Effectiveness of community outreach screening for glaucoma in improving equity and access to eye care in Nigeria

Olusola Oluyinka Olawoye*, Olufunmilayo Fawole, Adeyinka O Ashaye, Ving Fai Chan, Augusto Azuara-Blanco, Nathan Congdon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To determine the effectiveness of community outreach screening for glaucoma in improving equity and access to eye care in Nigeria. 

Methodology: This was a prospective study in which two cohort of participants were recruited in Nigeria: 1 from 24 outreach screenings and another from consecutive patients presenting spontaneously to a tertiary eye clinic in Nigeria. Sociodemographic and clinical data were obtained from participants and compared. 

Results: Our sample consisted of 120 patients with glaucoma or suspected glaucoma (6.38% of 1881 screenees) recruited from the 24 outreach screenings, and another 123 patients with glaucoma who presented spontaneously at the eye clinic. Participants from the screenings were significantly older (p=0.012), less educated (p<0.001), had lower incomes (p<0.001), lower glaucoma knowledge scores and were less aware of their glaucoma (both p<0.001) and were more likely to be dependent on relations and children (p=0.002) compared with clinic participants. Of the 120 patients identified at the screenings and referred to the clinic for definitive care, 39 (32.5%) presented at the clinic within 3 months. Reasons for poor uptake of referral services were lack of a felt need and lack of money for transportation. Considering only patients who accepted referral, they were still less educated (p<0.001), poorer (p=0.001) and less knowledgeable about glaucoma (p=0.003) than spontaneous clinic presenters.


Conclusion: Outreach screening improved equity of access but its effects were somewhat reduced by poor uptake of referral care. Interventions such as free transportation and educational efforts may improve the uptake of referral services and maximise equity gains.

Original languageEnglish
Article number319355
JournalBritish Journal of Ophthalmology
Early online date06 Aug 2021
DOIs
Publication statusEarly online date - 06 Aug 2021

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Keywords

  • epidemiology
  • glaucoma

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Fingerprint

Dive into the research topics of 'Effectiveness of community outreach screening for glaucoma in improving equity and access to eye care in Nigeria'. Together they form a unique fingerprint.

Cite this