Access to school-based eye health programs in Central Region, Malawi: a qualitative case study

Area of Science:

• Public Health
• Ophthalmology
• Pediatrics

Background:

• Vision impairment in children negatively impacts educational attainment.
• School-based eye health programs offer cost-effective solutions, especially in low-resource settings.
• Preventing childhood blindness and uncorrected vision impairment is crucial for development.

Purpose of the Study:

• To identify barriers and enablers for school-based eye health programs in Malawi's Central Region.
• To understand factors affecting referral to eye care services for children.
• To inform the improvement of child eye health initiatives.

Main Methods:

• Qualitative study using in-depth interviews and focus groups.
• Participants included children, parents, school staff, eye care practitioners, and government/NGO workers (n=44).
• Utilized the AAAQ (availability, accessibility, acceptability, quality) framework.

Main Results:

• Infrastructure and resourcing limitations hinder program delivery despite intersectoral collaboration.
• Geographic access to follow-up care and spectacle costs are parental barriers.
• Childhood stigma associated with wearing spectacles deters uptake.

Conclusions:

• School eye care can be enhanced through teacher-led vision screening and community health workers.
• Raising awareness about vision impairment's impact on education and employment is vital.
• Educational initiatives to reduce stigma and misconceptions about spectacles are necessary.