Pediatric Eye Health-Seeking Behavior in Ghana: A Community-Based Cross-Sectional Study

Childhood visual impairment remains a major public health concern in low-and-middle income settings, including Ghana, where timely intervention can prevent avoidable vision loss. Although Ghana's National Health Insurance Scheme (NHIS) aims to reduce financial barriers, pediatric eye health-seeking behavior among caregivers is poorly understood. This study assessed determinants of pediatric eye care-seeking behavior across multiple districts in Ghana.

A community-based cross-sectional study was conducted among 622 children aged ≤ 20 years and their caregivers in selected Ghanaian districts. Structured questionnaires collected data on socio-demographic characteristics, NHIS coverage, prior eye examinations, and eye care-seeking practices. Multivariable logistic regression was used to identify factors associated with seeking eye care (p < 0.05).

Among caregivers who reported that their child had experienced an eye problem (60.3%, 375/622), fewer than half (41.2%, 154/374) sought professional eye care, most commonly at general health facilities rather than specialized eye clinics. In multivariable analysis, children residing in peri-urban (AOR = 5.50, 95% CI: 1.33-23.47; p = 0.02) and urban districts (AOR = 6.91, 95% CI: 2.13-22.38; p = 0.001) had significantly higher odds of seeking eye care compared with those in rural areas. Prior eye examination history also influenced care-seeking: children examined within the past 2 years had lower odds of seeking additional eye care (AOR = 0.01, 95% CI: 0.00-0.04; p < 0.001), whereas those whose last examination occurred ≥ 2 years previously had higher odds of seeking care (AOR = 3.73, 95% CI: 1.18-11.82; p = 0.025), relative to children who had never undergone an eye examination. Socio-demographic factors, including education, income, and insurance status, showed no significant associations.

Overall, the study identified limited utilization of pediatric eye care services that is influenced by settlement type and previous engagement, rather than socioeconomic status. Strengthening community-based outreach and embedding pediatric eye care into primary healthcare can enhance early intervention and reduce avoidable childhood visual impairment.