Аннотация
Purpose: To determine barriers to uptake of cataract surgery by outreach patients at the University College Hospital, Ibadan and to make appropriate recommendations for improved cataract surgery uptake
Methods: Consenting cataract blind/visually impaired (presenting vision < 6/18) outreach patients identified from the outreach patient register of the University College Hospital, (UCH) Ibadan during a five months period (January to May 2009) were followed up for a visit in late June and July 2009. A semi-structured questionnaire schedule was used for data collection. People who did not use the services were administered a barriers questionnaire-schedule while those who accepted the services were administered a questionnaire schedule to elicit motivating factors for acceptance of services. Subjects were also examined using standard ophthalmic equipment (pen torch, ETDRS vision charts and ophthalmoscope) and information obtained recorded in a data entry form.
Results: A total of 186 subjects comprising 115 who had undergone cataract surgery and 71 who were yet to access cataract surgery services were followed up and included in the study. Reason for accessing surgery included awareness of quality service 63(57.0%), was referred 32(29.0%) and pressure from family or friends 13(12.0%). Barriers to access included, untreated medical problems 21(29.0%), not able to afford total (direct and indirect) cost of treatment 15(21.0%), cataract not mature10 (14.0%), not able to afford cost of surgery 9(13.0%) and Dr’s appointment 8(11.0%).
Conclusion: barriers to surgery uptake by outreach camp patients include cost of services, underlying medical problems and preferred doctors’ practice. Adoption and scaling up of health insurance to cover those most in need as well as a change in preferred practice amongst eye care practitioners are possible areas for intervention.
Keywords: Cataract, outreach camps, service barrier
Abstract
Objectif: déterminer les obstacles à l’absorption de la chirurgie de la cataracte par les patients de sensibilisation au centre hospitalier universitaire d’Ibadan et formuler des recommandations appropriées pour l’absorption chirurgicale de la cataracte amélioration
Méthodes: Le consentement de la cataracte aveugles / malvoyants (vision présentant <6/18) des patients identifiés à partir du registre de sensibilisation des patients du centre hospitalier universitaire d’Ibadan au cours d’une période de cinq mois (Janvier à mai 2009) ont été suivis au pendant une visite à la fin du mois de Juin et Juillet 2009. Un calendrier de questionnaire semi-structuré a été utilisé pour la collecte des données. Les gens qui n’ont pas utilisé les services ont été administrés un questionnaire-barrières horaires, tandis que ceux qui ont accepté les services ont été administrés un calendrier questionnaire visant à obtenir des facteurs de motivation pour l’acceptation des services. Les sujets ont été également examinés à l’aide du matériel ophtalmologique standard (stylo lampe de poche, cartes vision ETDRS et ophtalmoscope) et les renseignements obtenus ont été consignées dans un formulaire de saisie.
Résultats: Un total de 186 sujets comprenant 115 et qui avait subi une intervention chirurgicale de la cataracte et 71 qui n’avaient pas encore accédé aux services de chirurgie de la cataracte ont été suivis et inclus dans l’étude. L’une des raisons pour accéder à la chirurgie comprenait la sensibilisation sur la qualité du service 63(57,0%), 32 (29,0%) sont référés et la pression de la famille ou des amis 13 (12,0%). Les obstacles à l’accès inclus, les problèmes médicaux non traités 21 (29,0%), ce qui ne peuvent supporter le coût total (direct et indirect) de traitement15 (21,0%), la non maturité de la cataracte 10 (14,0%), Ceux qui ne sont en mesure de payer le coût de la chirurgie 9 (13,0%) et la nomination du Dr 8 (11,0%).
Conclusion: Les obstacles à l’absorption par la chirurgie les patients des camps de sensibilisation comprennent le coût des services, soulignant les problèmes médicaux et la pratique préférentielle des médecins. L’adoption et la mise à l’échelle de l’assurance maladie pour couvrir ceux qui en ont besoin d’urgence ainsi qu’un changement dans la pratique préférée parmi les praticiens de soins oculaires sont les domaines possibles d’intervention.
Correspondence: Dr. C.O. Bekibele, Department of Ophthalomology, College of Medicine, University of Ibadan, Ibadan. Nigeria. E-mail: cob150@yahoo.com
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