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Urbinati F, Jiménez-Siles L, Rocha-de-Lossada C, Valvecchia G, Barraquer-Compte E, Fernández J. Humanitarian missions and visual outcomes in cataract surgery: A literature review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024; 99:288-295. [PMID: 38309656 DOI: 10.1016/j.oftale.2024.01.008] [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: 09/05/2023] [Accepted: 12/01/2023] [Indexed: 02/05/2024]
Abstract
The limited accessibility to ophthalmological services in remote regions of developing countries poses a significant challenge in visual healthcare. Cataracts and refractive errors are prominent causes of visual impairment, and surgery, despite being an efficient option, faces barriers in developing countries due to financial and geographical constraints. Humanitarian missions play a vital role in addressing this issue. The improvement in the accuracy of calculating IOL power through techniques such as keratometry and biometry is a fundamental step towards optimizing surgical outcomes and the quality of life for patients in these underserved regions. In this context, the consideration of keratometry and immersion ultrasound biometry as preoperative assessment standards in cataract surgeries in developing countries is presented as a pertinent and advisable strategy.
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Affiliation(s)
- F Urbinati
- Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | | | - C Rocha-de-Lossada
- Hospital Regional Universitario de Málaga, Málaga, Spain; Fundación Elena Barraquer, Barcelona, Spain; Departamento de Oftalmología, Vithas Málaga, Málaga, Spain; Qvision, VITHAS Hospital, Almería, Spain; Departamento de Cirugía, Área de Oftalmología, Universidad de Sevilla, Sevilla, Spain.
| | - G Valvecchia
- Fundación Elena Barraquer, Barcelona, Spain; Clínica de Ojos Quilmes, Quilmes, Buenos Aires, Argentina
| | - E Barraquer-Compte
- Fundación Elena Barraquer, Barcelona, Spain; Centro de Oftalmología Barraquer, Barcelona, Spain
| | - J Fernández
- Fundación Elena Barraquer, Barcelona, Spain; Qvision, VITHAS Hospital, Almería, Spain
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McCormick I, Tong K, Abdullah N, Abesamis-Dischoso C, Gende T, Hashim EB, Ho SM, Jalbert I, Jeronimo B, Matoto-Raikabakaba E, Ono K, Piyasena PN, Rogers JT, Szetu J, Tran MA, Tse DYY, Win Y, Yap TP, Yoon S, Yusufu M, Burton MJ, Ramke J. Strategies to address inequity of uncorrected refractive error in the Western Pacific: A modified Delphi process. Ophthalmic Physiol Opt 2024. [PMID: 38881170 DOI: 10.1111/opo.13348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/26/2024] [Accepted: 06/03/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Uncorrected refractive error is the leading cause of vision impairment globally; however, little attention has been given to equity and access to services. This study aimed to identify and prioritise: (1) strategies to address inequity of access to refractive error services and (2) population groups to target with these strategies in five sub-regions within the Western Pacific. METHODS We invited eye care professionals to complete a two-round online prioritisation process. In round 1, panellists nominated population groups least able to access refractive error services, and strategies to improve access. Responses were summarised and presented in round 2, where panellists ranked the groups (by extent of difficulty and size) and strategies (in terms of reach, acceptability, sustainability, feasibility and equity). Groups and strategies were scored according to their rank within each sub-region. RESULTS Seventy five people from 17 countries completed both rounds (55% women). Regional differences were evident. Indigenous peoples were a priority group for improving access in Australasia and Southeast Asia, while East Asia identified refugees and Oceania identified rural/remote people. Across the five sub-regions, reducing out-of-pocket costs was a commonly prioritised strategy for refraction and spectacles. Australasia prioritised improving cultural safety, East Asia prioritised strengthening school eye health programmes and Oceania and Southeast Asia prioritised outreach to rural areas. CONCLUSION These results provide policy-makers, researchers and funders with a starting point for context-specific actions to improve access to refractive error services, particularly among underserved population groups who may be left behind in existing private sector-dominated models of care.
