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To determine the barriers and incentives to eye care utilization (ECU) in Abagana, a rural south-eastern Nigerian community. The study was a population-based cross-sectional mixed method (quantitative and qualitative) survey of adult inhabitants of Abagana, in July-August, 2011. Data on respondents' socio-demographics, barriers and incentives to ECU were collected, and analysed using descriptive and comparative statistics. A p < 0.05 was considered statistically significant. Qualitative data were obtained from focus group discussions and in-depth interviews and analyzed using ATLAS.ti software. The 549 respondents (males 224) were aged 49.8 ± 15.9 SD years (range 18-93 years). Overall, orthodox eye care had ever been sought by 42.4%, and 46.4% of those who reported change in vision. Lack of awareness-31.8%, cost-18.0%, and fatalistic attitudes-15.9% were the main ECU barriers. Possession of health insurance (OR 11.49; 95% CI 4.21-31.34; p = 0.001), family history of eye disorder (OR 3.27, 95% CI 2.03-5.26; p = 0.001), noticed change in vision (OR 11.30; 95% CI 1.42-90.09; p = 0.022), current eye disease (OR 4.06; 95% CI 2.29-7.19; p = 0.001) and systemic co-morbidity (OR 4.33; 95% CI 2.67-7.02; p = 0.001) were the incentives to ECU. To enhance the low ECU in Abagana community, educational interventions on eye health maintenance and eye health seeking behaviours, and measures to reduce eye care cost are recommended.
To determine the barriers and incentives to eye care utilization (ECU) in Abagana, a rural south-eastern Nigerian community. The study was a population-based cross-sectional mixed method (quantitative and qualitative) survey of adult inhabitants of Abagana, in July-August, 2011. Data on respondents' socio-demographics, barriers and incentives to ECU were collected, and analysed using descriptive and comparative statistics. A p < 0.05 was considered statistically significant. Qualitative data were obtained from focus group discussions and in-depth interviews and analyzed using ATLAS.ti software. The 549 respondents (males 224) were aged 49.8 ± 15.9 SD years (range 18-93 years). Overall, orthodox eye care had ever been sought by 42.4%, and 46.4% of those who reported change in vision. Lack of awareness-31.8%, cost-18.0%, and fatalistic attitudes-15.9% were the main ECU barriers. Possession of health insurance (OR 11.49; 95% CI 4.21-31.34; p = 0.001), family history of eye disorder (OR 3.27, 95% CI 2.03-5.26; p = 0.001), noticed change in vision (OR 11.30; 95% CI 1.42-90.09; p = 0.022), current eye disease (OR 4.06; 95% CI 2.29-7.19; p = 0.001) and systemic co-morbidity (OR 4.33; 95% CI 2.67-7.02; p = 0.001) were the incentives to ECU. To enhance the low ECU in Abagana community, educational interventions on eye health maintenance and eye health seeking behaviours, and measures to reduce eye care cost are recommended.
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.
Purpose:To describe the factors that determine the utilization of eye care services in a rural community in South-Western Nigeria.Methods:A descriptive cross-sectional survey using a multistage sampling technique was conducted. The main outcome measure was self-reported previous consultation of an orthodox medical facility for eye care.Results:The study sample included 643 participants. Only 122 (19%) respondents had previously visited orthodox facilities in search of eye care and 24% of those with presenting visual acuity <6/18 had sought eye care. Characteristics associated with previous utilization of eye care services were age of =70 years (odds ratio [OR] ≥ 1.7, P = 0.02); male gender (OR = 1.5, P = 0.04); literacy (OR = 1.7, P = 0.007); and residing close to an eye care facility (OR = 2.8, P < 0.001). Blind respondents were three times more likely to seek eye care (P < 0.001). Regression analysis revealed that factors associated with increased likelihood of utilization of eye care services included age ≥70 years; literacy; residence close to an eye facility; being diabetic or hypertensive; history of ocular symptoms, and blindness.Conclusions:These findings suggest that a significant proportion (75%) of adults in the study area are not utilizing eye care services and that blindness is an important determinant of utilization of eye care services. Health education and awareness campaigns about the importance and benefits of seeking eye care early, and the provision of community-based eye care programs are essential to boost the uptake of eye care services in this community as well as other rural areas of West Africa.
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