1
|
Alipour F, Hashemi H, Lashay A, Jafari F, Motamed-Gorji N, Jabbarvand Behrouz M, Mirzaei M, Alizade Y, Soleymani MR, Shoja MR, Shahraki K, Khataminia GR, Poustchi H, Malekzadeh R. PERSIAN Eye Cohort Study (PECS): Design, Methodology. ARCHIVES OF IRANIAN MEDICINE 2023; 26:459-469. [PMID: 38301109 PMCID: PMC10685732 DOI: 10.34172/aim.2023.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/03/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND To report the study protocol, methodology and latest enrollment data of a large epidemiological multi-central eye cohort named PERSIAN Eye Cohort Study (PECS), originating from the ongoing PERSIAN Cohort Study, to investigate the distribution of ophthalmic disorders in different regions and ethnicities of Iran, and determine their associations with various exposures of ophthalmic and non-ophthalmic nature. METHODS A central committee designed the study and equipped six chosen centers (Khameneh, Some'e Sara, Hoveizeh, Yazd, Rafsanjan and Zahedan). A focal point in each center conducted the study under close supervision of the central committee. RESULTS This ongoing study was launched in 2014. Out of 65,580 eligible participants of the PERSIAN Cohort, 48,618 individuals aged 35-70 have been enrolled in the PECS (response rate: 74.13%) until June 2021. Slit lamp and fundus photography were performed for 28,702 (59.03%) and 27,437 (56.43%) individuals, respectively. CONCLUSION This large epidemiological multi-central eye cohort can improve our epidemiological knowledge of the prevalent ophthalmic disorders in different regions and ethnicities of Iran, and determine their associations with various exposures of ophthalmic and non-ophthalmic nature. This will be very useful for future planned nationwide and global interventions.
Collapse
Affiliation(s)
- Fateme Alipour
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Lashay
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Jafari
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazgol Motamed-Gorji
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Jabbarvand Behrouz
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mirzaei
- Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Alizade
- Amiralmomenin hospital, Department of ophthalmology, Gillan University of Medical Sciences, Rasht, Iran
| | | | - Mohammad Reza Shoja
- Department of Ophthalmology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Kourosh Shahraki
- Department of Ophthalmology, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Hossein Poustchi
- Liver, Pancreatic, and Biliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Montazeri M, Galavi Z, Ahmadian L. The role of mobile health in prevention, diagnosis, treatment and self-care of COVID-19 from the healthcare professionals' perspectives. Digit Health 2023; 9:20552076231171969. [PMID: 37152239 PMCID: PMC10159248 DOI: 10.1177/20552076231171969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/10/2023] [Indexed: 05/09/2023] Open
Abstract
Background To facilitate disease management, understanding the attitude of healthcare professionals regarding the use of this tool can help mobile health (mHealth) program developers develop appropriate interventions. Aims To assess the perspective of healthcare professionals regarding the contribution of mobile-based interventions in the prevention, diagnosis, self-care, and treatment (PDST) of COVID-19. Methods This is a survey study conducted in 2020 in Iran with 81 questions. In this study mHealth functionalities were categorized into four dimensions including innovative, monitoring and screening, remote services, and education and decision-making. The data were analyzed using descriptive statistics, ANOVA, and the Kruskal-Wallis test to compare the attitudes of the different job groups. Results In total, 123 providers participated, and 87.4% of them reported that mHealth technology is moderate to most helpful for the management of COVID-19. Healthcare professionals believed that mHealth technology could be most helpful in self-care and least helpful in the diagnosis of COVID-19. Regarding the functionalities of the mobile application, the results showed that the use of patient decision aids can be most helpful in self-care and the use of computer games can be least helpful in treatment. The participants believed that mHealth is more effective in monitoring and screening dimensions and less effective in providing remote services. Conclusions This study showed that healthcare professionals believed that mHealth technology could have a better contribution to self-care for patients with COVID-19. Therefore, it is better to plan and invest more in the field of self-care to help patients to combat COVID-19. The results of this study revealed which mhealth functionalities work better in four domains of prevention, treatment, self-care, and diagnosis of COVID-19. This can help healthcare authorities to implement appropriate IT-based interventions to combat COVID-19.
Collapse
Affiliation(s)
- Mahdieh Montazeri
- Department of Health Information Sciences, Faculty
of Management and Medical Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
| | - Zahra Galavi
- Department of Health Information Sciences, Faculty
of Management and Medical Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
| | - Leila Ahmadian
- Department of Health Information Sciences, Faculty
of Management and Medical Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
- Leila Ahmadian, Department of Health
Information Sciences, Faculty of Management and Medical Information Sciences,
Kerman University of Medical Sciences, Haft-bagh Highway, PO Box 7616911320,
Kerman, Iran. Emails: ,
| |
Collapse
|
3
|
Sharma IP, Chaudhry M, Sharma D, Kaiti R. Mobile health intervention for promotion of eye health literacy. PLOS GLOBAL PUBLIC HEALTH 2021; 1:e0000025. [PMID: 36962088 PMCID: PMC10021255 DOI: 10.1371/journal.pgph.0000025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/15/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Improving eye health awareness in the underserved population is a universal eye health priority. The ubiquity of cell phones and internet usage provides new and innovative opportunities for health promotion. This study evaluated the effect of mobile health intervention (text message link) to promote eye health literacy (EHL) of priority ocular morbidities. METHODS This study was an intervention evaluation and employed a two-armed pre-test post-test approach. Baseline assessment on EHL was performed on 424 university students. Participants were categorised into intervention and control groups, using the 1:1 allocation ratio. The intervention and control group received a text message alone and text message with a link, respectively. EHL was assessed via a self-administered questionnaire. The primary outcome measures were changes in EHL scores between baseline and one month post-intervention. Descriptive analysis was performed to assess the cost-effectiveness of the intervention. RESULTS With low attrition and a response rate of 95.6%, 409 responses were eligible for analysis. The mean age of the participants (49.4% males and 50.6% of females) was 19.9±1.68 years. Baseline EHL scores were low, and there was no correlation with a demographic profile (all p<0.05, CI 95%). The demographic characteristics were similar between the two groups (for all, P <0.05, CI 95%) at baseline. The EHL scores improved in both groups between the pre-and post-test assessment; however, improvements were statistically significant only in the control group. The one-month post-intervention EHL scores were also higher in the intervention group compared to the control (p≤0.001, CI 95% for all). The total cost incurred for the intervention used was 11.5 USD. CONCLUSION Text message link demonstrated effectiveness for improving the EHL scores; the low baseline EHL scores substantially improved with intervention. The text message link intervention is a cost-effective method and could be considered in advocating for eye health in developing countries, particularly during global emergencies.
Collapse
Affiliation(s)
- Indra Prasad Sharma
- GKCW National Eye Center, JDW National Referral Hospital, Thimphu, Bhutan
- Department of Optometry and Vision Science, Amity University Haryana, Gurugram, India
| | - Monica Chaudhry
- Department of Optometry and Vision Science, Amity University Haryana, Gurugram, India
| | - Dhanapati Sharma
- Department of English, Gedu College of Business Studies, Chukha, Bhutan
| | - Raju Kaiti
- Department of Optometry, Nepal Eye Hospital, Tripureshwor, Nepal
| |
Collapse
|
4
|
Katibeh M, Sabbaghi H, Kalantarion M, Nikkhah H, Mousavi B, Beiranvand R, Ahmadieh H, Kallestrup P. Eye Care Utilization in A Community-oriented Mobile Screening Programme for Improving Eye Health in Iran: A Cluster Randomized Trial. Ophthalmic Epidemiol 2020; 27:417-428. [PMID: 32449414 DOI: 10.1080/09286586.2020.1768552] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the effect of a mobile-based screening programme on eye care utilization in Iran. METHOD In this cluster randomized community trial, a representative sample of residents aged≥50 years from urban and rural areas in four districts in Tehran province were enrolled. The clusters were randomly assigned to one of the three parallel arms; the mHealth arm with digital data collection, vision screening test and retina evaluation using an integrated mobile application, the conventional arm with manual data collection and screening tests using Snellen chart and Fundus photography at the local primary healthcare facility, and the control arm with manual data collection without screening tests. The main outcome measure was eye care utilization which was defined as at least one visit to an optometrist or ophthalmologist. RESULTS Of 3312 eligible individuals, 2520 (76.1%) participated. In the first 3 months after the screening programme, eye care utilization was higher among those who were referred by the mHealth method (35.6% 95%CI: 31.1-40.4%) compared to those referred by the conventional method (32.7%, 95%CI: 27.5-38.2%) and to those observed in the control arm (4.5%, 95%CI: 3.2-6.0). Eye care utilization improved (OR = 1.5, 95%CI: 1.2-1.9) among the referred people after the screening programme compared to the utilization before this programme; however, this improvement was significantly higher in the mHealth method (OR: 1.7, 95%CI: 1.2-2.4) compared to the conventional method (OR: 1.2, 95%CI: 0.8-1.8). CONCLUSION AND RELEVANCE The mobile-based screening programme can significantly improve eye care utilization at the community level.
