AIM: To determine the effectiveness of village-based strategies (using school teachers and village leaders) to increase the use of surgical services. METHODS: A cohort study was conducted in Tanzania using two village strategies (village leader and school teachers); trichiasis surgical uptake and the factors associated with uptake were measured after 1 year. RESULTS: The trichiasis surgical coverage at baseline was 16.9%; 200 patients who needed surgery were identified. One year later, we were able to re-examine and interview 163 of these patients. The surgical uptake among these patients was 44.8% (95% CI 37.2% to 52.4%). Patients in the school-teacher programme had a 36.5% uptake compared with 52.1% for those in the village-leader programme. No difference was observed in uptake by age or sex. Uptake was highest among those coming from multiple-generation households and those with more household wealth. Of the 90 people who still had not had surgery, 20 (22.2%) reported seeking surgery, but failing to receive it because of barriers at the provider side. CONCLUSIONS: Improved surgical uptake for trachomatous trichiasis was achieved by using village-based promotion efforts and surgical services at existing health clinics. Even with free surgery at health clinics, indirect costs and social support barriers limit utilisation by the most vulnerable, the poorest and those living in single-generation households. Problems at the provider level also create barriers for patients who need surgery.
AIM: To determine the effectiveness of village-based strategies (using school teachers and village leaders) to increase the use of surgical services. METHODS: A cohort study was conducted in Tanzania using two village strategies (village leader and school teachers); trichiasis surgical uptake and the factors associated with uptake were measured after 1 year. RESULTS: The trichiasis surgical coverage at baseline was 16.9%; 200 patients who needed surgery were identified. One year later, we were able to re-examine and interview 163 of these patients. The surgical uptake among these patients was 44.8% (95% CI 37.2% to 52.4%). Patients in the school-teacher programme had a 36.5% uptake compared with 52.1% for those in the village-leader programme. No difference was observed in uptake by age or sex. Uptake was highest among those coming from multiple-generation households and those with more household wealth. Of the 90 people who still had not had surgery, 20 (22.2%) reported seeking surgery, but failing to receive it because of barriers at the provider side. CONCLUSIONS: Improved surgical uptake for trachomatous trichiasis was achieved by using village-based promotion efforts and surgical services at existing health clinics. Even with free surgery at health clinics, indirect costs and social support barriers limit utilisation by the most vulnerable, the poorest and those living in single-generation households. Problems at the provider level also create barriers for patients who need surgery.
Authors: R J Bowman; O S Soma; N Alexander; P Milligan; J Rowley; H Faal; A Foster; R L Bailey; G J Johnson Journal: Trop Med Int Health Date: 2000-08 Impact factor: 2.622
Authors: Saul N Rajak; Esmael Habtamu; Helen A Weiss; Amir Bedri; Teshome Gebre; Robin L Bailey; David C W Mabey; Peng T Khaw; Clare E Gilbert; Paul M Emerson; Matthew J Burton Journal: Invest Ophthalmol Vis Sci Date: 2011-10-10 Impact factor: 4.799
Authors: Emily W Gower; Sheila K West; Sandra D Cassard; Beatriz E Munoz; Jennifer C Harding; Shannath L Merbs Journal: PLoS Negl Trop Dis Date: 2012-06-26
Authors: Saul N Rajak; Esmael Habtamu; Helen A Weiss; Amir B Kello; Bayeh Abera; Mulat Zerihun; Teshome Gebre; Clare E Gilbert; Peng T Khaw; Paul M Emerson; Matthew J Burton Journal: PLoS Negl Trop Dis Date: 2013-08-22
Authors: Saul N Rajak; Esmael Habtamu; Helen A Weiss; Amir Bedri; Teshome Gebre; Asrat Genet; Peng T Khaw; Robin L Bailey; David C W Mabey; Clare E Gilbert; Paul M Emerson; Matthew J Burton Journal: Ophthalmology Date: 2011-10-05 Impact factor: 12.079
Authors: Saul N Rajak; Esmael Habtamu; Helen A Weiss; Amir Bedri Kello; Teshome Gebre; Asrat Genet; Robin L Bailey; David C W Mabey; Peng T Khaw; Clare E Gilbert; Paul M Emerson; Matthew J Burton Journal: PLoS Med Date: 2011-12-13 Impact factor: 11.069
Authors: Saul N Rajak; Esmael Habtamu; Helen A Weiss; Amir Bedri; Mulat Zerihun; Teshome Gebre; Clare E Gilbert; Paul M Emerson; Matthew J Burton Journal: PLoS Negl Trop Dis Date: 2012-08-28