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Affiliation(s)
- Ian McCormick
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kelvin Tong
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Nurliyana Abdullah
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam
- Eccles Institute of Neuroscience, The John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Theresa Gende
- Divine Word University, Madang, Papua New Guinea
- The Fred Hollows Foundation New Zealand, Madang, Papua New Guinea
| | - Effendy Bin Hashim
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Ministry of Health, Putrajaya, Malaysia
| | - S May Ho
- The Fred Hollows Foundation, Melbourne, Victoria, Australia
| | - Isabelle Jalbert
- School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
| | - Belmerio Jeronimo
- Department of Ophthalmology, Guido Valadares National Hospital, Dili, Timor-Leste
| | | | - Koichi Ono
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Prabhath Nishantha Piyasena
- Directorate of Policy Analysis and Development, Ministry of Health, Colombo, Sri Lanka
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Jaymie T Rogers
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - John Szetu
- The Fred Hollows Foundation New Zealand Regional Eye Centre, Honiara, Solomon Islands
| | - Minh Anh Tran
- Department of Ophthalmology and Optometry, Hanoi Medical University, Hanoi, Vietnam
| | - Dennis Yan-Yin Tse
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ye Win
- Sight for All, Yangon, Myanmar
| | | | - Sangchul Yoon
- Department of Medical Humanities and Social Sciences, College of Medicine, Yonsei University, Seoul, South Korea
| | - Mayinuer Yusufu
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
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Allen LN, Nkomazana O, Kumar Mishra S, Ratshaa B, Ho-Foster A, Rono H, Roshan A, Macleod D, Kim M, Patricia Marques A, Bolster N, Burton M, Gichangi M, Karanja S, Bastawrous A. Sociodemographic characteristics of community eye screening participants: protocol for cross-sectional equity analyses in Botswana, India, Kenya, and Nepal. Wellcome Open Res 2023; 7:144. [PMID: 37485295 PMCID: PMC10357071 DOI: 10.12688/wellcomeopenres.17768.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 07/25/2023] Open
Abstract
Background Attendance rates for eye clinics are low across low- and middle-income countries (LMICs) and exhibit marked sociodemographic inequalities. We aimed to quantify the association between a range of sociodemographic domains and attendance rates from vision screening in programmes launching in Botswana, India, Kenya and Nepal. Methods We performed a literature review of international guidance on sociodemographic data collection. Once we had identified 13 core candidate domains (age, gender, place of residence, language, ethnicity/tribe/caste, religion, marital status, parent/guardian status, place of birth, education, occupation, income, wealth) we held workshops with researchers, academics, programme implementers, and programme designers in each country to tailor the domains and response options to the national context, basing our survey development on the USAID Demographic and Health Survey model questionnaire and the RAAB7 eye health survey methodology. The draft surveys were reviewed by health economists and piloted with laypeople before being finalised, translated, and back-translated for use in Botswana, Kenya, India, and Nepal. These surveys will be used to assess the distribution of eye disease among different sociodemographic groups, and to track attendance rates between groups in four major eye screening programmes. We gather data from 3,850 people in each country and use logistic regression to identify the groups that experience the worst access to community-based eye care services in each setting. We will use a secure, password protected android-based app to gather sociodemographic information. These data will be stored using state-of-the art security measures, complying with each country's data management legislation and UK law. Discussion This low-risk, embedded, pragmatic, observational data collection will enable eye screening programme managers to accurately identify which sociodemographic groups are facing the highest systematic barriers to accessing care at any point in time. This information will be used to inform the development of service improvements to improve equity.
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Affiliation(s)
- Luke N Allen
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Bakgaki Ratshaa
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Ari Ho-Foster
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Hillary Rono
- Peek Vision, Berkhamsted, UK
- Kitale County and Referral Hospital, Kitale, Kenya
| | - Abhiskek Roshan
- Nepal Netra Jyoti Sangh, Kathmandu, Nepal
- Sagarmatha Choudhary Eye Hospital, Lahan, Nepal
| | - David Macleod
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Min Kim
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ana Patricia Marques
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Nigel Bolster
- Peek Vision, Berkhamsted, UK
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Andrew Bastawrous
- Peek Vision, Berkhamsted, UK
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
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Allen LN, Nkomazana O, Mishra SK, Gichangi M, Macleod D, Ramke J, Bolster N, Marques AP, Rono H, Burton M, Kim M, Ratshaa B, Karanja S, Ho-Foster A, Bastawrous A. Improvement studies for equitable and evidence-based innovation: an overview of the 'IM-SEEN' model. Int J Equity Health 2023; 22:116. [PMID: 37330480 PMCID: PMC10276912 DOI: 10.1186/s12939-023-01915-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 05/11/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Health inequalities are ubiquitous, and as countries seek to expand service coverage, they are at risk of exacerbating existing inequalities unless they adopt equity-focused approaches to service delivery. MAIN TEXT Our team has developed an equity-focused continuous improvement model that reconciles prioritisation of disadvantaged groups with the expansion of service coverage. Our new approach is based on the foundations of routinely collecting sociodemographic data; identifying left-behind groups; engaging with these service users to elicit barriers and potential solutions; and then rigorously testing these solutions with pragmatic, embedded trials. This paper presents the rationale for the model, a holistic overview of how the different elements fit together, and potential applications. Future work will present findings as the model is operationalised in eye-health programmes in Botswana, India, Kenya, and Nepal. CONCLUSION There is a real paucity of approaches for operationalising equity. By bringing a series of steps together that force programme managers to focus on groups that are being left behind, we present a model that can be used in any service delivery setting to build equity into routine practice.
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Affiliation(s)
- Luke N Allen
- London School of Hygiene & Tropical Medicine (LSHTM), Keppel St, London, WC1E 7HT, UK.
