Integrating eye health into policy: Evidence for health systems strengthening in KwaZulu-Natal

Buthelezi, Lungile M.; Staden, Diane van

doi:10.4102/aveh.v79i1.549

Cited by 13 publications

(13 citation statements)

References 24 publications

(42 reference statements)

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“…From the public health perspective, affordability, availability of resources and challenges with eyecare policy could be determinants of this outcome. 55,56 Upon diagnosis of KC, spectacles may have been used because of their prompt availability and affordability and not on the clinical merit of the cases. Another possibility is that most of these spectacle users could have been put on a waiting list such as to be fitted with rigid contact lenses when possible.…”

Section: Discussionmentioning

confidence: 99%

Keratoconic patient profile and management at public sector facilities in South Africa

Nkoana¹,

Moodley²,

Mashige³

2023

Afr. vis. eye health

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Background: Keratoconus (KC) is a condition marked by thinning and protrusion of the cornea resulting in high myopia and irregular astigmatism. Knowledge of KC patients’ profiles and management approaches used can help to predict the needs of public hospitals to improve patient care.Aim: This study aimed to describe the profiles and management of KC patients.Setting: Capricorn district, Limpopo Province, South Africa.Methods: Medical records of 188 KC patients attending public hospitals of Capricorn District from January 2017 to December 2020 were reviewed. Data on patient profile and their management were collected and analysed.Results: The mean age of KC patients was 20.64 ± 6.82 years and the majority (56.9%) were males. Clinical findings were mean unaided visual acuity (UVA) of 0.19 ± 0.18, best corrected VA of 0.53 ± 0.24, spherical equivalence of -4.89 ± 9.17 dioptre (D), mean K of 57.37 ± 17 D and corneal astigmatism of -6.24 ± 4.27 D. A total of 54.5% of patients had severe KC. Bilateral KC was found in almost all patients (97.3%) and a mean K difference of 7.59 ± 6.08 D (p 0.001) between the better and the worse eye. The study found no significant difference in KC severity by age (p = 0.451) and gender (p = 0.819). Patients fitted with scleral lenses had the highest VA improvement of 0.44 ± 0.17.Conclusion: Most patients presented with bilateral and severe KC. Scleral lenses provided higher VA improvement than other methods.Contribution: The study aimed to present the clinical profile and management of keratoconic patients attending public sector facilities. Knowledge of the patterns of KC presentation may assist in the development of intervention strategies and guidelines for best practice in the management of KC, especially in public sector facilities.

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Section: Discussionmentioning

confidence: 99%

Keratoconic patient profile and management at public sector facilities in South Africa

Nkoana¹,

Moodley²,

Mashige³

2023

Afr. vis. eye health

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“…Similar problems with eye health systems have been identified in South Africa, where resources are scarce and inequitably distributed, resulting in varying levels of eye care service quality. There is also a lack of funds dedicated to eye care, and the scope of optometry is limited, for example in terms of binocular vision assessments and contact lens practice 164 . Inequity in distribution of eye care services has also been witnessed in Latin America where the level of training and distribution of ophthalmologists are highly unequal, with a disproportionate number concentrated in more developed, socially advantaged areas 165 .…”

Section: Discussionmentioning

confidence: 99%

“…There is also a lack of funds dedicated to eye care, and the scope of optometry is limited, for example in terms of binocular vision assessments and contact lens practice. 164 Inequity in distribution of eye care services has also been witnessed in Latin America where the level of training and distribution of ophthalmologists are highly unequal, with a disproportionate number concentrated in more developed, socially advantaged areas. 165 Furthermore, barriers to uptake of eye care services identified in Pakistan also exist in other countries.…”

Section: Implications For Clinical Practice and Eye Care Policy Inter...mentioning

confidence: 99%

Exploring eye care pathways, patient priorities and economics in Pakistan: A scoping review and expert consultation study with thematic analysis

Malik

Strang

Campbell

et al. 2022

Ophthalmic Physiologic Optic

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Purpose: As the prevalence of eye diseases increases, demand for effective, accessible and equitable eye care grows worldwide. This is especially true in lower and middle-income countries, which have variable levels of infrastructure and economic resources to meet this increased demand. In the present study we aimed to review the literature on eye care in Pakistan comprehensively, with a particular focus on eye care pathways, patient priorities and economics.Methods: A systematic scoping review was performed to identify literature relating to eye care in Pakistan. Searches of relevant electronic databases and grey literature were carried out. The results were analysed through a mixed methods approach encompassing descriptive numerical summary and thematic analysis. To consolidate results and define priority areas for future study, expert consultation exercises with key stakeholders were conducted using qualitative semi-structured interviews.Results: One hundred and thirty-two papers (published and unpublished) were included in the final review. The majority (n = 93) of studies utilised a quantitative design. Seven interlinked themes were identified: eye care pathways, burden of eye disease, public views on eye-related issues, workforce, barriers to uptake of eye care services, quality of eye care services and economic impact of blindness.Research priorities included investigating the eye care workforce, the quality and efficiency of current eye care services, eye care services available in rural Pakistan and the costs and benefits related to eye care provision and sustaining eye care programmes. Conclusions:To the best of our knowledge, this is the first review to synthesise evidence from papers across the field relating to eye care in Pakistan. As such, this work provides new insights into the achievements of the national eye health programme, challenges in eye care in Pakistan and priority areas for future research.

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“…They are poorly defined in health policy and there is no specific policy or financing model for eye health, resulting in poor service delivery and poor access to services, particularly in rural areas where there is inadequate equipment. There is a high prevalence of preventable age-related vision loss, pointing to inadequacy of eye-care services and eye health screening and promotion efforts[24][25][26]. The three leading causes of preventable blindness in older persons in South Africa (refractive error, cataracts and glaucoma) are addressed by national guidelines on refractive error screening for persons 60 years and older and on cataract surgery, as well as the National Guideline on the Prevention of Blindness in South Africa[27], but there is little information available on their implementation.…”

mentioning

confidence: 99%

The need to incorporate the impact of population ageing into the post-COVID-19 policy and planning reset in Low and Middle Income Countries

Solanki

Kelly

Cornell

et al. 2021

Global Health Action

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The COVID-19 pandemic is likely to widen the health care demand-supply gap, especially in low-and middle-income countries (LMICs). The virus has had the greatest impact on older persons in terms of morbidity and mortality, and is occurring at a time of rapid population ageing, which is happening three times faster in LMICs than in high-income countries. Addressing the demand-supply gap in a post-COVID-19 era, in which resources are further constrained, will require a major 'reset' of the health system. In this article, we argue that the impact of ageing populations needs to be factored into the post-COVID-19 policy and planning reset including explicit, transparent prioritisation processes.

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Integrating eye health into policy: Evidence for health systems strengthening in KwaZulu-Natal

Cited by 13 publications

References 24 publications

Keratoconic patient profile and management at public sector facilities in South Africa

Keratoconic patient profile and management at public sector facilities in South Africa

Exploring eye care pathways, patient priorities and economics in Pakistan: A scoping review and expert consultation study with thematic analysis

The need to incorporate the impact of population ageing into the post-COVID-19 policy and planning reset in Low and Middle Income Countries

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