Cataract Surgical Services in Palestine

ABSTRACT

Purpose

Cataract surgery, quantity and quality, is an indicator of ophthalmic care. A comprehensive assessment of cataract surgical services has never been carried out in Palestine, including West Bank, Gaza Strip and East Jerusalem. The objective of this study was to estimate the cataract surgical rate in 2015 to and to explore the modes of payment and referral systems.

Methods

A cross-sectional study conducted between June and August 2016. Medical Directors from Cataract Surgical Centres in Palestine were interviewed using a structured questionnaire to extract data on cataract output and surgical techniques. Additionally, data were collected on modes of payment for cataract services. The cataract surgical rate was calculated by dividing the total cataract output in 2015 by the estimated population of Palestine in millions.

Results

In 2015, 9908 cataract surgeries were carried out in 22 centres. The cataract surgical rate was 2,117 operations per million population. Phacoemulsification was the most common technique (73.4%), however in government centres 67% were performed by extracapsular cataract extraction.

In the Gaza Strip, 56.6% of cataract surgeries were operated at government centres, and 42.8% were operated at NGO centres while in West Bank, only 12% of cataract surgeries were operated at government centres, with two-thirds of cataracts diagnosed at governmental centres being referred to private and NGO centres. Seventy eight percent of cataract surgeries were funded by insurance, of which the government insurance scheme contributed 65%.

Conclusion

The cataract surgical rate in Palestine falls short of the required WHO target. The majority of cataract surgeries are funded by insurance.

KEYWORDS:

• Cataract
• cataract surgical rate
• cataract surgical output
• cataract payment methods

Acknowledgments

Acknowledgments are attributed to Dr. Islam Al-Beih, for his guidance and advice on study methodology, data collection tools, analysis and interpretation.

Conflicts of interest

None of the authors have any proprietary interests or conflict of interest related to submission. This article has not been published and is not under consideration for publication elsewhere. We have no conflicts of interest to disclose.

Financial support

The corresponding author received partial funding to conduct this study from the International Centre for Eye Health (ICEH) at the London School of Hygiene and Tropical Medicine. The funding covered part of the travel cost to Palestine.

Additional information

Funding

This work was supported by the International Center for Eye Health (ICEH) department at the London School of Hygiene and Tropical Medicine grant number [ITCR990810].