Factors affecting the academic performance of optometry students in Mozambique.

PURPOSE: The Mozambique Eyecare Project is a higher education partnership for the development, implementation, and evaluation of a model of optometry training at UniLúrio in Mozambique. There are many composite elements to the development of sustainable eye health structures, and appropriate education for eye health workers remains a key determinant of successful eye care development. However, from the first intake of 16 students, only 9 students graduated from the program, whereas only 6 graduated from the second intake of 24 students. This low graduation rate is attributable to a combination of substandard academic performance and student dropout. The aim of this article was to identify factors affecting the academic performance of optometry students in Mozambique. METHODS: Nine lecturers (the entire faculty) and 15 students (9 from the first intake and 6 from the second) were recruited to the study. Clinical competency assessments were carried out on the students, semistructured individual interviews were conducted with the course lecturers, and a course evaluation questionnaire was completed by students. The results were combined to understand the complexities surrounding the optometry student training and performance. RESULTS: One student out of nine from the first intake and three students out of six from the second were graded as competent in all the elements of the refraction clinical competency examination. Analysis of data from the interviews and questionnaire yielded four dominant themes that were viewed as important determinants of student refraction competencies: student learning context, teaching context, clinic conditions and assessment, and the existing operating health care context. CONCLUSIONS: The evaluations have helped the university and course partners to better structure the teaching and adapt the learning environments by recommending a preparatory year and a review of the curriculum and clinic structure, implementing more transparent entry requirements, increasing awareness of the program, and improving Internet infrastructure.

The development of a public optometry system in Mozambique: a Cost Benefit Analysis.

BACKGROUND: The economic burden of uncorrected refractive error (URE) is thought to be high in Mozambique, largely as a consequence of the lack of resources and systems to tackle this largely avoidable problem. The Mozambique Eyecare Project (MEP) has established the first optometry training and human resource deployment initiative to address the burden of URE in Lusophone Africa. The nature of the MEP programme provides the opportunity to determine, using Cost Benefit Analysis (CBA), whether investing in the establishment and delivery of a comprehensive system for optometry human resource development and public sector deployment is economically justifiable for Lusophone Africa. METHODS: A CBA methodology was applied across the period 2009-2049. Costs associated with establishing and operating a school of optometry, and a programme to address uncorrected refractive error, were included. Benefits were calculated using a human capital approach to valuing sight. Disability weightings from the Global Burden of Disease study were applied. Costs were subtracted from benefits to provide the net societal benefit, which was discounted to provide the net present value using a 3% discount rate. RESULTS: Using the most recently published disability weightings, the potential exists, through the correction of URE in 24.3 million potentially economically productive persons, to achieve a net present value societal benefit of up to $1.1 billion by 2049, at a Benefit-Cost ratio of 14:1. When CBA assumptions are varied as part of the sensitivity analysis, the results suggest the societal benefit could lie in the range of $649 million to $9.6 billion by 2049. CONCLUSION: This study demonstrates that a programme designed to address the burden of refractive error in Mozambique is economically justifiable in terms of the increased productivity that would result due to its implementation.