Envisioning Eye Care From a Rural Perspective: A Photovoice Project From India.

Background To understand barriers and promoters for accessing eye care by rural communities, we used a modified approach to Photovoice, a community-based participatory action research approach Methods Community members took photographs and wrote or spoke stories based upon a series of questions intended to facilitate deeper thinking. Fifteen rural paramedical team members who were affiliated with the rural network of L V Prasad Eye Institute, and 60 people from four villages reported barriers and promoters for eye care access for 20 villages Results Important barriers for accessing eye care included the following: no caretaker at home for grandchildren except for the grandparent(s), alcoholism, uncontrolled blood pressure, inadequate diabetes management, lack of escort for blind people and elders, affordability, and inadequate clinic staffing during summer season when farming villagers were available. Important promoters for seeking eye care included having a neighbor who had a good surgical outcome in one eye which resulted in the ability to resume work. The Photovoice project offered specific suggestions to hospital management for improving eye care access, including providing evening transportation, providing additional surgical staffing during busy summer season, and the creation of tool spectacle repair kits to be kept at the primary vision centers Conclusions This Photovoice project facilitated a deeper understanding of the important barriers and promoters for accessing eye care by villagers, and by the rural eye care team, offering specific suggestions to hospital management for improving eye care access and to communicate without any inhibiting factors like fear of hierarchy within the hospital administration.

Tribal Odisha Eye Disease Study (TOES). Report # 10. Disability inclusive eye health survey in a tribal district (Rayagada) in Odisha, India.

PURPOSE: To estimate seeing and other disabilities in a population cohort in a tribal district, Rayagada, in the Indian state of Orissa. METHODS: A door-to-door survey was conducted to identify the disabilities. The vision was measured at the residence of the subject, and other disabilities were documented from the history obtained from the subject/household/neighbor. All people with seeing disabilities were reexamined in the community eye center (primary or secondary), and required treatment was given at no cost to the patients. People with other disabilities were transported to the public health facility for appropriate care and disability certification. The results were compared with the 2011 national census data. RESULTS: A total of 147,699 people were enumerated, and 106,339 (72%) were examined over one year period, 2016-17. In this cohort, 47.3% (n = 50,320) were male and 27.5% (n = 29,215) were 40 years or older. We recorded systemic disease in 0.6% (n = 689) people; hypertension was two times higher than diabetes mellitus. Disability was identified in 2.8% (n = 3022). Common disabilities were seeing (46.7%; n = 1411), hearing (36.8%; n = 1112), mobility (10.4%; n = 315), and mental retardation (3.2%; n = 98). Dual sensory disability (seeing and hearing) was seen in 6.4% (n = 251), and it was higher in the older age group. Seeing and hearing disabilities were higher than the 2011 state (P =< 0.001) and national (P =< 0.001) disability census. CONCLUSION: The first population-based survey in Rayagada, Odisha (India) in 2017 showed a higher proportion of people with seeing and hearing disabilities. It calls for an appropriate service strategy.