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Exploring Service Users' Experiences of a Community-Based Intervention to Improve Follow-Up at Bharatpur Eye Hospital
Manisha Shrestha1, Gopal Bhandari1, Sadhan Bhandari1
1Bharatpur Eye Hospital, Bharatpur, Nepal.
Insights
Understanding patient experiences is key to improving pediatric eye care follow-up in Nepal. This study explored barriers and facilitators to ensure better community-based eye health services.
Area of Science:
- Ophthalmology
- Public Health
- Health Services Research
Background:
- Effective follow-up care for pediatric eye conditions is crucial for maintaining vision and preventing long-term disability.
- Continuity of care in eye health services, particularly in resource-limited settings like Nepal, remains a significant challenge.
- Bharatpur Eye Hospital (BEH) in Nepal implemented a community-based intervention to enhance patient follow-up rates for eye care services.
Purpose of the Study:
- To explore service users' experiences and perceptions of a community-based intervention aimed at improving follow-up care for pediatric eye services at BEH, Nepal.
- To identify barriers and facilitators influencing patient adherence to follow-up appointments in community-based eye care programs.
- To gather insights for optimizing future eye care interventions and ensuring equitable access to services.
Main Methods:
- A qualitative study employing in-depth interviews with service users of pediatric eye care at BEH.
- Purposive sampling was used to recruit 17 participants, including those who had not attended any follow-up and those who had attended at least one.
- Interviews were conducted by trained ophthalmic assistants using topic guides tailored to participant follow-up status.
Main Results:
- Four key themes emerged from the 17 service user interviews, offering critical insights into the follow-up process.
- Identified barriers and facilitators provide a nuanced understanding of patient engagement with community-based eye care.
- Participant experiences, both positive and negative, highlight areas for improvement in service delivery and patient support.
Conclusions:
- Systematic development of innovative and scalable interventions is necessary to address unmet needs in community eye care.
- The findings underscore the importance of patient-centered approaches to improve follow-up adherence and overall eye health outcomes.
- Optimizing these interventions for similar settings globally can contribute to achieving universal health coverage and global vision goals.
Background:
Follow-up to eye care services for children, especially in the context of Nepal, is essential for ensuring a continuum of care. Hence, as a continued effort, we designed this study to explore the service users' experience of a community-based intervention to improve follow-up at Bharatpur Eye Hospital (BEH) in Nepal.
Objective:
This study aimed to explore service users' experiences and perceptions of the community-based follow-up intervention for eye care services implemented by BEH in Nepal.
Methods:
A qualitative study using an in-depth interview approach was used. Participants were purposively selected for this research study. Participants who were part of a quasi-experimental study conducted to improve follow-up services in BEH and their service catchment area were chosen. Participants who had not attended even a single follow-up visit and participants who attended at least one follow-up were recruited for this qualitative study. Based on the distance from the base hospital and the follow-up status, 65 participants were initially found eligible for the qualitative study. However, only 17 participants were available and consented. Topic guides were developed for the purpose of in-depth interviews specifically for participants who had not attended even the first follow-up visits and those who attended at least one follow-up visit. A total of 2 ophthalmic assistants, who were not a part of the main intervention study, conducted the interviews.
Results:
In total, 17 service users whose children were receiving services from BEH participated in the qualitative study. We identified 4 key themes that provided invaluable information about the barriers and facilitators to follow-up as well as the experiences (positive or negative) of the participants that need to be considered in any future initiatives to improve follow-up in Nepal.
Conclusions:
This study highlights the need for systematic development of interventions to address the unmet need for eye care services in the community through innovative, scalable solutions. As a next step, the BEH team will be working to develop such scalable solutions for Nepal. Such interventions will also need to be optimized for similar settings and countries to meet the goals of universal health coverage, vision 2030, and sustainable development goals worldwide.
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