Factors influencing non-attendance to scheduled eye surgery in rural Swaziland

Norris, Alexander J.S.; Norris, Caroline E.

doi:10.4102/aveh.v78i1.490

Cited by 3 publications

(2 citation statements)

References 34 publications

(72 reference statements)

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“…A hospital-based study within the same setting also found fear (55.9%) to be the leading reason for refusing free cataract surgery [ 94 ]. Fear was also reported among 41 subjects as one of the 3 leading reasons for not taking up eye surgery in rural Eswatini [ 109 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the Reasons for Low Cataract Surgery Uptake Among Patients Detected in a Community Outreach Program in Cameroon: Focused Ethnographic Mixed Methods Study

Mbwogge¹,

Nkumbe²

2022

JMIRx Med

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Background Vision 2020: The Right to Sight, was one potential way to deal with the barriers surrounding cataract surgery and improve access to eye care. To this effect, the Magrabi International Council of Ophthalmology (ICO) Cameroon Eye Institute (MICEI) has performed more than 1000 sight-restoring cataract surgeries among patients referred from outreach camps. However, quite a good number of patients diagnosed with cataracts during community screening camps fail to present for surgery. This study sought to explore some of the challenges to accepting cataract surgery among community-diagnosed patients with cataract, patients operated for cataract, and community members. Objective The study objective was 5-fold: (1) to assess the level of awareness about cataract and available treatment, (2) to explore barriers to cataract surgery uptake, (3) to assess people’s perception about the outcome of cataract surgery, (4) to understand people’s perception about free cataract surgery, and (5) to explore reasons for outright refusal of cataract surgery. Methods This was a focused ethnographic study from December 2018 through February 2019 in 3 different communities of the Center Region of Cameroon, in which patients with cataract were diagnosed. The study sample was composed of patients operated for cataract, those diagnosed with cataract, key informants, and community members. Focus group discussions (FGDs), personalized in-depth interviews, and a short demographic questionnaire were used to collect data. Data were analyzed using a Microsoft Excel spreadsheet and Stata 14 (StataCorp). Data were presented using tabular and graphical methods. Results A total of 29 subjects (19 men) with a mean age of 54.5 (SD 14.5) years took part in the study. The most prominent barriers to cataract surgery were found to be cost (25/29, 86%) and fear of surgery (17/29, 59%). It was also noted by 41% (12/29) of subjects that those who do not take up cataract surgery turn to traditional medicine. Other barriers included the lack of awareness of available treatment (6/29, 21%), no perceived need (5/29, 17%), cultural beliefs and superstition (4/29, 14%), and negligence (4/29, 14%). Conclusions We found cost (25/29, 86%) and fear (17/29, 59%) to be the main barriers. Belief in traditional medicine and superstition were the main drivers of fear. The implementation of a tiered pricing system, counseling training for key informants, incentives for the referral of patients with cataract, mass media engagement, advocacy, training and active involvement of traditional doctors as key informants, acquisition of a 4×4 outreach van, and motorbikes for camp organizers were some of the recommendations based on our results.

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Section: Discussionmentioning

confidence: 99%

Exploring the Reasons for Low Cataract Surgery Uptake Among Patients Detected in a Community Outreach Program in Cameroon: Focused Ethnographic Mixed Methods Study

Mbwogge¹,

Nkumbe²

2022

JMIRx Med

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“…Our study had cataract (48.6%) accounting for most of the ophthalmic procedures, followed by YAG laser capsulotomy (19.8%) for posterior capsular opacification and Pterygium excision Cataract extraction was the commonest reason for ocular surgery in most studies and it should be readily accessible as it has been found to be an extremely cost effective intervention capable of increasing the quality of life and productivity of the individual in 75-90% [8,9,10] of cases.…”

Section: Fig 3 Comparison Of Mean Ages Of Patients Across the Threementioning

confidence: 95%

Pattern of Ophthalmic Procedures Performed at a New Peripheral Eye Clinic in a Semi-urban Area in Port Harcourt, Nigeria - A 5 Year Review

