Cataract services for all: Strategies for equitable access from a global modified Delphi process.
Jacqueline Ramke1,2, Juan Carlos Silva3, Michael Gichangi4
1International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLOS Global Public Health
|March 24, 2023
Summary
This study identified key strategies and priority populations to improve cataract vision services for underserved groups globally. Findings highlight the need to address health system factors for equitable access to screening and surgery.
Area of Science:
- Ophthalmology
- Public Health
- Health Services Research
Background:
- Cataract-related vision loss disproportionately affects certain populations, yet evidence for equitable service delivery is limited.
- Addressing inequities in access to cataract screening and surgical services is a global health priority.
Purpose of the Study:
- To identify and prioritize strategies for improving cataract service access for underserved populations.
- To determine target population groups for enhanced cataract care delivery worldwide.
Main Methods:
- A modified Delphi process involving 183 international cataract service experts across two online rounds.
- Panellists identified and ranked strategies and population groups for improved cataract care access.
Main Results:
- Globally, priority groups include those in rural areas, with low socioeconomic status, and low social support.
- Women were a top 5 priority group only in South Asia and Sub-Saharan Africa.
- 16 screening and 19 surgical service strategies were identified, focusing on health system improvements (policy, HR, financing, delivery).
Conclusions:
- The identified strategies and priority groups offer a foundation for targeted interventions to reduce cataract-related vision loss.
- Coordinated action is needed to improve access to cataract services, especially for historically marginalized populations.
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