Determinants of utilization of eye care services in a rural adult population of a developing country

Abstract

Purpose:To describe the factors that determine the utilization of eye care services in a rural community in South-Western Nigeria.Methods:A descriptive cross-sectional survey using a multistage sampling technique was conducted. The main outcome measure was self-reported previous consultation of an orthodox medical facility for eye care.Results:The study sample included 643 participants. Only 122 (19%) respondents had previously visited orthodox facilities in search of eye care and 24% of those with presenting visual acuity <6/18 had sought eye care. Characteristics associated with previous utilization of eye care services were age of =70 years (odds ratio [OR] ≥ 1.7, P = 0.02); male gender (OR = 1.5, P = 0.04); literacy (OR = 1.7, P = 0.007); and residing close to an eye care facility (OR = 2.8, P < 0.001). Blind respondents were three times more likely to seek eye care (P < 0.001). Regression analysis revealed that factors associated with increased likelihood of utilization of eye care services included age ≥70 years; literacy; residence close to an eye facility; being diabetic or hypertensive; history of ocular symptoms, and blindness.Conclusions:These findings suggest that a significant proportion (75%) of adults in the study area are not utilizing eye care services and that blindness is an important determinant of utilization of eye care services. Health education and awareness campaigns about the importance and benefits of seeking eye care early, and the provision of community-based eye care programs are essential to boost the uptake of eye care services in this community as well as other rural areas of West Africa.

Barriers to Utilization of Eye Care Services in the Upper East Region, Ghana

“…This demonstrates a generally good eye care seeking behaviour among the participants. This finding however conflicts with those of Ebeigbe and Ovenseri-Ogbomo, Robin et al and Olusanya et al [7][8][9], in which majority of the participants had previously not gone for an eye examination in a hospital before. There was no statistically significant difference in gender utilization of eye care services (p=0.204), even though female participants were more than male participants.…”

Choice of Eye Care Giver in A Rural Community of Ebonyi State Nigeria

“…As expected, education was found to have a positive influence on the choice of care giver in this study. This trend agrees with other studies [8], [9], [15], [17], [21] that observed that educated individuals had a greater likelihood of seeking orthodox eye care. However, we found out paradoxically that educational level did not influence the source of obtaining spectacles as majority of both those with less education and those with higher education used un-prescribed spectacles obtained from the market or obtained as a gift.…”

“…[17]- [21] This agrees with our finding as only 31.2 % of our respondents patronized the available eye clinic for treatment and 24.5% for spectacles. This is in spite of the fact that the Nchokko village is part of the Igbeagu community, which hosts the community eye care services of the department of Ophthalmology of FETHA, and is only 20 minutes drive away from Abakaliki the state capital where the teaching hospital is situated.…”

“…[9] - [14] The poor utilization of orthodox eye care services in this study agrees with most other studies in Nigeria and Africa [17] - [21] ; but conflicts with the study conducted at Afon, a rural community in Kwara state, where most respondents (62.5%) used orthodox eye care services. [9] It has been reported that utilization of existing eye care infrastructure in Nigerian communities is as low as 25% compared to the optimum target utilization set at 90%.…”

“…This observation agrees with that of Olusanya et al [21] but differs from some other studies where women had better utilization of eye care services than men. [4] - [5] This might be related to cost as males are traditionally more economically viable than females in our study environment.…”