Cataracts in India: current situation, access, and barriers to services over time.

BACKGROUND: Blindness, especially related to cataracts, poses a major challenge all over the developing world. India, as one of the biggest developing countries, has a large number of blind requiring sight-restoring cataract surgery. Despite the increase in service availability and heightened outreach screening efforts, blindness has not decreased and uptake of offered cataract surgery services is suboptimal.
METHODS: Barriers to access cataract surgery services in India have been investigated in several studies, which were reviewed after having been identified through a Medline and Pubmed search and summarized by using a model of health care utilization.
RESULTS: Numerous barriers, such as financial reasons, distance, fear, lack of service awareness, lack of support, or other obligations, could be identified but have not been put into the wider context of health care utilization behavior. Financial barriers continue to be a major reason not to take up offered cataract surgery services. DISCUSSION: More in-depth research of underlying factors is needed to increase self-motivated uptake of offered cataract surgery services. This would free resources currently invested into patient recruitment such as outreach screening. Freed resources could then be invested into treatment and further interventions such as health literacy promotion.