Cost and productivity of cataract surgery in different eye care deliverly settings in Kenya

Abstract

Cataract which is defined as an opacity of the crystalline lens of the eye is the leading cause of visual impairment and blindness in Kenya and in the whole world in general. The global backlog of people blind from cataract is expected to be about 25 million by the turn of the century. Majority of cataracts are age related. Surgical removal of the opaque lens and correction with an intraocular lens implant or aphakic spectacles is the only known treatment. There is no known drug treatment. The global burden of cataract blindness is on the increase as a result of the increase in life expectancy and a relative shortage of facilities for cataract surgery. The poor developing nations in Africa and Asia are most affected(9). Resources allocated for the treatment of cataract in Kenya like in other developing nations, are not only scarce but have also been shrinking with time. Prioritisation during planning and resource allocation should be done for the benefit of the majority in the spirit of “ health for all by the year 2000 and beyond ”. This can only be possible if we are aware of the costs incurred in cataract surgery and the ways by which costs can be contained. Cost sharing is one of the means of financing health services in Kenya. When the costs of each individual health services e.g. cataract surgery is known, it is easy to estimate how much patients should be charged as hospital user charges. Overcharging lowers utilisation while undercharging threatens sustainability of the heath services. The exact cost per unit service should thus be reviewed regularly.