| | | | | | | | - David Macleod
- London School of Hygiene & Tropical Medicine (LSHTM), Keppel St, London, WC1E 7HT, UK
| | - Jacqueline Ramke
- London School of Hygiene & Tropical Medicine (LSHTM), Keppel St, London, WC1E 7HT, UK
| | | | - Ana Patricia Marques
- London School of Hygiene & Tropical Medicine (LSHTM), Keppel St, London, WC1E 7HT, UK
| | - Hilary Rono
- Kitale Hospital and Peek Vision, Kitale, Kenya
| | - Matthew Burton
- London School of Hygiene & Tropical Medicine (LSHTM), Keppel St, London, WC1E 7HT, UK
| | - Min Kim
- London School of Hygiene & Tropical Medicine (LSHTM), Keppel St, London, WC1E 7HT, UK
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McCormick I, Kim MJ, Hydara A, Olaniyan SI, Jobe M, Badjie O, Sanyang NMB, Jarju G, Njai M, Sankareh A, Bastawrous A, Allen L, Mactaggart I, Burton MJ, Ramke J. Socioeconomic position and eye health outcomes: identifying inequality in rapid population-based surveys. BMJ Open 2023; 13:e069325. [PMID: 36882236 PMCID: PMC10008479 DOI: 10.1136/bmjopen-2022-069325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVE Monitoring health outcomes disaggregated by socioeconomic position (SEP) is crucial to ensure no one is left behind in efforts to achieve universal health coverage. In eye health planning, rapid population surveys are most commonly implemented; these need an SEP measure that is feasible to collect within the constraints of a streamlined examination protocol. We aimed to assess whether each of four SEP measures identified inequality-an underserved group or socioeconomic gradient-in key eye health outcomes. DESIGN Population-based cross-sectional survey. PARTICIPANTS A subset of 4020 adults 50 years and older from a nationally representative sample of 9188 adults aged 35 years and older in The Gambia. OUTCOME MEASURES Blindness (presenting visual acuity (PVA) <3/60), any vision impairment (VI) (PVA <6/12), cataract surgical coverage (CSC) and effective cataract surgical coverage (eCSC) at two operable cataract thresholds (<6/12 and <6/60) analysed by one objective asset-based measure (EquityTool) and three subjective measures of relative SEP (a self-reported economic ladder question and self-reported household food adequacy and income sufficiency). RESULTS Subjective household food adequacy and income sufficiency demonstrated a socioeconomic gradient (queuing pattern) in point estimates of any VI and CSC and eCSC at both operable cataract thresholds. Any VI, CSC <6/60 and eCSC <6/60 were worse among people who reported inadequate household food compared with those with just adequate food. Any VI and CSC <6/60 were worse among people who reported not enough household income compared with those with just enough income. Neither the subjective economic ladder question nor the objective asset-wealth measure demonstrated any socioeconomic gradient or pattern of inequality in any of the eye health outcomes. CONCLUSION We recommend pilot-testing self-reported food adequacy and income sufficiency as SEP variables in vision and eye health surveys in other locations, including assessing the acceptability, reliability and repeatability of each question.
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Affiliation(s)
- Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Min J Kim
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Abba Hydara
- Sheikh Zayed Regional Eye Care Centre, Banjul, Gambia
| | | | - Modou Jobe
- MRC Unit The Gambia at LSHTM, Banjul, Gambia
| | - Omar Badjie
- Directorate of Health Promotion and Education, Ministry of Health, Kotu, Gambia
| | | | - Gibril Jarju
- Directorate of Planning and Information, Ministry of Health, Kotu, Gambia
| | - Modou Njai
- Directorate of Health Promotion and Education, Ministry of Health, Kotu, Gambia
| | - Alhagie Sankareh
- Regional Directorate of Health Services, West Coast Health Region, Ministry of Health, Kanifing, Gambia
| | - Andrew Bastawrous
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Luke Allen
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
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Ramke J, Silva JC, Gichangi M, Ravilla T, Burn H, Buchan JC, Welch V, Gilbert CE, Burton MJ. Cataract services for all: Strategies for equitable access from a global modified Delphi process. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000631. [PMID: 36962938 PMCID: PMC10021896 DOI: 10.1371/journal.pgph.0000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 11/22/2022] [Indexed: 02/24/2023]
Abstract
Vision loss from cataract is unequally distributed, and there is very little evidence on how to overcome this inequity. This project aimed to engage multiple stakeholder groups to identify and prioritise (1) delivery strategies that improve access to cataract services for under-served groups and (2) population groups to target with these strategies across world regions. We recruited panellists knowledgeable about cataract services from eight world regions to complete a two-round online modified Delphi process. In Round 1, panellists answered open-ended questions about strategies to improve access to screening and surgery for cataract, and which population groups to target with these strategies. In Round 2, panellists ranked the strategies and groups to arrive at the final lists regionally and globally. 183 people completed both rounds (46% women). In total, 22 distinct population groups were identified. At the global level the priority groups for improving access to cataract services were people in rural/remote areas, with low socioeconomic status and low social support. South Asia and Sub-Saharan Africa were the only regions in which panellists ranked women in the top 5 priority groups. Panellists identified 16 and 19 discreet strategies to improve access to screening and surgical services, respectively. These mostly addressed health system/supply side factors, including policy, human resources, financing and service delivery. We believe these results can serve eye health decision-makers, researchers and funders as a starting point for coordinated action to improve access to cataract services, particularly among population groups who have historically been left behind.
