Primary Eye Care in Eastern Nepal

ABSTRACT

Purpose: Vision 2020 and the Global Action Plan 2013–2019 prioritise primary eye care (PEC) as an important component of reducing avoidable blindness. Studies in sub-Saharan Africa have demonstrated that current PEC provision is poor. There has been no evaluation of the current practice of PEC among primary health care workers (PHCWs) in Nepal.

Methods: A mixed methods descriptive cross-sectional study with semi-structured interviews and focus group discussions (FGDs) was carried out in Eastern Nepal. Government employed PHCWs working at health posts in three districts were invited to take part in a PEC knowledge and skills assessment. Each health post was assessed for ophthalmic equipment and medications. Three focus group discussions and eight semi-structured interviews were carried out with community ophthalmic assistants, PHCWs and a district health manager.

Results: 107 PHCWs in 35 health posts took part in the quantitative study. Only 8.4% had received eye care training. 27.1% PHCWs could diagnose a corneal ulcer, 83.2% conjunctivitis, 75.7% cataract and 54.2% ophthalmia neonatorum. Only 14.0% could measure visual acuity, and 5.7% of HPs had a vision chart. Ophthalmic assistants described their concern for the low level of PEC at health posts. PHCWs were keen to receive training and highlighted the need for greater government support in the provision of eye care services.

Conclusion: PEC knowledge and skills among PHCWs in eastern Nepal is inadequate to provide quality PEC services. There is a pressing need for PEC training in the region, provision of ophthalmic equipment and greater government support for eye care.

KEYWORDS:

• Primary eye care
• eye health systems
• Nepal
• primary eye health workers
• human resources for eye health

Declaration of interest

None of the following authors have any proprietary interests or conflicts of interest related to this submission: Helen Burn, Lila Puri, Abhishek Roshan, Sanjay K. Singh and Matthew J. Burton

Financial support

Matthew J Burton is supported by the Wellcome Trust (Grant Number: 207472/Z/17/Z)

Helen Burn received funding from the London School of Hygiene Travel Bursary to support international travel costs and Curriculum Study Leave Health Education East Midlands Trainee Bursary Scheme 2017 to support research costs.

Submission Declaration

This submission has not been published anywhere previously and it is not simultaneously being considered for any other publication

Additional information

Funding

This work was supported by the Wellcome Trust [207472/Z/17/Z].