Assessment of human resource for eye health services in Southern Ethiopia

Human resources related to eye health are critical to significant reductions in blindness and low vision on a global and regional scale. Blindness and visual impairment affect the quality of life, poverty rates, and employment and educational opportunities of people with visual impairment. This study aimed to assess the availability and distribution of human resources for eye care to determine gaps in eliminating preventable and treatable blindness.

This study employed a descriptive cross-sectional design. Data were collected using a structured, self-administered questionnaire distributed electronically via the KoboToolbox platform. The survey targeted all government, private, and NGO/Mission eye care facilities across the two regions. The respondents were primarily heads or coordinators of eye care units; in cases of nonresponse, senior staff members were invited to complete the questionnaire. The tool gathered information on the type, number, and distribution of eye care professionals, as well as the services provided at each facility.

Out of the 77 public hospitals and 642 public health centers, only 39 (5.4%) provided eye care services. A total of 48 facilities were provided with eye care services, each of which served 388,765 people in the two regions. Thirty-nine (81.3%) were government owned, 5 (10.4%) were private for profit, and 4 (8.3%) were NGO/Mission owned. In these facilities, a total of 217 eye care professionals were practicing: 30 were ophthalmologists, 10 were cataract surgeons, 93 were optometrists, 62 were ophthalmic nurses, 6 were ophthalmic officers, one was a low vision specialist, and 15 were optical technicians. The only low vision specialist identified was an optometrist with additional training in low vision care. The mean number of cataract operations performed per unit per year was 860 (range: 30-2,800). The CSR of the SNNPR and Sidama regions was 1086 operations/million population/year in 2022. Among all the eye care centers in the study area, 50% provided cataract surgery services, 19% provided glaucoma surgery services, and 90% provided refraction services. Only one facility had panretinal photocoagulation (PRP) and intravitreal injection services. However, none of the facilities provided an in vitro retinal surgery service.

The findings of this study indicate that the current human resource capacity for eye care in southern Ethiopia remains below the recommended thresholds outlined by the World Health Organization (WHO) and the IAPB Africa Strategic Plan. Furthermore, the distribution of eye care professionals is uneven, with the majority living in urban centers, whereas many rural areas remain critically underserved. These disparities suggest the need for more targeted workforce planning and support for rural deployment. However, these conclusions should be interpreted cautiously, given the study's reliance on self-reported data and the absence of a standardized urban‒rural classification. Addressing the quantitative and geographic gaps in human resources for eye health will be essential for improving equitable access to services in the region.