Collapse
Affiliation(s)
- Marzieh Katibeh
- Centre for Global Health, Department of Public Health, Aarhus University , Aarhus, Denmark.,Ophthalmic Research Centre, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Hamideh Sabbaghi
- Ophthalmic Research Centre, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Masomeh Kalantarion
- Ophthalmic Research Centre, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Homayoun Nikkhah
- Ophthalmic Research Centre, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Batool Mousavi
- Department of Prevention, Janbazan Medical and Engineering Research Centre , Tehran, Iran
| | - Ramin Beiranvand
- Ophthalmic Research Centre, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Hamid Ahmadieh
- Ophthalmic Research Centre, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Per Kallestrup
- Centre for Global Health, Department of Public Health, Aarhus University , Aarhus, Denmark
| |
Collapse
|
5
|
Oliveira IPRM, Meneguin S. Resolubility of eye care in a secondary care center: a quantitative approach. EINSTEIN-SAO PAULO 2019; 17:eGS4385. [PMID: 30892380 PMCID: PMC6422360 DOI: 10.31744/einstein_journal/2019gs4385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/12/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate the resolubility of ophthalmologic care in an integrated health center. METHODS This was a cross-sectional study including 816 patients who were attended from November 2013 to November of 2015. Data were collected from a medical consultation database and patients' medical records. RESULTS The majority of participants were women, non-diabetic, and had high school education. The main cause of referral for ophthalmologic evaluation was the consultation with a specialist, the waiting time for consultation was shorter for non-diabetic patients. CONCLUSION This Integrated health center presented, partial resolubility conditions to meet the ophthalmologic needs of users of the Brazilian Unified Health System. Eye care needs to be reorganized particularly by consider the priority cases of those at ophthalmological risk, and referrals should be done to the adequate care level and on time to guarantee resolubility.
Collapse
Affiliation(s)
| | - Silmara Meneguin
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
| |
Collapse
|
6
|
Katibeh M, Kalantarion M, Sabbaghi H, Mousavi B, Schriver M, Nikkhah H, Ahmadieh H, Kallestrup P. Designing a Screening Program for Prevention of Avoidable Blindness in Iran through a Participatory Action Approach. J Ophthalmic Vis Res 2019; 14:52-61. [PMID: 30820288 PMCID: PMC6388524 DOI: 10.4103/jovr.jovr_43_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To design a screening program for prevention of blindness at the community level in Iran. Methods In this qualitative study, the components and properties of the screening program were identified using a participatory action research method with focus group meetings (FGMs) with relevant health care providers and authorities. A content analysis approach was used for data analysis. Results In total, 18 stakeholders including six ophthalmologists with different sub-specialties participated in the five FGMs. The screening program aims to discover vision-threatening eye conditions in people aged 50 years and over. Primary health care workers deliver the program including vision tests and fundus imaging with the support of an ophthalmic technician. Retina specialists perform decision-making. Referral plans are interacted through an automated digital program. The screening environment, feedback, ethics and medical legal issues are other main components of the program. Conclusion This study presents the initial concepts and components of a screening program for prevention of blindness in the adult population in Iran. The program has the potential to improve eye health at the community level and may potentially be replicated as a model for similar settings elsewhere.