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Affiliation(s)
- Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Juan Carlos Silva
- Pan American Health Organization, World Health Organization, Bogotá, Colombia
| | | | | | - Helen Burn
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - John C. Buchan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Clare E. Gilbert
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matthew J. Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Moorfields Eye Hospital, London, United Kingdom
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Barraquer-Compte E, Rocha-de-Lossada C, Ferreiro-Vazquez T, Valvecchia G, Fernández J. Logistics description of a high yield cataract surgery non-profitable expedition. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:193-198. [PMID: 36801255 DOI: 10.1016/j.oftale.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/17/2022] [Indexed: 02/17/2023]
Abstract
PURPOSE To describe the logistics and methodology of a high yield surgical non-profitable campaign. METHODS A descriptive study based on previous non-profitable campaigns dedicated to cataract surgery. RESULTS The method is based on planification, finance acquisition, volunteer support, foreign affairs with the collaborating country where the surgeries are going to be performed, team organization, and overall, summoning all the stated items to materialize a global humanitarian campaign to eradicate cataracts by clinical and surgical procedures. CONCLUSIONS Blindness due to cataracts can be over-ruled. We consider that through our planification and methodology, other organizations may acquire some knowledge to improve their methodology and carry out similar volunteering surgical campaigns. Planification, coordination, financial aid, determination, and a strong will power are altogether compulsory for a successful non-profitable surgical campaign.
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Affiliation(s)
- E Barraquer-Compte
- Fundación Elena Barraquer, Barcelona, Spain; Centro de Oftalmología Barraquer, Barcelona, Spain
| | - C Rocha-de-Lossada
- Fundación Elena Barraquer, Barcelona, Spain; Qvision, VITHAS Hospital, Almería, Spain; Hospital Regional Universitario de Málaga, Málaga, Spain; Departamento de Cirugía, Área de Oftalmología, Universidad de Sevilla, Sevilla, Spain.
| | | | - G Valvecchia
- Fundación Elena Barraquer, Barcelona, Spain; Clínica de Ojos Quilmes, Quilmes, Buenos Aires, Argentina
| | - J Fernández
- Fundación Elena Barraquer, Barcelona, Spain; Qvision, VITHAS Hospital, Almería, Spain
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Sharma N, Sharma C, Sharma A. A qualitative study on gender barriers to access cataract surgery in rural Gurugram, Haryana, India. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/02646196221144869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study aims to comprehend nuances of gender barriers to access cataract surgery in the rural population of Gurugram district, Haryana, India. Data from 100 male and 100 female cataract surgery patients who underwent surgery at the university-affiliated hospital’s department of ophthalmology were examined. Data on the patients’ ages, the better eye’s and operated eye’s visual acuity, the cataract’s maturity at the time of surgery and the type of cataract surgery chosen were examined. Visual impairment was defined when the better eye’s visual acuity was less than 6/18 (0.32). At the time of surgery, women had a serious visual impairment in the better eye and also opted for a less expensive surgery option. In-depth interviews and focus group discussions were planned to understand the attitude, social norms and nuances of women’s accessibility to cataract surgery. This essay includes a qualitative investigation on access restrictions based on gender.
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Affiliation(s)
- Neeraj Sharma
- SGT Medical College Hospital and Research Institute, India
| | | | - Ananya Sharma
- College of Medicine and Sagore Dutta Hospital, India
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9
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Tegegn MT, Assaye AK, Belete GT, Munaw MB. Visually significant cataract and associated factors among older people attending a community ophthalmic service in central Gondar Zone, Northwest Ethiopia: a cross-sectional study. J Int Med Res 2022; 50:3000605221104761. [PMID: 35698450 PMCID: PMC9201317 DOI: 10.1177/03000605221104761] [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] [Indexed: 12/03/2022] Open
Abstract
Objective In this study, we aimed to determine the prevalence of visually significant
cataract and associated factors among older people attending community
ophthalmic services in the central Gondar Zone, Northwest Ethiopia. Methods We conducted a community outreach-based cross-sectional study among adults
aged ≥40 years in the central Gondar Zone from 30 May to 15 June 2021. We
used systematic random sampling to select study participants.
Interviewer-administered questionnaires and ocular examinations were
performed and the data recorded. We applied binary logistic regression to
identify factors associated with visually significant cataract. Results A total of 821 participants were included, with median age 57 years. The
prevalence of visually significant cataract was 29.1% (95% CI: 26.1–32.0).
Age ≥80 years (adjusted odds ratio [AOR] = 16.9; 95% CI: 7.5–38.4), rural
residence (AOR = 1.7; 95% CI: 1.02–2.7), unmarried status (AOR = 1.9; 95%
CI: 1.2–3.2), illiteracy (AOR = 2.9; 95% CI: 1.4–6.1), unemployed status
(AOR = 1.7; 95% CI: 1.1–2.7), and sunlight exposure ≥5 hours per day
(AOR = 1.6; 95% CI: 1.04–2.4) were significantly associated with visually
significant cataract. Conclusion In this study, visually significant cataract was found to be high, which
requires immediate public health intervention.
