Eye care in Timor-Leste: a population-based study of utilization and barriers

To determine utilization of Western-style conventional health services for eye problems in Timor-Leste, and barriers to seeking that care.

An interview-based questionnaire was administered as part of a population-based cross-sectional survey of 50 clusters (urban and rural) of 30 people aged > or =40 years.

Of 1470 people enumerated, 1414 were examined (96.2%). A total of 1293 (91.4%) reported at least one previous or present eye problem, mostly (88.6%) blurred/poor vision, for near and/or distance. Men (OR 1.6, 95% CI 1.1-2.3), literates (OR 2.1, 95% CI 1.4-3.5), urban dwellers (OR 4.1, 95% CI 2.6-6.4) and those in paid employment compared with being a farmer (OR 3.0, 95% CI 1.5-5.9) were more likely to have reported a problem. A total of 858 (66.4%) sought Western-style care for its remedy. Non-utilization was associated with being illiterate (OR 3.7, 95% CI 2.9-4.8), a rural dweller (OR 3.8, 95% CI 3.0-4.9), unemployed (OR 1.6, 95% CI 1.1-2.2) or a farmer (OR 5.2, 95% CI 3.5-7.6) compared with being in paid employment, having moderately impaired compared with non-impaired near vision (OR 1.4, 95% CI 1.1-1.8), and red/itchy/painful eyes compared with blurred vision (OR 2.3, 95% CI 1.6-3.2), but not age, gender or poor distance vision. Lack of awareness of service availability was the most frequent reason for not seeking treatment (32.9%), especially for rural respondents. Attitudinal reasons were also prevalent (32.5%), with social (11.8%), economic (11.5%) and service-related (9.0%) issues less so.

If eye health is to improve in Timor-Leste, there must be better appreciation of it, and increased availability, accessibility and awareness of services.