Barriers to Cataract Surgery Utilization Among Cataract Patients Attending Surgical Outreach Sites in Ethiopia: A Dual Center Study

Abstract

Background: Cataract is the leading cause of avoidable blindness globally and in Africa. Various barriers limit access of cataract blind individuals to cataract surgery. This study aimed to determine the barriers to cataract surgery utilization among cataract blind patients presenting to campaign sites in Ethiopia. Methods: An institution-based cross-sectional design study was conducted to select 209 patients. The study was conducted from July to August 2020. A structured questionnaire was used to collect socio-demographic data and barriers for not having cataract surgery. Physical examination such as visual acuity, slit lamp bio microscopy and direct ophthalmoscopy was done for all participants. Epi Info 7 was used for data entry and Statistical Package for Social Science/SPSS version 23 was used for analysis after data were exported. Descriptive methods were employed for analysis. Results: A total of 209 subjects were recruited in the study with a mean age of 64.2 (±14.6) years, with a range of 32-99 years. From the total study subjects, 53% were males and 40.2% were over 66 years old. Upon presentation to the campaign site, 33% of study subjects had visual acuity of operable eye under blindness category and half of the study subjects (50.2%) had mature cataract. The most reported barriers were waiting until cataract becomes mature (18.7%), fear of surgery complications (16.7%), far from eye health institution (16.4%) and lack of income/cost for surgery (11.5%). Conclusion:Recognizing the severity and the blindness burden of cataract in Ethiopia, creating public awareness, establishing eye health institutions, increasing the number of eye health professionals, increasing the quantity and the quality of cataract campaigns to alleviate these barriers are of paramount importance at the country level.

Quality of life and barriers to undergo cataract surgery

“…It is also observed that the demographic variable occupation ( 2 =10.361, p=0.035) had shown statistically significant association with mean score of barriers to undergo cataract surgery at p<0.05 level. These findings are consistent with a study byBizuneh et al, (2021)…”

“…Thus, the quality of life was decreased across all the domains before surgery. [5] on Barriers to Cataract surgery utilization among Cataract patients attending surgical outreach sites in Ethiopia for the association of Occupation with Barriers and contradictory for the association of Gender and age with the Barrier. Hence, hypothesis (RH1) is partially accepted.…”

Evaluation of the better operative outcome software tool to predict cataract surgical outcome in the early postoperative follow-up

“…This is because it more closely reflects the situation of low-income countries where most of the patients are admitted on the day of surgery and discharged the following day after the first postoperative visit, especially in outreach cataract campaigns. In settings with high barriers to access, vision on day 1 will be available, whereas vision on day 3 will be just as inaccessible as vision at 6 weeks [ 15 , 16 ].…”

Visually significant cataract and associated factors among older people attending a community ophthalmic service in central Gondar Zone, Northwest Ethiopia: a cross-sectional study

“… 12 – 14 Studies conducted in different countries have reported that the cost of treatment, distance to eye care services, waiting until the cataract is mature, fear of cataract surgery, lack of awareness about cataract, lack of an escort, and perception of no need for cataract surgery are the main barriers to treating cataract. 15 – 20 …”

“…[12][13][14] Studies conducted in different countries have reported that the cost of treatment, distance to eye care services, waiting until the cataract is mature, fear of cataract surgery, lack of awareness about cataract, lack of an escort, and perception of no need for cataract surgery are the main barriers to treating cataract. [15][16][17][18][19][20] Despite cataract being a public health problem in Ethiopia and a common finding in clinical practice and at community eye care services, there is little evidence on the magnitude and associated factors of visually significant cataract in the country, and that which is available is outdated. In addition, none of the available evidence covers our study area.…”