Abstract
The number of people coming for cataract surgery in Madagascar remains low and most ophthalmologists could do many more surgeries than currently done. Knowing why people identified with cataract do not accept surgery will help to design programs that use existing resources more effectively. The study was carried out in Sava Region of Madagascar. People with blinding (<6/60) cataract were identified by cataract case finders in the community, interviewed, and given a referral card for surgery at the hospital. We then monitored uptake of surgery at the hospital. Overall, 142 people were identified, interviewed and referred. Among the referrals, 35 (24.6%) presented at the hospital for surgery. The most important factors associated with acceptance were proximity to hospital (people from Sambava district were twice as likely to present as people from more distant districts) and perceived price of transport and food (being higher for people not accepting). The actual price of surgery was not the main barrier to acceptance of surgery; instead it appears that distance to the hospital and the willingness to pay are important predictors. Strategies to improve uptake need to be revised in order to ensure that people have access to and use cataract surgical services.
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References
Resnikoff S, Pascolini D, Etya’ale D, Kocur I, Pararajasegaram R, Pokharel GP et al (2004) Global data on visual impairment in the year 2002. Bull World Health Organ 82(11):844–851
Rabiu MM (2001) Cataract blindness and barriers to uptake of cataract surgery in a rural community of northern Nigeria. Br J Ophthalmol 85(7):776
Geneau R, Massae P, Courtright P, Lewallen S (2008) Using qualitative methods to understand the determinants of patients’ willingness to pay for cataract surgery: a study in Tanzania. Soc Sci Med 66(3):558–568
Briesen S, Roberts H, Ilako D, Karimurio J, Courtright P (2010) Are blind people more likely to accept free cataract surgery? A study of vision-related quality of life and visual acuity in Kenya. Ophthal Epidemiol 17(1):41–49
Kessy JP, Lewallen S (2007) Poverty as a barrier to accessing cataract surgery: a study from Tanzania. Br J Ophthalmol 91(9):1114
Lewallen S, Roberts H, Hall A, Onyange R, Temba M, Banzi J et al (2005) Increasing cataract surgery to meet Vision 2020 targets; experience from two rural programmes in east Africa. Br J Ophthalmol 89(10):1237–1240
Nkumbe H, Rakotondrajoa P, Rabemiarana E, Rakotondrajoa H (2010) Soins oculaires primaires dans les centres de santé de base de Madagascar : premier bilan. Revue de Santé Oculaire Communautaire 7(8):12–14
Byamukama E, Courtright P (2010) Knowledge, skills, and productivity in primary eye care among health workers in Tanzania: need for reassessment of expectations? Int Health 2:247–252
Acknowledgments
The authors are grateful to the Swiss Lions who support the Sava Regional programme. We also appreciate the work of Mamy Rafenoarinesa and Severin Randrianandrasana for their hard work in the field and all the staff of SALFA Sambava. Finally, we are grateful for the participation of the people from communities in the survey.
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Razafinimpanana, N., Nkumbe, H., Courtright, P. et al. Uptake of cataract surgery in Sava Region, Madagascar: role of cataract case finders in acceptance of cataract surgery. Int Ophthalmol 32, 107–111 (2012). https://doi.org/10.1007/s10792-012-9523-7
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DOI: https://doi.org/10.1007/s10792-012-9523-7