Barriers to availing refractive error services among an urban slum population in Mumbai, India

Barriers to availing refracti ve error services among an urban slum population in Mumbai, India.

Background: A refractive error project for management of refractive errors in adults was undertaken in the urban slums of Mumbai, India. The project looked at the burden of refractive errors in the predominantly lower socio economic status groups as well as what common barriers prevent access to refractive services amongst this population. This presentation highlights the barriers that were elicited for availing and accessing refractive error services among the urban slum population in Mumbai, India. AIM: The study aimed to identify the common barriers to availing & accessing refractive error services among an urban slum population in Mumbai, India.

Methods : A situation analysis of the community, with respect to availability of services was done as a part of the service delivery planning. The analysis revealed that services were available but the community was not accessing the same. Based on the situation analysis report a questionnaire with all perceived barriers was developed and the same was validated. Service delivery was done by establishing vision centers within the community. Trained health workers performed a door to door vision screening, identified and referred the needy population to the vision centre. Here the questionnaire was run by trained social workers on the people visiting the centers for eye examinations, who were referred by the social workers.

Results : Data analysis was carried out to know the reasons for not availing the services within the community. Of the 4070 subjects who visited the vision centre, 4039 case records were complete and analyzed. The demographic associations of the use of spectacles and reasons for not availing services were assessed with age, gender, education, socioeconomic status. On further analyses it was revealed, that, 3373 (83.5%) were aware of their poor vision, of these 2000 people did not visit an eye doctor. When the questions were analyzed as economic reasons and lack of awareness, lack of awareness superseded economic reasons, as lack of awareness was 54.5% Vs economic was 53.70%.

Conclusion: When refractive error service delivery was planned for this population, besides providing free spectacles, emphasis on generating awareness for need for refractive errors was also considered.