Barriers to uptake of free pediatric cataract surgery in Malawi.
Ophthalmic Epidemiol
; 21(3): 138-43, 2014 Jun.
Article
en En
| MEDLINE
| ID: mdl-24597953
ABSTRACT
PURPOSE:
To examine the demographic, sociocultural and socioeconomic factors that prevent families of cataract blind children from accepting free pediatric cataract surgery in Malawi.METHODS:
A total 58 parents of 62 children were recruited into the study. Of these, 53 parents partook in in-depth interviews and focus group discussions after the children were screened and the parents offered free cataract surgery. Overall, 37 parents accepted (acceptors) and 16 parents did not accept (non-acceptors) cataract surgery. All interviews were transcribed and iteratively analyzed. Household economic status was quantified using the Progress out of Poverty Index for Malawi.RESULTS:
Acceptors were better off economically (p = 0.13). Understanding of cataract, its causing blindness and impairment, as well as treatment options, by the decision makers in the families was poor. Decision-making involved a complex array of aspects needing consideration before accepting, of which distance to the health facility was a frequently mentioned barrier. Non-acceptors were more likely to come from twice the distance compared to acceptors (p = 0.0098). Non-acceptors were more likely to be peasant (subsistence) farmers than acceptors (p = 0.048). Non-acceptors were more likely to live in a house made of mud bricks with a roof of grass thatch (p = 0.001). There was no significant difference in acceptance rate between educated and non-educated mothers (p = 0.11). Intensive counseling as provided in this project increased the likelihood of accepting surgery.CONCLUSION:
Economic hardship and long distances to health facilities decrease acceptance even of free pediatric cataract surgical services, highlighting that just providing surgery free of cost may not be sufficient for the most economically disadvantaged in rural Africa.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trastornos de la Visión
/
Catarata
/
Aceptación de la Atención de Salud
/
Extracción de Catarata
/
Honorarios y Precios
Tipo de estudio:
Health_economic_evaluation
/
Prognostic_studies
/
Qualitative_research
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
País/Región como asunto:
Africa
Idioma:
En
Revista:
Ophthalmic Epidemiol
Asunto de la revista:
EPIDEMIOLOGIA
/
OFTALMOLOGIA
Año:
2014
Tipo del documento:
Article
País de afiliación:
Malawi