Health seeking behaviours of those accessing primary Eye care services in Tamil Nadu, India

The aim of this study was to understand the health-seeking behaviours of individuals attending primary vision centres (VCs) operated by Sankara Eye Hospital in Tamil Nadu, India, to inform service provision.

A mixed-methods study was conducted with 158 patients attending seven VCs across three districts over three weeks. Quantitative data included demographic, clinical, and travel-related variables, visual acuity and primary diagnosis. Additionally, 53 patients participated in semi-structured interviews exploring perceptions of eye health and factors influencing attendance. Quantitative data were analysed for associations, with exploratory multivariable analyses for key outcomes, while qualitative data underwent inductive thematic analysis.

Women were significantly more likely to attend with a companion (p < 0.001), and this association remained after adjustment for age and education. Older age was associated with paying for transport in univariable analysis but not after adjustment, while lower educational attainment remained associated in multivariable analysis. Qualitative findings identified barriers and motivators to attendance, sources of eye health knowledge, and strategies to improve utilisation.

Patients often assumed costs and delayed attendance until daily activities were affected. While eye health was valued, recommendations from friends/family were a key driver of attendance. These findings highlight the role of social influence and socioeconomic factors in shaping access to primary eye care. An important area for future research is to explore why women are more likely to attend with a companion, and whether there is a correlation between age and the cost of travel to a VC.