Understanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study

Article


Bechange, S., Jolley, E., Tobi, P., Mailu, E., Sentongo, J., Chulu, T., Abony, M., Chege, M., Mulenga, G., Ngorok, J., Adera, T. and Schmidt, E. 2022. Understanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study. International Health. 14 (Supp 1), pp. i57-i63. https://doi.org/10.1093/inthealth/ihab061
TypeArticle
TitleUnderstanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study
AuthorsBechange, S., Jolley, E., Tobi, P., Mailu, E., Sentongo, J., Chulu, T., Abony, M., Chege, M., Mulenga, G., Ngorok, J., Adera, T. and Schmidt, E.
Abstract

Background
Cataract is a major cause of visual impairment globally, affecting 15.2 million people who are blind, and another 78.8 million who have moderate or severe visual impairment. This study was designed to explore factors that influence the uptake of surgery offered to patients with operable cataract in a free-of-charge, community-based eye health programme.
Methods Focus group discussions and in-depth interviews were conducted with patients and healthcare providers in rural Zambia, Kenya and Uganda during 2018–2019. We identified participants using purposive sampling. Thematic analysis was conducted using a combination of an inductive and deductive team-based approach.
Results
Participants consisted of 131 healthcare providers and 294 patients. Two-thirds of patients had been operated on for cataract. Two major themes emerged: (1) surgery enablers, including a desire to regain control of their lives, the positive testimonies of others, family support, as well as free surgery, medication and food; and (2) barriers to surgery, including cultural and social factors, as well as the inadequacies of the healthcare delivery system.
Conclusions
Cultural, social and health system realities impact decisions made by patients about cataract surgery uptake. This study highlights the importance of demand segmentation and improving the quality of services, based on patients’ expectations and needs, as strategies for increasing cataract surgery uptake.

Keywordsaccess to eye care; cataract surgery; health system; health-seeking behaviour; sub-Saharan Africa; uptake of services
LanguageEnglish
PublisherOxford University Press (OUP)
JournalInternational Health
ISSN1876-3413
Electronic1876-3405
Publication dates
Online28 Sep 2021
Print06 Apr 2022
Publication process dates
Deposited07 Oct 2021
Submitted27 Jul 2021
Accepted14 Sep 2021
Output statusPublished
Publisher's version
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Copyright Statement

© The Author(s) 2021. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Digital Object Identifier (DOI)https://doi.org/10.1093/inthealth/ihab061
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