Rapid assessment of cataract surgical services in Embu district, Kenya

Abstract

Objectives: To conduct a rapid assessment of cataract surgical services in Embu District. Design: Community based survey Setting: Embu district of the Eastern Province of Kenya Subjects: 85 clusters selected by systematic method. Each cluster had 40 people aged >50 years. Conclusions: The prevalence of blindness in people aged >50 years in Embu district is 2.0% (95%CI: 1.5%-2.5%). Cataract is the commonest cause of blindness (39.7%; 95%CI:38.9%-40.5%). The Cataract surgical coverage for cataract blind persons is 65.7 %. The outcome of cataract surgery with IOL is good in 39.5% of all the operated eyes and improved to 53.5% with best correction/VA with pinhole. Most of the cataract operations are done in voluntary/charity hospitals (47.4%) and in government hospitals (44.9%). The main barriers to utilization of cataract surgical services in the district are lack of awareness and cost of surgery. Conclusions: Most of the cataract blind patients (65.7%) have assess to surgical services. The proportion of cataract surgeries resulting in good surgical outcomes is low. Recommendations: There is need to improve the outcome of cataract surgery in Embu through continuing skills update courses for existing staff, supply of biometry equipment and vitrectomy machine plus establishing a cataract audit system. Collaboration between the Government and charitable eye care institutions should be strengthened because they are equal partners in delivery of cataract surgical services in the district. There is need to initiate community eye health promotion activities and cost-containment strategies in order to break the barriers to utilization of surgical services.