Development of a model to support primary eye-care service provision in rural south Omo Zone, Ethiopia

Abstract

Primary eye-care is an important component of comprehensive eye-care services, enabling communities to enjoy high-quality basic services. However, due to various factors, the community does not use the service properly. The purpose of this study was to develop a model to support optimal provision and utilisation of primary eye-care services by exploring and describing the provision and use. The study applied a three-phased exploratory sequential mixed method research design in four districts of the Southern Omo Zone, Ethiopia, that involved qualitative and quantitative data collection and analysis. The study population was adult service users, primary eye-care workers, mid-level healthcare workers, and primary eye-care units. Qualitative data was collected through 6 focus group discussions and 12 in-depth individual face-to-face interviews. A purposive sampling technique was used to select study participants. Quantitative data was collected using 103 self-administered questionnaires and 32 checklists. A simple random sampling technique was used to select respondents. ATLAS.ti version 23.2.2 and SPSS version 28 were used to analyse the data. The study results reveal different determinants and barriers to the provision and use of primary eye-care services. The emerging themes of the study were the perspective of the community and service providers, preference for the service, barriers to service, and suggestions for improvement. Only a third of primary eye-care units were ready in infrastructure, equipment, and service delivery. Less than half of primary eye-care service providers were found to have intermediate knowledge and skills required to provide services. Multivariate analysis showed serving more patients per month [AOR 25.44; 95% CI 4.06-159.45], receiving additional training [AOR 100.49; 95% CI 3.96-2,551.58], and having a first-degree [AOR 23.92; 95% CI 4.88-117.23] had a statistically significant association with knowledge and skill. The use of primary eye-care services is low and fenced with many barriers. Therefore, this study developed an integrated community-based primary eye-care model to support optimal service provision. Experts validated the developed model. The model is new to the country and will greatly contribute to improving the provision and use, resulting in a reduced burden of avoidable blindness and low vision.