Implementation of a Free Cataract Surgery Program in Rural China

Barriers for Poor Cataract Surgery Uptake among Patients with Operable Cataract in a Program of Outreach Screening and Low-cost Surgery in Rural China

“…Yorston 26 highlighted four major obstacles that deter people from receiving cataract surgery in developing countries, each of which has been validated independently in a variety of settings: Lack of knowledge, 14,15,21 perception of poor surgical quality, 11,13,14 transportation, 12,15,16,21 and cost. 10,11,18,19 The major barrier for poor uptake of low-cost cataract surgery in our study was lack of family support, which is similar to earlier reports from other countries, 11,27 but differs from previous reports from China, 14,17,22 Recent reports from China showed that lack of knowledge about cataract, concerns about the quality of local services, 14,17 and cost 19,22 appeared to be the principal barriers. One possible explanation for this apparent discrepancy is that we mainly focused on a specific population who had already been provided with an option of low-cost surgery as well as a detailed explanation of the surgical procedure.…”

“…While the concept of provision of high quality and affordable cataract surgery seems to be a very promising intervention for increasing the uptake of cataract surgery in rural China, a substantial proportion of the eligible population may be in need of enhanced social support and family education in order to convince them of the need to undergo cataract surgery. In another study, 19 the rate of uptake of cataract surgery was still lower than expected after a second round of counseling of participants. Therefore, more resources should be employed in order to reliably identify the most vulnerable and disadvantaged people in the society and to design practical schemes to cater to their visual needs in terms of providing cataract surgery services.…”

“…Barriers to uptake of cataract surgery have been well-described in Africa 6,[9][10][11] and Asia, [12][13][14][15][16][17] and appear to include direct and indirect costs, 10,11,18,19 lack of knowledge, 13,20 fear of surgery, 13,20 concerns about the quality of services, 11,13 transportation problems, 12,15,16,21 and discrimination on the basis of sex and age. 12,15,16 Information on barriers to cataract surgery in China is sparse; barriers 14,17,19,22 include lack of knowledge, concern over poor quality of local services and cost of cataract surgery.…”

“…12,15,16 Information on barriers to cataract surgery in China is sparse; barriers 14,17,19,22 include lack of knowledge, concern over poor quality of local services and cost of cataract surgery. Based on this information, we tried to reduce these three barriers in a cataract-screening program by including a detailed explanation of cataract and the cataract surgery procedure, and by subsidizing the cost of surgery.…”

Variations and Trends in Health Burden of Visual Impairment Due to Cataract: A Global Analysis

“…27 More free or low-price surgeries are needed to reduce the health burden of cataract vision loss. 28 The educational factor was found to be the most prominent HDI component. It was previously reported that increased knowledge was associated with accepting cataract surgery, whereas cost and transportation were not.…”