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Affiliation(s)
- Melkamu Temeselew Tegegn
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aragaw Kegne Assaye
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gizachew Tilahun Belete
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Minychil Bantihun Munaw
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Ramke J, Evans JR, Habtamu E, Mwangi N, Silva JC, Swenor BK, Congdon N, Faal HB, Foster A, Friedman DS, Gichuhi S, Jonas JB, Khaw PT, Kyari F, Murthy GVS, Wang N, Wong TY, Wormald R, Yusufu M, Taylor H, Resnikoff S, West SK, Burton MJ, Aghaji A, Adewole AT, Csutak A, Salam AS, Paduca A, Bron AM, Denniston AK, Lazo Legua A, Halim A, Tefera AW, Mwangi A, Jenkins AJ, Davis A, Meddeb-Ouertani A, Wali AH, Palis AG, Bastos de Carvalho A, Joshi A, Kreis AJ, Mueller A, Bastawrous A, Cooper A, Smith AF, Grzybowski A, Arvind A, Karanu AM, Orlina AO, Burnett A, Yashadhana A, Abeydeera AP, Abdurakhmanova A, Mohamed A, Bacchav A, Bernhisel A, Webson AW, Azuara-Blanco A, Hossain A, Ilhan B, Assumpta Lucienne B, Tousignant B, Shamanna BR, Wiafe B, Mueller B, Caglar C, Mpyet C, Abraham CH, Cheung CY, Thiel CL, Jan CL, Emedike C, Chuluunkhuu C, Chinyere C, Henein C, Gilbert CE, Bascaran C, Nitulescu CE, Patel D, Bachani D, Kiage D, Etya'ale D, Dahdal D, Woo Lawson D, Godin D, Nkanga DG, Ondeyo DM, O'Brien D, Mutie DM, Alalawi ESK, Mayorga E, Bin Hashim E, Ashrafi E, Kishiki EA, Kurian E, D'Esposito F, Masila F, Pena FY, Büsch F, Topouzis F, Bandello F, Oyediji FJ, Thumann G, Ezz Elarab G, Kitema GF, Schlenther G, Fefoame GO, Cochrane GM, Laganovska G, Awan HR, Ansari HM, Philippin H, Burn H, Dimaras H, Filipe HP, Monye HI, Kandel H, Randrianarisoa HL, Jones I, Murdoch IE, Fabian ID, Khan IA, Sharma IP, Elbeih I, Mactaggart I, Pastor JC, Keunen JEE, Ohuma JA, Pithuwa Nirwoth J, Hammou J, Vianna JR, Biao JE, Burr JM, Keenan JD, Blijkers J, Black JM, Barbosa Breda J, Furtado JM, Buchan JC, Lawrenson JG, Kempen JH, Ehrlich JR, Stern J, Zhang JH, Keskinbora KH, Knoll KM, Blanchet K, Schmid KL, Ono K, Ogundimu K, Balo K, Somda KP, Yeboah K, Amissah-Arthur KN, Nasehi L, Øverland L, Vijaya L, Keay L, Hamm LM, Mowatt L, Harrison-Williams LCM, Silva L, Bilotto L, Mörchen M, Rabiu M, Zondervan M, Chagunda M, Sandinha MT, Yee Melgar M, Salas Vargas M, Daniell MD, Katibeh M, Broom M, Collins ME, Alp MN, Kwarteng MA, Belkin M, Gichangi M, Sylvanowicz M, Wu M, Cano MR, Shalaby M, Duggal M, Khairallah M, Batur M, Bikbov MM, Ramappa M, Pamarathi N, Khachatryan N, Muhammad N, Kennedy N, Murray N, Beare NAV, Astbury N, Carnt NA, St Rose NA, Barker NH, Pehere NK, Uche NJ, Lois N, Awe OO, Mujica OJ, Okolo OE, Rani PK, Ruamviboonsuk P, Ndiaye PA, Dhakhwa P, Rozsival P, Mbulawa PK, Keane PA, Jones PR, Holland P, Nukella PB, Burgess PI, O'Dwyer PA, Piyasena P, Bastola P, Morjaria P, Nasimee Q, Rambacal RAT, Das R, Khandekar RB, Azad R, Bashshur R, Sousa RARC, Oenga R, Gurung R, Geneau R, Jacobs RJ, Finger RP, Guymer RH, Sevciuc R, Khanna RC, George R, Graham R, Kawasaki R, Ho SM, Mishra SK, Buttan S, Block SS, Talero S, Yoon S, Joseph S, Safi S, Dodson S, Munoz SR, Bakayoko S, Mohammadi SF, Muez SA, Pardhan S, Hopkins S, Sheu SJ, Coulibaly SM, Schellini SA, Arunga S, Bush SR, Sivaprasad S, Salomao SR, Marmamula S, Onwubiko SN, Misra SL, Kuyyadiyil S, Kulkarni S, khanal S, Yasmin S, Pavljasevic SN, Gilbert SS, Braithwaite T, Ghidirimschi T, Ravilla T, Fricke TR, Cogliati T, Kassa T, Peto T, Dibb U, Lansingh VC, Hu VH, Sheffield VM, Mathenge W, Dean WH, Nolan W, Hiratsuka Y, Mahsood YJ, Sapkota Y. Grand Challenges in global eye health: a global prioritisation process using Delphi method. THE LANCET. HEALTHY LONGEVITY 2022; 3:e31-e41. [PMID: 35028632 PMCID: PMC8732284 DOI: 10.1016/s2666-7568(21)00302-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. METHODS Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. FINDINGS Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. INTERPRETATION This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. FUNDING The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. TRANSLATIONS For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK,School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand,Correspondence to: Dr Jacqueline Ramke, International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Jennifer R Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK,Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Esmael Habtamu
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK,Eyu-Ethiopia: Eye Health Research, Training and Service Centre, Bahirdar, Ethiopia
| | - Nyawira Mwangi
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK,Kenya Medical Training College, Nairobi, Kenya
| | | | - Bonnielin K Swenor
- The Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, UK,Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China,Orbis International, New York, NY, USA
| | - Hannah B Faal
- Department of Ophthalmology, University of Calabar, Calabar, Nigeria,Africa Vision Research Institute, Durban, Kwa-Zulu Natal, South Africa
| | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - David S Friedman
- Massachusetts Eye and Ear, Harvard Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Stephen Gichuhi
- Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
| | - Jost B Jonas
- Institute of Clinical and Scientific Ophthalmology and Acupuncture Jonas & Panda, Heidelberg, Germany,Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany,Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Peng T Khaw
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Fatima Kyari
