Poverty as a barrier to accessing cataract surgery: a study from Tanzania

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.…”

“…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.…”

Follow-Up Survey of Cataract Surgical Coverage and Barriers to Cataract Surgery at Nkhoma, Malawi

“…This raises concerns about the perceptions about cost (both direct and indirect), especially amongst the women. 18,19 In order to ensure continuity of the Nkhoma program it may become necessary to charge a small fee for surgery in the future, although no plans are currently underway. In this case, patient counselling about the benefits of cataract surgery is an effective way to increase the acceptance of cataract surgery in those who have previously stated that they were too poor to pay.…”

Are Blind People More Likely to Accept Free Cataract Surgery? A Study of Vision-Related Quality of Life and Visual Acuity in Kenya

“…11,24,25 However, recent findings from Tanzania show that costs are often used as an excuse for refusal of surgery which will be unchallenged by health workers; the real reasons for refusal are often not given. 26 In South Africa uptake of cataract surgery was reported to be low despite being offered at a very low price (US $3.00) or even offered free of charge. 12 Similarly, a study conducted in rural Malawi, where free surgery and free transport to the hospital were provided the cost of surgery was not the major problem.…”