Collapse
Affiliation(s)
- Marzieh Katibeh
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Masomeh Kalantarion
- Department of Medical Education, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Sabbaghi
- Ophthalmic Epidemiology Research Center, Shahid Behesthi University of Medical Sciences, Tehran, Iran.,Ophthalmic Research Center, Shahid Behesthi University of Medical Sciences, Tehran, Iran
| | - Batool Mousavi
- Department of eHealth, Asre Danesh Afzar, Tehran, Iran.,Department of Prevention, Janbazan Medical and Engineering Research Center, Tehran, Iran
| | - Michael Schriver
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Homayoun Nikkhah
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Shahid Behesthi University of Medical Sciences, Tehran, Iran
| | - Per Kallestrup
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
7
|
Damari B, Mahdavi A, Hajian M. How to improve Iranians' vision health: on the national policy of preventing Iranians' blindness. Int J Ophthalmol 2019; 12:114-122. [PMID: 30662850 DOI: 10.18240/ijo.2019.01.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 11/27/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To review vision health situation of Iranian community, analyze its determinants, and discuss the adopted improvement strategies by the Iran Ministry of Health and Medical Education (MOHME). METHODS This was a rapid situation analysis with a qualitative approach in three parts of recognition, orientation and implementation. The data were gathered via review of upstream documents, national and international experiences, and experts and stakeholders' opinions. RESULTS Eradicating trachoma, increasing human resources, increasing educational and research centers and promotion of ophthalmic technologies were important achievements in the field of vision health in Iran. Through these achievements, it seemed that the pattern of causes of blindness and low vision was similar to that of the developed countries. However, the review of Iranians' vision health indicators showed that a considerable percent of the blindness and low vision was avoidable through a national program demanding 3 types of interventions in social determinants of health (SDH), community education, and increasing the access to health care services by integrating the necessary services in primary health care system. CONCLUSION Managing the issue requires attentions from a national committee for preventing blindness with participation of all stakeholders, implementing a national survey on vision health, preparation of the primary level health centers including employment and education of community health workers (Behvarzes), optometrists and general practitioners, fair distribution of specialized human resources and establishing at least one specialized center in each province for referring patients from the primary levels.
Collapse
Affiliation(s)
- Behzad Damari
- Neuroscience Institute, Tehran University of Medical Sciences, Tehran 1416833481, Iran
| | - Alireza Mahdavi
- Ministry of Health and Medical Education, Tehran 1467664961, Iran
| | - Maryam Hajian
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran 1445613113, Iran
| |
Collapse
|
8
|
Katibeh M, Mousavi B, Kalantarion M, Sabbaghi H, Abdolahi E, Nikkhah H, Ahmadieh H, Kallestrup P. Using mHealth to improve eye care in remote areas of Iran. COMMUNITY EYE HEALTH 2019; 32:65-66. [PMID: 32123481 PMCID: PMC7041833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Marzieh Katibeh
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Batool Mousavi
- Department of eHealth, Asre Danesh Afzar (ADA), Tehran, Iran
| | - Masomeh Kalantarion
- World Health Organization Collaborating Centre for Eye Health and Prevention of Blindness, Ophthalmic Research Centre, Shahid Behesthi University of Medical Sciences, Tehran, Iran
| | - Hamideh Sabbaghi
- World Health Organization Collaborating Centre for Eye Health and Prevention of Blindness, Ophthalmic Research Centre, Shahid Behesthi University of Medical Sciences, Tehran, Iran
| | - Ehsan Abdolahi
- Department of eHealth, Asre Danesh Afzar (ADA), Tehran, Iran
| | - Homayoun Nikkhah
- World Health Organization Collaborating Centre for Eye Health and Prevention of Blindness, Ophthalmic Research Centre, Shahid Behesthi University of Medical Sciences, Tehran, Iran
| | - Hamid Ahmadieh
- World Health Organization Collaborating Centre for Eye Health and Prevention of Blindness, Ophthalmic Research Centre, Shahid Behesthi University of Medical Sciences, Tehran, Iran
| | - Per Kallestrup
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
9
|
Sukati VN, Moodley VR, Mashige KP. A situational analysis of eye care services in Swaziland. J Public Health Afr 2018; 9:892. [PMID: 30854181 PMCID: PMC6379695 DOI: 10.4081/jphia.2018.892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 08/23/2018] [Indexed: 11/23/2022] Open
Abstract