Chukwuka

Awoyesuku

2020

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Aim: A number of ophthalmic procedures are essential in the management of ocular disorders and are an integral part of ophthalmic practice all over the world. As different therapeutic methods evolve, some ophthalmic procedures have become outdated and some have been modified or replaced by various forms of laser therapy, leading to an increase in uptake of ophthalmic procedures in this country. Also though our patients still prefer non-surgical therapy, when surgery is performed, the results are much improved leading to greater patient satisfaction. This is a result of the use of more sophisticated and expensive surgical equipment and better surgical techniques. The ophthalmic procedures analyzed here were carried out in a general ophthalmic clinic without any subspecialty affiliation. Methodology: This is a retrospective review of ophthalmic procedures carried out in a specialist facility over a five year period. Information on age, sex and type of ocular procedure was retrieved from case notes of patients and entered into excel sheets. Data was exported from excel sheets for statistical analysis. Results: A total of 111 patients had Ophthalmic procedures over the 5 –year period under review with a mean age of 56.7±18.5 years and age range from 7 to 89 years. Sixty-three of the patients (56.8%) were males while forty-eight (43.2%) were females (M:F = 4:3). The commonest ophthalmic procedure carried out was cataract extraction which accounted for 48.6% of cases followed by yag laser capsulotomy (19.8%) and pterygium excision (18%). No surgical or laser procedures for glaucoma were performed during this period. Conclusion: Ophthalmic procedures are a very important mode of treatment of eye disorders. The most common procedure performed in our study was cataract extraction and more males than females underwent both cataract surgery and pterygium excision while more females had laser capsulotomy.

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Exploring the Reasons for Low Cataract Surgery Uptake Among Patients Detected in a Community Outreach Program in Cameroon: Focused Ethnographic Mixed Methods Study (Preprint)

Mbwogge¹,

Nkumbe²

2021

Preprint

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BACKGROUND Cataract, a leading cause of blindness in Sub-Saharan Africa is the clouding effect of the eye’s natural lens that can be treated through surgery. Given the many barriers surrounding cataract surgery, district eye care delivery was emphasized by Vision 2020: The Right to Sight, as one potential way to improve access to eye care. To this effect, the Magrabi ICO Cameroon Eye Institute has been involved in community eye care services since its inception, with more than 1000 sight-restoring cataract surgeries performed among patients referred from outreach camps. That notwithstanding, quite a good number of patients diagnosed with cataracts during community screening camps fail to present for surgery. This study sought to explore some of the challenges to accepting cataract surgery among community-diagnosed cataract patients. OBJECTIVE The objective of this study was five-fold including to (1) assess the level of awareness about cataract and available treatment, (2) explore barriers to cataract surgical uptake, (3) assess people’s perception about the outcome of cataract surgery, (4) understand people’s perception about free cataract surgery, and (5) explore reasons for outright refusal of cataract surgery. METHODS This was an ethnographic study from December 2018 through February 2019 in three different communities of the Lekié Division in Cameroon, in which cataract patients were diagnosed. The study sample was composed of operated cataract patients (identified through the hospital database), cataract blind patients, key informants, and community members identified through a purposeful snowball sampling technique. Focus group discussions, personalized in-depth interviews, and a short demographic questionnaire were used to collect data. Data were analyzed using an excel spreadsheet and Stata 14. Data was presented using tabular and graphical methods. RESULTS A total of 29 subjects (19 males) with a mean age of 54.5±14.5 years took part in the study. The most prominent barriers to cataract surgery were found to be cost (86.2%, 25/29) and fear of surgery (58.6%, 17/29). It was also found that 41.4% of those who do not take up cataract surgery turn to traditional medicine which itself turns out to be a major barrier to cataract surgery. Other barriers included the lack of awareness of available treatment (20.7%), no perceived need (17.24%), cultural beliefs and superstition (13.79%), and negligence (13.79%). CONCLUSIONS This study aimed at exploring the reasons for the low uptake of cataract surgery among community-diagnosed cataract patients. We found that cost (86.2%, 25/29) and fear (58.6%, 17/29) to be the main barriers. Belief in traditional medicine and superstition were the main drivers of fear. The implementation of a tiered pricing system, counselling training for Key Informants, incentives for referral of cataract patients, mass media engagement, advocacy, training and active involvement of traditional doctors as Key Informants, acquisition of a 4X4 outreach van, and motorbikes for camp organizers are some of the recommendations based on our results.

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Factors influencing non-attendance to scheduled eye surgery in rural Swaziland

Abstract: To investigate factors influencing disengagement with surgical services, specifically nonattendance to scheduled eye surgery in the low-income setting.

Cited by 3 publications

References 34 publications

Exploring the Reasons for Low Cataract Surgery Uptake Among Patients Detected in a Community Outreach Program in Cameroon: Focused Ethnographic Mixed Methods Study

Exploring the Reasons for Low Cataract Surgery Uptake Among Patients Detected in a Community Outreach Program in Cameroon: Focused Ethnographic Mixed Methods Study

Pattern of Ophthalmic Procedures Performed at a New Peripheral Eye Clinic in a Semi-urban Area in Port Harcourt, Nigeria - A 5 Year Review

Exploring the Reasons for Low Cataract Surgery Uptake Among Patients Detected in a Community Outreach Program in Cameroon: Focused Ethnographic Mixed Methods Study (Preprint)

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