The patient-based socioeconomic burden of glaucoma care in nigeria: a scoping review

Glaucoma remains the leading cause of irreversible blindness worldwide, with Nigeria facing a substantial public health burden that affects approximately 1.1-1.4 million individuals, with many that remain undiagnosed. Socioeconomic factors such as income, education, and access to healthcare services play a crucial role in the management and treatment outcomes of glaucoma in diagnosed individuals.

This scoping review aims to investigate the socioeconomic burden of glaucoma care in Nigeria and to determine potential solutions to improve access to diagnosis and treatment of glaucoma.

A comprehensive literature review was conducted to assess the socioeconomic burden of Glaucoma care (direct and indirect costs) in Nigeria. Five databases, namely PubMed, Scopus, Web of Science, African Journals Online (AJOL), and Nigerian Journal Online (NJOL), were searched for peer-reviewed articles published within the last 15 years, including grey literature, policy documents, the WHO Global Health Expenditure Database, World Bank Health Statistics, government, and NGO reports were also included. PRISMA-ScR guidelines were followed to ensure transparency. The JBI checklist was used to examine the quality and bias of the included studies. A thematic analysis was utilized in synthesizing the findings, and narrative synthesis was used in presenting the findings.

From the initial search, only seven (7) articles met the inclusion criteria. Six (5) were quantitative, and two (2) were qualitative studies. Regarding geo-political distribution, three (3) articles were conducted in the South-South, two (2) in the North-West, one (1) combined North-Central and North-West locations, and one (1) was a national survey. Seven (7) studies examined patients with glaucoma, and one (1) study used physicians as a study population. It was demonstrated that the high cost of glaucoma care disproportionately affected low socioeconomic and uninsured populations, with significant barriers to timely diagnosis and treatment.

The review highlighted the burden of glaucoma care on the poor in Nigeria. Therefore, there is an urgent need to improve access for this group through integration policies, such as the national health insurance scheme, as well as subsidized costs for diagnosis, medications, treatments, and surgeries. Comprehensive policy interventions may be essential to sustain glaucoma care initiatives in Nigeria, improve treatment adherence, and ultimately reduce the socioeconomic burden of this debilitating public health condition.