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK,College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Gudlavalleti V S Murthy
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK,Indian Institute of Public Health, Hyderabad, India
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore,Duke-NUS Medical School, Singapore
| | - Richard Wormald
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK,National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Hugh Taylor
- Melbourne School of Population Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Serge Resnikoff
- Brien Holden Vision Institute and School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
| | - Sheila K West
- Dana Center for Preventive Ophthalmology, Johns Hopkins University, Baltimore, MD, USA
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK,National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Aghaji A, Burchett HED, Hameed S, Gilbert C. Assessing the capacity of primary health care facilities in Nigeria to deliver eye health promotion: Results of a mixed-methods feasibility study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000645. [PMID: 36962620 PMCID: PMC10022001 DOI: 10.1371/journal.pgph.0000645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022]
Abstract
Over 25 million people in sub-Saharan Africa are blind or visually impaired, the majority from avoidable causes. Health promotion and disease prevention are important strategies for eye health, through good governance, health literacy and increasing access to eye care services. To increase equity in access for eyecare services, the World Health Organization Africa Region developed a package of interventions for primary eye care, which includes health promotion. The aim of this study was to assess the capacity of the primary healthcare system to deliver health promotion for eye care in Nigeria. Mixed methods were used during a survey of 48 government-owned primary health care facilities in Anambra state, Nigeria: interviews with district health supervisors, facility staff and village health workers, and a desk review of policy documents for primary health care and eye care in Nigeria. Findings were benchmarked against the capacities needed to deliver health promotion agreed through a Delphi exercise and were analysed using the World Health Organization's health system building blocks. Eye health promotion policies exist but are fragmented across different national health policies. Health promotion activities focussed on "mobilising" community members to access care provided in facilities, particularly for women of childbearing age and young children, and health education was limited. Only one in ten facilities engaged the elderly and a fifth delivered health promotion for eye care. Health promotion activities were supervised in 43.2% of facilities and transport to remote areas was limited. A robust eye health promotion strategy needs to be included in the National Eye Health Policy. The scope of existing health promotion will need to expand to include eye conditions and different age groups. Increasing eye health literacy should be emphasized. Governance, training health workers in eye health promotion, educational materials, and transport to visit communities will also be needed.
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Affiliation(s)
- Ada Aghaji
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Helen E D Burchett
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Shaffa Hameed
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Clare Gilbert
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Yoshizaki M, Ramke J, Zhang JH, Aghaji A, Furtado JM, Burn H, Gichuhi S, Dean WH, Congdon N, Burton MJ, Buchan J. How can we improve the quality of cataract services for all? A global scoping review. Clin Exp Ophthalmol 2021; 49:672-685. [PMID: 34291550 DOI: 10.1111/ceo.13976] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cataract is a leading cause of blindness and vision impairment globally. Cataract surgery is one of the most frequently performed operations worldwide, but good quality services are not universally available. This scoping review aims to summarise the nature and extent of published literature on interventions to improve the quality of services for age-related cataract globally. METHODS We used the dimensions of quality adopted by WHO-effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency-to which we added planetary health. On 17 November 2019, we searched MEDLINE, Embase and Global Health for manuscripts published since 1990, without language or geographic restrictions. We included studies that reported quality-relevant interventions and excluded studies focused on technical aspects of surgery or that only involved children (younger than 18 years). Screening of titles/abstracts, full-text review and data extraction were performed by two reviewers independently. Studies were grouped thematically and results synthesised narratively. RESULTS Most of the 143 included studies were undertaken in high-income countries (n = 93, 65%); 29 intervention groups were identified, most commonly preoperative education (n = 17, 12%) and pain/anxiety management (n = 16, 11%). Efficiency was the quality element most often assessed (n = 58, 41%) followed by people-centredness (n = 40, 28%), while integration (n = 4) and timeliness (n = 3) were infrequently reported, and no study reported outcomes related to planetary health. CONCLUSION Evidence on interventions to improve quality of cataract services shows unequal regional distribution. There is an urgent need for more evidence relevant to low- and middle-income countries as well as across all quality elements, including planetary health.
