Eye Health Integration in Southern and Eastern Africa: A Scoping Review

Area of Science:

• Public Health
• Health Systems Research
• Ophthalmology

Background:

• Integrated health systems are crucial for achieving universal health coverage.
• The East, Central, and Southern Africa Health Community (ECSA-HC) supports integrating eye health into wider health systems.
• This review examines the current status of eye health system integration in the ECSA-HC region.

Purpose of the Study:

• To present the current state of eye health system integration within the ECSA-HC region.
• To identify progress and challenges in integrating eye health services.

Main Methods:

• A systematic literature search was conducted across four electronic databases, identifying 812 articles published between 1946 and 2020.
• Article selection and data extraction were performed independently by two reviewers.
• A narrative synthesis was used for the 30 eligible articles.

Main Results:

• The majority of included studies were observational (60%) and from Tanzania (43%).
• No explicit definition of integration was found; integration was often viewed as service delivery at the primary level.
• Challenges included inadequate data documentation, limited national prioritization cascading to lower levels, concerns regarding service quality from workforce integration, and limited government funding for eye care.

Conclusions:

• Eye health system integration in the ECSA-HC region has been ongoing for approximately four decades, focusing on incorporating eye health services into existing healthcare programs.
• There is a need to emphasize comprehensive eye care integration across all health system building blocks, particularly financial integration, to advance universal health coverage.