Task-shifting eye care to ophthalmic community health officers (OCHO) in Sierra Leone: A qualitative study

Pente, Vladimir; Bechange, Stevens; Jolley, Emma; Tobi, Patrick; Roca, Anne; Ruddock, Anna; Smart, Nancy; Ogundimu, Kolawole; Vandy, Matthew Jusu; Schmidt, Elena

doi:10.7189/jogh.11.07001

Cited by 11 publications

(16 citation statements)

References 24 publications

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“…Interventions to support integrating human resources were observed across multiple contexts, including training non-eye care providers in the promotion, detection or treatment of basic eye care in primary care or school-based settings,18–24 retinopathy of prematurity screenings,25 or ophthalmic surgeries,26 27 managing non-communicable diseases (NCDs)28 29 and incorporating immunisation into child healthcare 30 31. Upskilling district eye coordinators visiting primary healthcare settings in ‘enhanced’ supervisory methods were also tested 32 33…”

Section: Resultsmentioning

confidence: 99%

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Integrating eye care in low-income and middle-income settings: a scoping review

Lee

Moo²,

Angelopoulos³

et al. 2023

BMJ Open

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ObjectivesIntegrated people-centred eye care has been recommended as a strategic framework for reducing global vision impairment and blindness. The extent to which eye care has integrated with other services has not been widely reported. We aimed to investigate approaches to integrating eye care service delivery with other systems in low resource settings, and identify factors associated with integration.DesignRapid scoping review based on Cochrane Rapid Review and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesMEDLINE, Embase, Web of Science, Scopus and Cochrane Library databases were searched in September 2021.Eligibility criteriaPapers with interventions involving eye care or preventative eye care integrated into other health systems, peer-reviewed in English, conducted in low-income or middle-income countries, and published between January 2011 and September 2021 were included.Data extraction and synthesisTwo independent reviewers screened, quality appraised and coded included papers. A deductive–inductive iterative analysis approach was used with a focus on integrating service delivery.ResultsThe search identified 3889 potential papers, of which 24 were included. Twenty papers incorporated more than one intervention type (promotion, prevention and/or treatment), but none included rehabilitation. Most articles involved human resources development yet rarely appeared to be people-centred. The level of integration was associated with building relationships and enhancing service coordination. Integrating human resources was challenged by the need for ongoing support and worker retention. In primary care settings, workers were often already at full capacity, had competing priorities, varying capabilities and limited motivation. Additional barriers included inadequate referral and information systems, poor supply chain management and procurement practices and finite financing.ConclusionIntegrating eye care into low resource health systems is a challenging task, compounded by resource limitations, competing priorities and ongoing support needs. This review highlighted a need for people-centred approaches to future interventions, and further investigation into integrating vision rehabilitation services.

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Section: Resultsmentioning

confidence: 99%

“…With capacity development, Kenyan teachers could effectively refer children requiring further eye care using smartphone technology,31 yet teachers in Pakistan struggled to complete referral forms 18. Post implementation, trainees also requested refresher training to maintain newly acquired skills 27 30 35…”

Section: Resultsmentioning

confidence: 99%

Integrating eye care in low-income and middle-income settings: a scoping review

Lee

Moo²,

Angelopoulos³

et al. 2023

BMJ Open

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“…There appears to be a mismatch between the reality on the ground and these documents, which do not take into account the routine activities relating to the functioning of the services and the constant interactions between the population and the health workers. [26,[48][49][50] In addition, 80% of respondents stated that the insu cient use of these reforms or policy documents would be due to a lack of involvement of other actors in the health system such as education and nance during their development. Another factor could be the lack of leadership within state and health care structures, which can undermine the motivation of health system actors in the implementation of these projects or policies.…”

Section: Discussionmentioning

confidence: 99%

Situation Analysis of Uncorrected Refractive Errors in Sub-Saharan Francophone African Countries