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Affiliation(s)
- Miho Yoshizaki
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Justine H Zhang
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ada Aghaji
- Department of Ophthalmology, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Helen Burn
- Department of Ophthalmology, Stoke Mandeville Hospital, Aylesbury, United Kingdom
| | - Stephen Gichuhi
- Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
| | - William H Dean
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,Department of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Nathan Congdon
- Centre for Public Health, Queens University Belfast, Belfast, United Kingdom.,Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Orbis International, New York, USA
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - John Buchan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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13
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Reis T, Lansingh V, Ramke J, Silva JC, Resnikoff S, Furtado JM. Cataract as a Cause of Blindness and Vision Impairment in Latin America: Progress Made and Challenges Beyond 2020. Am J Ophthalmol 2021; 225:1-10. [PMID: 33412124 DOI: 10.1016/j.ajo.2020.12.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To provide an update of cataract as a cause of vision loss in Latin America and to analyze sex inequalities in cataract surgical coverage (CSC) and effective CSC (eCSC) in the region. DESIGN Population-based systematic review with longitudinal comparisons. METHODS The Latin American and Caribbean Health Sciences Literature (LILACS) and PubMed databased were searched for population-based studies reporting cataract blindness, surgical coverage, and outcomes published between January 2014 and December 2019. Information on the number of surgeries performed from the 2014-2016 period was obtained from ministries of health and was used for calculation of the cataract surgical rate (CSR). Sources such as Rapid Assessment of Avoidable Blindness (RAAB) and Rapid Assessment of Cataract Surgical Services data were reanalyzed to calculate sex inequality in CSC and eCSC by subtracting the rate in women from the rate in men. RESULTS Cataract was the cause of 29.8%-77.6% of cases of blindness in the included studies; the CSR improved in 10 countries. The CSC pinhole visual acuity of 3/60 varied from 24.1% in Peru to 97.1% in Argentina, and the median absolute gender inequality CSC pinhole visual acuity 3/60 was -0.7%. The eCSC pinhole visual acuity 3/60 varied from 14.8% in Guatemala to 92.1% in Argentina, and the median absolute gender inequality eCSC pinhole visual acuity 3/60 was -0.8%. CONCLUSIONS Cataract remains a leading cause of blindness in Latin America. Coverage is suboptimal, and surgical results are also below target levels in many countries. Incentives for a better distribution of human resources, adequate training of ophthalmologists, and the inclusion of vision services in universal health care coverage could reduce the burden of cataract in Latin America.
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Affiliation(s)
- Tulio Reis
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Van Lansingh
- HelpMeSee, New York City, New York, USA; Instituto Mexicano de Oftalmología, Queretaro, Mexico
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Juan Carlos Silva
- Eye Care Program, Pan-American Health Organization, Bogotá, Colombia
| | - Serge Resnikoff
- Brien Holden Vision Institute and School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, Ah Tong BAM, Arunga S, Bachani D, Bascaran C, Bastawrous A, Blanchet K, Braithwaite T, Buchan JC, Cairns J, Cama A, Chagunda M, Chuluunkhuu C, Cooper A, Crofts-Lawrence J, Dean WH, Denniston AK, Ehrlich JR, Emerson PM, Evans JR, Frick KD, Friedman DS, Furtado JM, Gichangi MM, Gichuhi S, Gilbert SS, Gurung R, Habtamu E, Holland P, Jonas JB, Keane PA, Keay L, Khanna RC, Khaw PT, Kuper H, Kyari F, Lansingh VC, Mactaggart I, Mafwiri MM, Mathenge W, McCormick I, Morjaria P, Mowatt L, Muirhead D, Murthy GVS, Mwangi N, Patel DB, Peto T, Qureshi BM, Salomão SR, Sarah V, Shilio BR, Solomon AW, Swenor BK, Taylor HR, Wang N, Webson A, West SK, Wong TY, Wormald R, Yasmin S, Yusufu M, Silva JC, Resnikoff S, Ravilla T, Gilbert CE, Foster A, Faal HB. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. Lancet Glob Health 2021; 9:e489-e551. [PMID: 33607016 PMCID: PMC7966694 DOI: 10.1016/s2214-109x(20)30488-5] [Citation(s) in RCA: 487] [Impact Index Per Article: 162.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Ana Patricia Marques
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rupert R A Bourne
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK; Department of Ophthalmology, Cambridge University Hospitals, Cambridge, UK
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, UK; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | | | - Simon Arunga
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Damodar Bachani
- John Snow India, New Delhi, India; Ministry of Health and Family Welfare, New Delhi, India
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew Bastawrous
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Peek Vision, London, UK
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, University of Geneva, Geneva, Switzerland
| | - Tasanee Braithwaite
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; The Medical Eye Unit, St Thomas' Hospital, London, UK
| | - John C Buchan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - John Cairns
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Chimgee Chuluunkhuu
- Orbis International, Ulaanbaatar, Mongolia; Mongolian Ophthalmology Society, Ulaanbaatar, Mongolia
| | | | | | - William H Dean
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Alastair K Denniston
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; Ophthalmology Department, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK; Health Data Research UK, London, UK
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Paul M Emerson
- International Trachoma Initiative and Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer R Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Kevin D Frick
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
| | - David S Friedman
- Massachusetts Eye and Ear, Harvard Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - João M Furtado
- Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Stephen Gichuhi
- Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
| | | | - Reeta Gurung
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Esmael Habtamu
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Eyu-Ethiopia Eye Health Research, Training, and Service Centre, Bahirdar, Ethiopia
| | - Peter Holland
- International Agency for the Prevention of Blindness, London, UK
| | - Jost B Jonas
- Institute of Clinical and Scientific Ophthalmology and Acupuncture Jonas and Panda, Heidelberg, Germany; Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Pearse A Keane
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Rohit C Khanna
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, LV Prasad Eye Institute, Hyderabad, India; Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Peng Tee Khaw
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Fatima Kyari
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Van C Lansingh
