Measuring cataract surgical services in children: an example from Tanzania

Abstract

Practical application of a measure of service delivery for childhood cataract has been useful in identifying gaps in utilisation of existing services by region as well as by gender. Testing in other settings would be helpful. An apparent inequity in use of services by girls requires attention.

Meeting the need for childhood cataract surgical services in Madagascar

“…This is similar to observations in other sub-Saharan African countries where two-thirds of pediatric cataract operations are done on boys. [2][3][4][5] As observed in Kenya, the disparity observed in our study is likely to be due to gender roles in the community. [4] Male genetic predisposition to congenital and developmental cataract is also unlikely, given that a recent study conducted in Denmark revealed no male genetic predisposition.…”

“…This figure does not compare favorably with an overall CCSR of 9 in Tanzania. [2] Though we do not have estimates for the incidence of traumatic cataracts, these figures alone suggest that this part of Madagascar is underserved with pediatric cataract surgical services. Possible reasons for these low figures are lack of awareness that children can also have cataract and that it should be treated early.…”

“…In the latter, the CSSRs were 39.8 and 29.2, respectively. [2] For all seven regions constituting the hospital's catchment area, 2.7% of incident congenital and developmental cataract cases during the study period were operated on, with a mean CCSR of 1.1, a best case scenario if the figures were to be extrapolated to the entire country. This figure does not compare favorably with an overall CCSR of 9 in Tanzania.…”

“…[1] Using estimates from Tanzania, [2] we believe that more than 2500 children are currently living with blindness from non-traumatic cataract in Madagascar. Although there is no Child Eye Health Tertiary Facility (CEHTF) in the country, as recommended by the World…”

A Review of Primary Congenital Glaucoma in the Developing World

“…13 Distance from the hospital is one of the most important factors contributing to delay in the developing world of pediatric cataract surgery. 18 Furthermore, most surgical procedures require a provider to administer general anesthesia to infants and young children. In many rural regions, access to a trained anesthesiologist may be difficult, and most anesthesia is provided by minimally trained technicians.…”