Improving eye health using a child-to-child approach in Bariadi, Tanzania

Abstract

Purpose: Vision Champions (VC) are children trained to perform simple eye health screening and share eye health messages among their community. Our objectives were to assess the ability of VC in identifying and referring children and the community with refractive error and obvious ocular disease and to assess the change in knowledge and practice of eye healthseeking behaviour of the community 3 months after the introduction of the Vision Champion Programme.Methods: We purposively sampled 600 households and interviewed 1051 participants in two phases with a close-ended questionnaire. The numbers of children screened, referred by the VC and those who attended the Vision Centre were recorded. The percentage of people who answered the questions correctly were compared between Phase 1 (P1) and Phase 2 (P2).Results: The VC shared their eye health messages with 6311 people, screened 7575 people’s vision and referred 2433 people for further care. The community were more aware that using eye ointment not prescribed by doctors (P1 = 58.96% vs. P2 = 72.75%) can lead to blindness. Participants were more aware that they should not administer eye drops in stock (P1 = 44.18% vs. P2 = 61.37%) or received from a friend or relative (P1 = 53.23% vs. P2 = 72.35%) if their eyes are red and painful.Conclusion: Children have the potential to effectively share eye health messages and conduct simple vision screening for their families and peers. Efforts are needed to sensitise the community to improve the referral or follow-up rate.

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.…”

“…Many studies noted the availability of uncomplicated referral pathways between education and health systems, and clarity regarding referral processes, as being crucial in successful follow-up, provision of spectacles and continuity of care 20 , 22 , 23 , 29 , 32 , 33 , 41 , 51 , 61 , 64 . For example, a study exploring children as potential vision screeners found that, despite being effective screeners, they were not held with sufficient credibility when referring those they screened to other health services 57 . Inappropriate or overprescribing of spectacles was identified in studies from India and Mexico, 26 , 43 suggesting that the prescribing of spectacles for moderate vision impairment should be balanced with cost and willingness to pay 43 .…”

“…However, studies evaluating spectacle compliance at unannounced follow-up visits found that boys were significantly less likely to be wearing spectacles (Table 2) in China 44 , 65 and South Africa; 35 no differences between boys and girls were observed elsewhere, however. Sex also influenced the success of health promotion activities in the United Republic of Tanzania 57 and Viet Nam 59 …”

Co-creating an arts-based eye health education strategy in Zanzibar: process, outcomes and lessons learnt

“… 12 Further engagement with local communities revealed that these communities perceived traditional healers as the first point of contact for treatment and a previous arts-based, peer-delivered eyecare education intervention in rural mainland Tanzania was developed to address the barrier. 21 This intervention significantly enhanced the community’s eye health knowledge by 6.3%, leading to a - four times increase in monthly service uptake. 21 This non-traditional intervention attracted the attention of Zanzibar health authorities and they indicated a strong commitment to codevelop an arts-based education initiative.…”

Developing “Vision-for-Learning” Competencies among Teachers in Tanzania <br/>—An Innovative Higher Education Initiative

“…In order to address the fact that 70% of all classroom activities involve vision (Narayanasamy, Vincent, Sampson, & Wood, 2016), this project was intended to focus on the area of vision. Tanzania has limited eye health infrastructure (Mwakyusa et al, 2017) and vision screening in schools is not mandatory (Chan et al, 2017).…”