AbstractBackground
Globally, there are few examples of repeated eye health surveys to assess changes in prevalence and causes of visual impairment, and service coverage over time. Two separate, unlinked rapid assessments of avoidable blindness (RAAB) were conducted in Nampula province, Mozambique in 2011 and 2018. This paper reports the observed changes and examines how the trends differ for males and females.
Methods
Standard RAAB methodology was used in both studies. Two-stage cluster sampling was used to generate random samples of adults aged over 50 years. Participants underwent a simplified visual acuity exam focusing on presenting and pinhole visual acuity (VA), a lens exam and posterior segment exam using a direct ophthalmoscope for all subjects with presenting VA < 6/18. Data were analysed using Stata and logistic regression models were developed to assess changes.
Results
The 2011 study enrolled 3,050 people and examined 96.9% (2,954 people). The 2018 survey enrolled 4,191 people and examined 95.8% (4,015 people). Age and sex adjusted estimates of blindness decreased from 6.2% in 2011 to 4.5% in 2018 (z=-2.21, p = 0.028), severe visual impairment remained the same (2.6% in 2011 and 2.7% in 2018, z = 0.1, p = 0.9) and moderate visual impairment increased (5.9% in 2011 to 11.0% in 2018, z = 5.78, p < 0.001). Cataract surgical coverage was higher among males in both surveys (13.4% among males vs 7.7% among females in 2011, and 40.0% among males vs 19.4% among females in 2018) and the gender disparity grew between surveys.
Conclusions
Significant changes were observed in the eye health and service coverage between 2011 and 2018. An increase in the proportion of good visual acuity among operated eyes between the surveys is of note and may correspond with improvements made to the services provided in the province. Further improvements to services are required to improve access for women and people with moderate visual impairment.
Introduction: In the last two decades an increasing number of African countries have established Optometry training to tackle the largely unmet eye health needs of the population. However not sufficient evidence exist on how the profession is integrated and contributing to national health systems. In Mozambique, the optometry program started under the Faculty of Health Sciences in the public Lúrio University in 2009. From 2012 to 2016, 23 graduates were employed by the National Health System (NHS). Objective: The aim of this research is to document the integration of Optometrists at the National Health System in Mozambique. Methods: This is a descriptive, quantitative and cross-sectional study. Questionnaires and structured interviews were administered to all participants. Results: The response rate was 100% and the Optometrists were found practicing in 10 of the 11 provinces of the country distributed among primary, secondary and tertiary health facilities, providing refraction and managing common ocular pathologies along with the Ophthalmic Technicians, resolving the majority of patient needs and needing to refer 28% of cases to other professionals. The lack of equipment was the main expressed barrier to the provision of effective eye care services. According to them, the optometry curriculum responds well (91%) to the competencies required at the workplace. Areas for improvement training and provision of services were identified and presented in the study Conclusion: Optometrists are providing effective services needing to work closely and in coordination with other professionals. This research revealed the need for equipment provision and continuing education.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.