Compared to other African countries, Swaziland performs the worst in terms of providing eye health care services. A priority goal of the World Health Organization (WHO) is to alleviate childhood blindness, particularly in low-income countries such as Swaziland, where many people live in poverty, which is a contributor to poor health outcomes. A mixed method approach that entailed a document review, key informant interviews and clinical facility assessment questionnaires was used. Hospitals and mission clinics offering ophthalmic services were identified through the website of the Ministry of Health and verified during key informant interviews. A saturated sampling procedure was applied due to the few facilities that offer eye care services. Six framework components from the WHO for analysing health systems were utilised in an eye health care service context: leadership and governance, eye health services, eye health workforce, eye health financing systems, eye health medical supplies and technologies, and eye health information systems. Poor management, lack of accountability, poor monitoring and evaluation mechanisms, weak coordination and ineffective private-public sector regulations were identified as factors that lead to poor eye care in the country. The optometrists indicated that refractive services are the most rendered ophthalmic services. The exodus of healthcare practitioners has contributed to the downfall of the public health sector in the country. Five government eye care facilities, 3 government hospitals, 1 non-governmental organization (NGO) and a church mission clinic were included in this analysis. The eye services distribution favors the more affluent areas, particularly the more urban Hhohho Region, which is also where most of the eye health professionals are located. No campaigns have been conducted to prevent childhood blinding diseases or create awareness about getting children's eyes tested for refractive correction. The burden of eye diseases among children in Swaziland remains unknown. More eye health care personnel and equipped facilities are needed throughout the country, and the eye health care program needs to be adopted.
Collapse
Affiliation(s)
- Velibanti Nhlanhla Sukati
- Discipline of Optometry, School of Health Sciences, University of KwaZulu- Natal, Durban, South Africa
| | | | | |
Collapse
|
10
|
Jolley E, Mafwiri M, Hunter J, Schmidt E. Integration of eye health into primary care services in Tanzania: a qualitative investigation of experiences in two districts. BMC Health Serv Res 2017; 17:823. [PMID: 29237503 PMCID: PMC5729236 DOI: 10.1186/s12913-017-2787-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/07/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Visual impairment is a public health problem in sub-Saharan Africa, affecting nearly 5% of the population. Efforts to combat avoidable causes have been hampered by weak health systems and little evidence exists to suggest what interventions may be effective to improve the situation. Despite this, there are calls to promote some specific interventions, one of which being the closer integration of eye health services into health systems, often focusing on training primary health workers to deliver basic eye health services. This study seeks to understand how eye health services are delivered by primary health workers who have received training and what constraints remain to effective service provision. METHODS This was a qualitative investigation into the experiences of 20 primary health workers trained in primary eye care and eight key informants working within specialist eye health services or regional and district health management positions in two districts in Tanzania. RESULTS Despite feeling confident in their own eye care skills, most primary health workers felt constrained in the services they could provide to their communities by insufficient resources needed for diagnosis and treatment, and by lack of systematic supportive supervision to their work. Specialist ophthalmic staff were aware of this issue, although for the most part they felt it was not within their capacity to remedy and that it fell within the remit of general health managers. Many participants discussed the low support to eye health from the national government, evidenced through the lack of dedicated funding to the area and traditional reliance on outside funds including international charities. CONCLUSIONS Although training of primary health workers is useful, it is recognised that is not sufficient to address the burden of eye health disease present in rural communities in Tanzania. It is likely that broader engagement with the general health system, and most likely with the private sector, will be necessary to improve the coverage of eye health care to remote and poor communities such as those in Morogoro. Further investment is needed to develop innovative approaches to delivering eye health services, including preventative, curative and rehabilitative services.
Collapse
Affiliation(s)
- Emma Jolley
- Sightsavers, 35 Perrymount Road, Haywards Heath, UK.
| | - Milka Mafwiri
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | | | | |
Collapse
|