Caretakers' stated willingness to pay for children's spectacles in cross river state, Nigeria and its implication for a cross-subsidisation scheme: a cross-sectional study

BACKGROUND

Understanding caretakers' willingness to pay (WTP) for their children's spectacles is essential to improving the sustainability of refractive error services and spectacle provision. Therefore, we investigated the willingness of caretakers to pay for their children's spectacles in a multi-centre study to develop a spectacle cross-subsidisation scheme in the Cross River State (CRS), Nigeria.

METHODS

We administered the questionnaire to all caretakers whose children were referred from school vision screenings to four eye centres for full refraction assessment and dispensing of corrective spectacles from 9 August to 31 October 2019. We collected information on socio-demography, children's refractive error types, and spectacle prescription and then asked the caretakers about their WTP for the spectacles using a structured questionnaire and bidding format (in the local currency, Naira, ₦).

RESULTS

A total of 137 respondents (response rate = 100%) from four centres were interviewed: with greater proportion of women (n = 92, 67.1%), aged between 41 and 50 years (n = 59, 43.1%), government employees (n = 64, 46.7%) and had acquired college or university education (n = 77, 56.2%). Of the 137 spectacles dispensed to their children, 74 (54.0%) had myopia or myopic astigmatism (equal to or greater than 0.50D). The mean stated WTP for the sample population was ₦3,560 (US$ 8.9) (SD ± ₦1,913.4). Men (p = 0.039), those with higher education (p < 0.001), higher monthly incomes (p = 0.042), and government employees (p = 0.001) were more willing to pay ₦3,600 (US$9.0) or more.

CONCLUSION

Combining our previous findings from marketing analysis, these findings provided a basis to plan for a children's spectacles cross-subsidisation scheme in CRS. Further research will be needed to determine the acceptability of the scheme and the actual WTP.

Indomethacin and recurrent ileal perforations in a preterm infant

This article reports a case of a very low birth weight infant who was given intravenous indomethacin for a symptomatic patent ductus arteriosus and subsequently had two isolated ileal perforations several days apart. Spontaneous or indomethacin-related ileal perforation appears to constitute a separate clinical and pathologic entity, different from necrotizing enterocolitis, with a benign clinical picture and good prognosis when promptly recognized.

Autoimmune diseases in pregnancy: their effect on the fetus and newborn

A variegated group of autoimmune disorders tend to occur in women during childbearing years. Autoantibodies, often of IgG type, directed against the mother's (self) antigens has been well characterized in a number of these disorders. Transplacental transfer of IgG autoantibodies has been frequently demonstrated without demonstrable ill effects of offspring of affected mothers. However, transient neonatal autoimmune syndromes have been described in a subset of infants born with circulating autoantibodies. The time course of clinical symptomatology often parallels the presumed half life IgG immunoglobulins. This review details the clinical manifestations of different transient neonatal autoimmune syndromes and describes possible pathogenic mechanisms. Autoimmune disorders reviewed include connective tissue disorders, thyroid autoimmune disorders, myasthenia gravis, idiopathic thrombocytopenic purpura, and other uncommon disorders.