Attitudes and perceptions of eye care workers and health administrators regarding task sharing in screening and detection for management of diabetic retinopathy in Pakistan

ABSTRACT

Purpose: The shortage of ophthalmologists in many countries is a major barrier to timely provision of eye care. A team work approach to screen, detect and manage diabetic retinopathy (DR) could achieve greater screening coverage of people with diabetes to prevent vision loss. This study aimed to assess the attitudes and perceptions of eye care workers and health administrators regarding task sharing for management of DR.

Methods: Using purposive sampling, 121 eye and health care workers in five selected hospitals in two provinces in Pakistan were recruited. A cross-sectional survey explored the possibility for involvement of optometrists and mid-level eye care workers to share tasks with ophthalmologists for DR management and the potential outcomes of task sharing, through multiple choice and open-ended questions.

Results: Ninety-six (79%) participants–doctors (n = 56), optometrists (n = 29) and mid-level eye care workers (n = 11) responded to the survey. All participants supported task sharing in screening and detection for management of DR. There was no significant difference among the groups with respect to their positive attitude towards task sharing (p = 0.22). The majority in each group believed that the task sharing would not degrade the quality of care (p = 0.48). Two potential major outcomes of task sharing in the eye care system included the benefits for people with diabetes and potential DR and the strengthening of the health care system.

Conclusion: Task sharing among various cadres of eye care workers has the potential to improve screening coverage of people with diabetes to prevent visual loss from DR.

Keywords:

• Task sharing
• attitudes and perceptions
• diabetes
• diabetic retinopathy
• low resource countries

Declaration of interest

No potential conflict of interest was reported by the author. This submission has not been published anywhere previously and is not being considered for any other publication.

Funding

The authors acknowledge funding for research from Centre for Eye Research Australia (CERA), Royal Victorian Eye & Ear Hospital, Melbourne. CERA receives Operational Infrastructure Support from the Victorian Government.

Additional information

Funding

The authors acknowledge funding for research from Centre for Eye Research Austral (CERA), Royal Victorian Eye & Ear Hospital, Melbourne. CERA receives Operational Infrastructure Support from the Victorian Government.