- Instituto Mexicano de Oftalmologia, Queretaro, Mexico; Centro Mexicano de Salud Visual Preventiva, Mexico City, Mexico; Help Me See, New York, NY, USA
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Milka M Mafwiri
- Department of Ophthalmology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Priya Morjaria
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Lizette Mowatt
- University Hospital of the West Indies, Kingston, Jamaica
| | - Debbie Muirhead
- The Fred Hollows Foundation, Melbourne, Australia; Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Gudlavalleti V S Murthy
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Indian Institute of Public Health, Hyderabad, India
| | - Nyawira Mwangi
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Kenya Medical Training College, Nairobi, Kenya
| | - Daksha B Patel
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Solange R Salomão
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Bernadetha R Shilio
- Department of Curative Services, Ministry of Health Community Development, Gender, Elderly, and Children, Dodoma, Tanzania
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Bonnielin K Swenor
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hugh R Taylor
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Aubrey Webson
- Permanent Mission of Antigua and Barbuda to the United Nation, New York, NY, USA
| | - Sheila K West
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Duke-NUS Medical School, Singapore
| | - Richard Wormald
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | | | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Brien Holden Vision Institute, University of New South of Wales, Sydney, Australia
| | | | - Clare E Gilbert
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah B Faal
- Department of Ophthalmology, University of Calabar, Calabar, Nigeria; Africa Vision Research Institute, Durban, South Africa
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15
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Factors associated with the uptake of cataract surgery and interventions to improve uptake in low- and middle-income countries: A systematic review. PLoS One 2020; 15:e0235699. [PMID: 32645065 PMCID: PMC7347115 DOI: 10.1371/journal.pone.0235699] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/21/2020] [Indexed: 11/19/2022] Open
Abstract
Despite significant evidence around barriers hindering timely access to cataract surgery in low- and middle-income countries (LMICs), little is known about the strategies necessary to overcome them and the factors associated with improved access. Despite significant evidence that certain groups, women for example, experience disproportionate difficulties in access, little is known about how to improve the situation for them. Two reviews were conducted recently: Ramke et al., 2018 reported experimental and quasi-experimental evaluations of interventions to improve access of cataract surgical services, and Mercer et al., 2019 investigated interventions to improve gender equity. The aim of this systematic review was to collate, appraise and synthesise evidence from studies on factors associated with uptake of cataract surgery and strategies to improve the uptake in LMICs. We performed a literature search of five electronic databases, google scholar and a detailed reference review. The review identified several strategies that have been suggested to improve uptake of cataract surgery including surgical awareness campaigns; use of successfully operated persons as champions; removal of patient direct and indirect costs; regular community outreach; and ensuring high quality surgeries. Our findings provide the basis for the development of a targeted combination of interventions to improve access and ensure interventions which address barriers are included in planning cataract surgical services. Future research should seek to examine the effectiveness of these strategies and identify other relevant factors associated with intervention effects.
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16
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Lee CN, Ramke J, McCormick I, Zhang JH, Aghaji A, Mwangi N, Burn H, Gordon I, Yusufu M, He M, Silva JC, Burton MJ. Are we advancing universal health coverage through cataract services? Protocol for a scoping review. BMJ Open 2020; 10:e039458. [PMID: 32641342 PMCID: PMC7348466 DOI: 10.1136/bmjopen-2020-039458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Universal health coverage (UHC) includes the dimensions of equity in access, quality services that improve health and protection against financial hardship. Cataract continues to be the leading cause of blindness globally, despite cataract surgery being an efficacious intervention. The aim of this scoping review is to map the nature, extent and global distribution of data on cataract services for UHC in terms of equity, access, quality and financial protection. METHODS AND ANALYSIS The search will be constructed by an Information Specialist and undertaken in MEDLINE, Embase and Global Health databases. We will include all published non-interventional primary research studies and systematic reviews that report a quantitative assessment of access, equity, quality or financial protection of cataract surgical services for adults at the subnational, national, regional or global level from population-based surveys or routinely collected health service data since 1 January 2000 and published through to February 2020.Screening and data charting will be undertaken using Covidence systematic review software. Titles and abstracts of identified studies will be screened by two authors independently. Full-text articles of potentially relevant studies will be obtained and reviewed independently by two authors against the inclusion criteria. Any discrepancies between the authors will be resolved by discussion, and with a third author as necessary. A data charting form will be developed and piloted on three studies by three authors and amendments made as necessary. Data will be extracted by two reviewers independently and summarised narratively and using maps. ETHICS AND DISSEMINATION Ethical approval was not sought as the scoping review will only use published and publicly accessible data. The review will be published in an open access peer-reviewed journal. A summary of the results will be developed for website posting, stakeholder meetings and inclusion in the ongoing Lancet Global Health Commission on Global Eye Health.
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Affiliation(s)
- Chan Ning Lee
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Ian McCormick
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Justine H Zhang
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - Ada Aghaji
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Opthalmology, University of Nigeria, Enugu, Nigeria
| | - Nyawira Mwangi
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Clinical Medicine, Kenya Medical Training College, Nairobi, Kenya
| | - Helen Burn
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Ophthalmology, Stoke Mandeville Hospital, Aylesbury, United Kingdom
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Juan Carlos Silva
- Division of Blindness Prevention, Pan American Health Organization, Bogota, Colombia
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Moorfields Eye Hospital, London, United Kingdom
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