Public Health
Volume 121, Issue 2 , Pages 130-136, February 2007

Coverage, utilization and barriers to cataract surgical services in rural South India: Results from a population-based study

  • T.S. Chandrashekhar

      Affiliations

    • Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, 576119, India
    • Corresponding Author InformationCorresponding author. Tel.:+97761526416x215; fax: +97761522160.
    • ,
  • H.V. Bhat

      Affiliations

    • Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, 576119, India
    • ,
  • R.P. Pai

      Affiliations

    • Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, 576119, India
    • ,
  • S.K. Nair

      Affiliations

    • Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, 576119, India
    • Department of Community Medicine, Manipal College of Medical Sciences, PO. Box. 155, Deep Heights, Pokhara 16, Nepal

Received 27 June 2005; received in revised form 28 June 2006; accepted 14 July 2006.

Summary 

Objectives

To determine the cataract surgical coverage, utilization and barriers to cataract surgery in a rural taluk of south India.

Study design

A cross-sectional, community-based survey.

Methods

A house-to-house survey was carried out in 15 villages that were selected by cluster sampling during January to October, 2002. A total of 1505 people aged 50 years and above were tested for visual acuity (VA) and their eyes examined. Cataract surgical coverage was calculated for people and eyes, and for VA levels of <3/60 and <6/60. Information about details of cataract surgery and barriers to cataract surgery were collected using a pre-designed proforma.

Results

Cataract surgical coverage was 63% (people) and 51% (eyes) for VA<3/60 compared with 49% (people) and 36% (eyes) for VA<6/60. Of 109 operated eyes, 51.2% of operations were carried out in private hospitals and 33.3% in voluntary/charitable hospitals. Inability to afford the operation (22.9%) and fear of the operation (19.2%) were the main barriers to cataract surgery.

Conclusions

The reasons for underutilization of government hospitals are to be investigated. Awareness of low-cost cataract intraocular lens (IOL) non-governmental organization (NGO) surgery and free-of-cost NGO services available in the region needs to be raised. Barriers to cataract surgical services should be addressed by community-based health-education programmes to improve the uptake of existing services.

Keywords: Cataract surgery, Coverage, Utilization, Barriers

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PII: S0033-3506(06)00216-2

doi:10.1016/j.puhe.2006.07.027

Public Health
Volume 121, Issue 2 , Pages 130-136, February 2007

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