Identifying barriers and potential solutions to improve equitable access to community eye services: an exploratory...

Area of Science:

• Public Health
• Health Services Research
• Health Equity

Background:

• Access to healthcare services is inequitably distributed across sociodemographic groups.
• Certain populations face significant barriers to accessing timely and appropriate care.
• Understanding these barriers is crucial for developing effective interventions.

Purpose of the Study:

• To explore barriers to care and identify potential solutions from the perspective of underserved populations.
• To develop and test service modifications for improving equitable access to care.
• To generate generalizable findings and actionable insights rapidly.

Main Methods:

• A multiphased, exploratory sequential mixed-methods study conducted across four screening programmes (Botswana, India, Kenya, Nepal).
• Phase 1: In-depth interviews with individuals from 'left-behind' sociodemographic subgroups to identify barriers and perceived solutions.
• Phase 2: Survey to rank potential service modifications by impact; Phase 3: Multistakeholder workshops to assess feasibility, cost, and risks of proposed modifications.

Main Results:

• Qualitative data analysis identified specific barriers faced by 'left-behind' groups.
• Quantitative survey data ranked proposed modifications by perceived effectiveness.
• Workshop discussions prioritized modifications based on impact, feasibility, cost, and risk.

Conclusions:

• Tailored, community-informed service modifications can significantly improve equitable access to care.
• A rapid, mixed-methods approach can yield actionable insights for health service improvement.
• Addressing barriers faced by underserved populations is essential for achieving health equity.