1. Understanding Barriers to Access to Eye Care in Western India
Vikram Paranjpe1,2, Madhuri Valvekar3, Purva Date3, Antonia Eyssallenne2
1MD/MPH Class of 2019
2Department of Public Health Sciences; University of Miami Leonard M. Miller School of Medicine. Miami, Florida, USA
3Valvekar Medical and Research Center, Solapur, Maharashtra, India
This work was supported by funds through the Global Health Scholars Award
Study Contact:
BACKGROUND
RESULTS
Worldwide, 39 million people are blind due to avoidable conditions, and another 246 million people have visual impairment1
India accounts for 20% of global blindness, and 80% is due to cataract or refractive error1
The National Programme for the Control of Blindness (NPCB) was established in 1976 to reduce the prevalence of blindness from 1.4% to 0.3% of the population by the year 20202
Despite increased access to free cataract surgery, the burden of avoidable blindness remains high1
758 patients were examined at the clinics and screening fairs
152 patients met the inclusion criteria and were surveyed
43% (65) were male, 57% (87) were female
Average age was 65.3 (male) and 62.4 (female)
142 patients had cataracts, 9 had refractive error, and 1 had another issue causing their visual impairment
Prevalence of cataract at screening fairs was 349 per 1,000, 105 per 1,000 at the private clinic and 109 per 1,000 at the low-cost clinics
The top two reasons for not seeking eye care reported were one, financial constraints 38% (57) and two, an ability to see adequately 30% (45)
CONCLUSION
OBJECTIVE
Through the NPCB, availability of free eye care services for underserved populations has increased
Despite increased efforts by the government and NGOs, patients still don’t access these services
The main barriers reported by patients were financial and a perceived lack of need for eye care. These barriers can be overcome through increased education about cataracts and about the availability of free surgical services
A weakness of this study design was that we surveyed patients coming to the clinic or fairs, who had already overcome their barriers. Future studies should identify and educate patients about their cataract and available services. Then, complete this survey at a 1 year follow up in their homes
To better understand the barriers that prevent patients with avoidable conditions from accessing eye care before significant visual impairment
MATERIALS AND METHODS
A survey with questions about past medical history, ocular history, demographics, socioeconomic information, barriers to access, and knowledge of eye disease was administered
All patients presenting to a private clinic, low-cost clinic, or free cataract screening fairs with visual acuity less than 20/60 in their better eye were surveyed
Verbal consent was obtained, and the survey was conducted in the local language, Marathi
Data were entered into a REDCap database and analyzed using SAS statistical software
REFERENCES
Misra V, Vashist P, Malhotra S, Gupta SK. Models for primary eye care services in India. Indian J Community Med. 2015;40(2):79-84.
A National Programme for Control of Blindness (NPCB) [Last accessed on 2016 Apr 20]. Available from: