluate the effect of education sessions on Indian schoolteacher awareness of childhood eye health issues, responsibility for children’s eye health, and successful participation in a teacher-led eye screening health intervention programme in primary schools aimed at addressing avoidable childhood blindness in India. Design: Quantitative study, pre-intervention and post-intervention surveys and questionnaires. Setting: One hundred and four government-employed schoolteachers in primary schools of Hyderabad, India. Method: Prior to the screening intervention programme, questionnaires were administered to evaluate baseline teacher knowledge and observed responsibility for management of children’s eye health. The intervention consisted of three one-hour educational training sessions at central community locations about children’s eye health and proper screening practices, followed by on-site monitoring of teacher screenings after a period of 10 school days. Post-programme questionnaires and surveys were administered to evaluate changes in knowledge and attitudes. Results: Despite low levels of pre-programme knowledge and felt responsibility, teachers demonstrated significant improvements in overall knowledge of eye parts and functions, common childhood diseases, and local myths (39.3% to 63.7%, p < 0.01) and significant increases in felt responsibility for children’s eye health (45.5% to 77.8%, p < 0.01) through the course of the programme. Conclusion: Apart from technical training, educational sessions may play an important role in promoting sustained teacher interest in school-based health intervention programmes and overall impact on community health. Urban schoolteachers have therefore been identified as promising candidates in the continued effort to eliminate avoidable childhood blindness in India and other parts of the developing world.

Interventions to improve school-based eye-care services in low- and middle-income countries: a systematic review

“… 19 – 66 Identified articles were from 13 countries spanning five World Health Organization (WHO) Regions including Africa (eight studies), the Americas (10 studies), the Eastern Mediterranean (one study), South-East Asia (18 studies) and the Western Pacific (11 studies). Identified articles comprised 19 school-based eye-care programme evaluations, 19 – 33 , 62 – 64 , 66 16 studies investigating spectacle compliance associations, 34 – 48 , 65 eight studies exploring the quality of various eye-care screening personnel, 49 – 56 four studies evaluating the effectiveness of eye health promotion, 57 – 60 and one study that included both spectacle compliance and the quality of screening personnel 61 . When appraised for quality, 15 we classified 18 studies as being of high quality, 20 as medium quality and 10 as low quality.…”

“…As the availability of eye-care specialists can be limited in school settings, particularly in low- and middle-income countries, studies have investigated the use of teachers, nurses, certified medical assistants and key informants for the provision of screening and basic eye-care for children 20 , 21 , 29 , 51 – 54 , 56 , 58 , 60 , 62 . Several studies found that training teachers in vision screening enabled the provision of a good-quality 51 , 53 , 56 and cost–effective service, 53 while facilitating the opportunity to motivate spectacle use among students 54 .…”

“…Any intervention must be culturally appropriate, as longstanding cultural practices can have a stronger influence than national health policy 60 . For instance, a study from India identified how children’s participation in school-based eye-care programmes can be influenced by elderly family members, hindering parental decision-making 64 .…”

“…Other common reasons for not wearing prescribed spectacles included a lack of perceived need, 45 , 65 , 66 fear of potential harm, 36 , 45 , 48 , 65 , 66 affordability 45 , 48 , 66 and parental objections 42 , 66 . Support networks within schools, including health promotion interventions, 28 , 41 , 59 teacher training 60 and curriculum-based eye health education, 23 , 58 were key in correcting negative perceptions regarding spectacles or eye care.…”

Screening efficacy of a simplified logMAR chart

“…12 Using school teachers to detect pupil's vision related problems was first documented in 1975; however, since then many studies have documented the reliability and effectiveness of teacher's involvement in screening. 12,13,14,15,16,17,18 The advantages of VA testing using logarithm of minimum angle of resolution (logMAR) acuity measurement charts, over the use of Snellen charts, are well known. LogMAR acuity measurement utilizes the letter-by-letter scoring principle in contrast to Snellen where the acuity will be obtained by the line-by-line scoring method.…”