Eye Care in Fiji: A Population-based Study of Use and Barriers

Abstract

Purpose: To determine the use of medical services for eye problems in Fiji, and barriers to seeking that care.

Methods: An interview-based questionnaire was administered as part of a population-based cross-sectional survey of adults selected by multistage random sampling from those aged ≥40 years living on Fiji’s main island.

Results: Participation rate was 73.0% (n = 1381). A current vision or eye problem was reported by 931 participants, and a further 235 recalled a previous difficulty. Urban dwellers (P = 0.002) and those aged ≥50 years (P = 0.017) were more likely to report a problem. Gender was not predictive (P = 0.215). “Blurred/poor vision” was the most common complaint (78.5%). Over half (53.3%) had not sought care for the problem most important to them. For current problems, being younger (P < 0.001) and from a household without paid income (P = 0.007) were predictive of being less likely to seek treatment. Gender was not (P = 0.416). The most frequently cited principal reason for not seeking care was “able to manage/accept the problem” (66.5%; of whom 84.7% claimed vision problems). Direct and indirect costs were mentioned as deterrents. “Thought nothing could be done” (P = 0.032) and “lack of awareness of service availability” (P = 0.026) were more common among rural dwellers. Of participants who sought care, 75.6% used government services. Most participants requiring spectacles or medication incurred costs for these. Satisfaction with overall care was independent of provider (P = 0.062) and user gender (P = 0.851).

Conclusion: With expanding service delivery, increased eye health promotion, and attention to the financing of treatments, improved service use ought to be possible in Fiji.

Keywords::

• Barriers
• Developing country
• Eye care
• Fiji
• Service use

ACKNOWLEDGMENTS

The authors acknowledge the help of Sanya Baker, Louisa Semmons, Tom Schaefer, Carmel Williams, Losalini Tavaga and the FEHS2009 survey team.

Funding sources: The design, implementation and analysis of the Fiji Eye Health Survey 2009 were financially supported by the New Zealand Agency for International Development (NZAID), the Australian Agency for International Development (AusAID), and The Fred Hollows Foundation New Zealand.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the article.