Dougnon¹,

Guirou²,

Bakayoko³

et al. 2022

J Opthalmol Res

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Background: Uncorrected refractive errors (URE) are a serious public health problem by their magnitude, the multiple consequences they result in, but also by the inability of the countries of French-speaking Sub-Saharan Africa (FSSA) to meet the needs of the population. Governance problems, associated with human resources problems, nancing problems for care, infrastructure and consumables, led us to initiate this study, the objective of which is to analyze the situation of UREs in FSSA with the stakeholders involved in the eye health system. Materials and Methods: We carried out a cross-sectional survey of eye health actors and stakeholders in all of the French-speaking Sub-Saharan Africa countries from March 1 st to August 31 st , 2020. An online questionnaire was developed and translated into French, and then sent to the targeted eye health stakeholders involved in eye health. The survey and data collection were carried out in two phases: rst by collecting information from the eye health o cials of the countries which then enabled us to reach all the other actors in the country. Data were entered directly into SPSS 20 software followed by cleaning prior to analysis and presented as percent, mean or median, and standard deviation.Results: A total of 500 questionnaires were sent to the various actors involved in eye health in the 21 countries of French-speaking Sub-Saharan Africa. The number of people who opened the questionnaire is 215, of which 151 have completed at least one question.Eye health policy documents existed in countries according to 95% of respondents. In the words of 76.6%, 54.6% and 85.2% of the participants respectively, the mechanisms for describing the tasks of the agents, for reporting to the actors and for collecting data existed. Also, according to respectively 61.5%, 58.8 % and 61.3% of respondents, the following are not effective: existence of documents of standards and procedures, speci c allocation of eye health in the budget of the Ministry of Health and the obligation of continuous training. Conclusion:Although policy documents that comply with standards do exist in the French-speaking region of sub-Saharan Africa, several challenges remain to be taken up; in particular the involvement of all stakeholders of the health system, and the strengthening in the areas of governance, nancial and human resources, as well as the information and supply system for materials and consumables, hence the need to initiate more targeted research activities. BackgroundUncorrected refraction errors (URE) are a severe public health problem in view of their magnitude and also by the multiple consequences they cause around the world. They are the leading cause of visual impairment and a major cause of blindness worldwide. [1-3] URE have consequences at both the individual and community level. Indeed, several studies have established the link between quality of life and visual impairment caused by refractive errors. [4][5][6][7][8][9][10][11] For those affected and their communities, these losses can lead to...

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“…Due to the lack of human resources in secondary care, some CHOs were inappropriately placed with secondary hospitals, undermining the essence of task-shifting. 17 …”

Section: What Do Recent Evaluations Of Pec Interventions Tell Us?mentioning

confidence: 99%

Primary eye care: opportunities for health system strengthening and improved access to services

Yasmin

Schmidt

2022

International Health

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Primary eye care (PEC) is a vital component of primary healthcare (PHC) and is the cornerstone for the progress towards universal eye health coverage. While the concept of PEC is not new, with the increased focus of the global eye-health agenda on equity and people-centred care, it is critical to review experiences of delivering PEC in low- and middle-income countries and to identify common lessons learnt. This commentary builds on the available evidence and focuses specifically on three recently published evaluations of PEC in Sightsavers-supported programmes in Tanzania, Sierra Leone and Pakistan. It argues that systems thinking is critical in the delivery of PEC interventions, as only this approach can ensure that the integration of PEC into PHC is delivered in a comprehensive, coherent and sustainable way.

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Task-shifting eye care to ophthalmic community health officers (OCHO) in Sierra Leone: A qualitative study

Cited by 11 publications

References 24 publications

Integrating eye care in low-income and middle-income settings: a scoping review

Integrating eye care in low-income and middle-income settings: a scoping review

Situation Analysis of Uncorrected Refractive Errors in Sub-Saharan Francophone African Countries

Primary eye care: opportunities for health system strengthening and improved access to services

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