Why are Children Brought Late for Cataract Surgery? Qualitative Findings from Tanzania

Abstract

Purpose: Worldwide, at least 190,000 children are blind due to cataract. Although, surgical intervention is the treatment of choice, in most developing countries the number of children with cataract being brought to hospital for surgery has been few in number, considerably less than the burden of disease in the community. Furthermore, long delay in presentation is a major deterrent to improved visual outcome and compromises the future quality of life of children and their families. The main objective of this qualitative study was to provide a better understanding of surgical delay in the care of children with congenital or developmental cataract. Methods: We conducted 117 semi-structured interviews with parents or guardians of children admitted for cataract surgery at a tertiary hospital in northern Tanzania. Results: We identified several factors influencing the treatment-seeking behaviors of parents and guardians, including gender relations within the household, local health beliefs about cataract and cataract surgery and the ability of health care professionals in primary and secondary care settings to adequately inform parents and guardians about cataract and cataract surgery. Conclusions : Practical, short and medium term avenues must be explored to reduce delays of presentation. Public education, training of health workers and counseling efforts in the communities may be necessary to enable children to access services in a timely fashion.

Keywords:

• Childhood cataract
• avoidable blindness
• surgical delay
• gender and blindness
• health-seeking behaviors