Validity of recall absent schoolchildren to free eye health projects

Abstract

Purpose: To analyze the results of recall absent schoolchildren to eye health projects. Methods: Crosssectional study. Visual screening was performed in schoolchildren attending 1 st to 4 th grades at public schools, from 7 to 10 yearsold, to select and forward to complete ophthalmic evaluation. The projects were performed during weekends, at a public school, in the same municipality. Free transportation, food and eyeglasses were offered. A second opportunity of examination was offered to the students who were absent from the first call, with the same facilities. Results: 51,509 schoolchildren had their vision tested, 14,651 (28.4%) were referred for ophthalmic examination. Of these, 8,683 (59.3%) attended the first call, 2,228 (37.3%) attended the recall and 25.5% of parents did not take their children to oph thalmic examination. The need for eyeglasses for children who attended the examination was 23.8% and 32.0% in the first opportunity and recall, respectively. The recall increased the coverage in 15.2% (59.3% to 74.5%). Conclusion: An expressive number of parents (25.5%) did not bring their children to be examined, even at a second opportunity of exam. The facilities offered: access, free examination, transportation and glasses. Children who were absent in the first opportunity and appeared at recall had a greater need for eyeglasses. Recall increa sed the coverage in 15.2% (59.3% to 74.5%) and it is not recommended when financial resources are limited.

Interventions to improve school-based eye-care services in low- and middle-income countries: a systematic review

“… 19 – 66 Identified articles were from 13 countries spanning five World Health Organization (WHO) Regions including Africa (eight studies), the Americas (10 studies), the Eastern Mediterranean (one study), South-East Asia (18 studies) and the Western Pacific (11 studies). Identified articles comprised 19 school-based eye-care programme evaluations, 19 – 33 , 62 – 64 , 66 16 studies investigating spectacle compliance associations, 34 – 48 , 65 eight studies exploring the quality of various eye-care screening personnel, 49 – 56 four studies evaluating the effectiveness of eye health promotion, 57 – 60 and one study that included both spectacle compliance and the quality of screening personnel 61 . When appraised for quality, 15 we classified 18 studies as being of high quality, 20 as medium quality and 10 as low quality.…”

“…However, several studies noted that these guidelines were not being met by some school-based eye-care programmes, 27 , 49 , 55 , 62 with some children having never been screened 52 . Routine vision screening within schools can provide a solution to poor uptake of care external to education systems 33 , 37 . A study that conducted mass vision screenings in 51 Indian schools at the start of each academic year was identified as a cost–effective intervention 63 .…”

“…A study that conducted mass vision screenings in 51 Indian schools at the start of each academic year was identified as a cost–effective intervention 63 . Many studies noted the availability of uncomplicated referral pathways between education and health systems, and clarity regarding referral processes, as being crucial in successful follow-up, provision of spectacles and continuity of care 20 , 22 , 23 , 29 , 32 , 33 , 41 , 51 , 61 , 64 . For example, a study exploring children as potential vision screeners found that, despite being effective screeners, they were not held with sufficient credibility when referring those they screened to other health services 57 .…”

“…Factors associated with a higher willingness to pay for spectacles included previous or current ownership of spectacles, 35 regular spectacle wear, 45 a recognized need for spectacles or an understanding that vision improves with spectacles 35 , 56 . An additional economic factor that was reported to influence the demand of parents or guardians for eye-care services and spectacles was the loss of daily wages 64 , 66 due to a lack of a carer to accompany children to additional appointments 33 . Approaches to reduce programme costs were reported as sourcing instrumentation from local tertiary institutions, 63 and the use of cost–effective personnel (e.g.…”

“…However, girls, children with higher maternal education and children with poorer visual acuity at presentation were generally more likely to be wearing spectacles at follow-up. Many studies 28 , 33 , 36 , 37 , 41 , 43 , 45 , 48 , 56 , 64 , 66 reported that children’s experiences or perspectives of wearing spectacles were linked to stigma and discrimination, or included verbal 36 , 37 , 48 , 56 or physical abuse 43 . In Timor-Leste, 18.1% (43/237) of children surveyed believed that vision-impaired people could not attend school 28 .…”