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Why are children brought late for cataract surgery? Qualitative findings from Tanzania
Annie Bronsard1, Robert Geneau, Sylvia Shirima
1Université Laval, Québec, Canada.
Insights
Delays in pediatric cataract surgery are common in developing nations due to household factors and inadequate health worker communication. Addressing these barriers is crucial for improving visual outcomes in children with congenital or developmental cataract.
Area of Science:
- Ophthalmology
- Global Health
- Pediatric Care
Background:
- Congenital or developmental cataract affects at least 190,000 children globally, leading to blindness.
- Surgical intervention is the primary treatment, yet many children in developing countries do not receive timely surgery.
- Delayed presentation significantly impairs visual outcomes and impacts the quality of life for children and their families.
Purpose of the Study:
- To explore the reasons behind surgical delays in pediatric cataract care.
- To understand the factors influencing treatment-seeking behaviors for congenital or developmental cataract in children.
Main Methods:
- A qualitative study was conducted involving 117 semi-structured interviews.
- Interviews were held with parents or guardians of children undergoing cataract surgery.
- The study was set in a tertiary hospital in northern Tanzania.
Main Results:
- Several factors influence parental treatment-seeking behaviors.
- These include household gender dynamics and local health beliefs regarding cataract and its surgery.
- Inadequate information provided by primary and secondary healthcare professionals also contributes to delays.
Conclusions:
- Short and medium-term strategies are needed to reduce presentation delays.
- Public education, enhanced training for healthcare workers, and community-based counseling are essential.
- Timely access to services can be improved through these interventions.
Purpose:
Worldwide, at least 190,000 children are blind due to cataract. Although, surgical intervention is the treatment of choice, in most developing countries the number of children with cataract being brought to hospital for surgery has been few in number, considerably less than the burden of disease in the community. Furthermore, long delay in presentation is a major deterrent to improved visual outcome and compromises the future quality of life of children and their families. The main objective of this qualitative study was to provide a better understanding of surgical delay in the care of children with congenital or developmental cataract.
Methods:
We conducted 117 semi-structured interviews with parents or guardians of children admitted for cataract surgery at a tertiary hospital in northern Tanzania.
Results:
We identified several factors influencing the treatment-seeking behaviors of parents and guardians, including gender relations within the household, local health beliefs about cataract and cataract surgery and the ability of health care professionals in primary and secondary care settings to adequately inform parents and guardians about cataract and cataract surgery.
Conclusions:
Practical, short and medium term avenues must be explored to reduce delays of presentation. Public education, training of health workers and counseling efforts in the communities may be necessary to enable children to access services in a timely fashion.
