Comparing key informants to health workers in identifying children in need of surgical eye care services.

The objective of the study was to compare the productivity of key informants (KIs) and dedicated health workers (HWs) in identifying children with surgical eye care needs. In two regions of Tanzania, KIs and HWs were trained to identify and register children with severe visual impairment or blindness, with the objective of providing them with surgical eye care services. Identified children were examined at predetermined sites. The total numbers of children in need of surgical services identified by KIs and HWs were compared to measure their relative efficacy. A total of 197 KIs and 63 HWs were trained in the two regions. Five hundred and forty-nine children were identified by KIs and 22 children were identified by HWs: KIs were three times more productive than the HWs. Most of the children identified and examined had serious eye pathology and received surgery or low vision services. The cost per child found was significantly less for children found by KI compared to HW. The study indicates that, in rural Africa, finding children in need of surgical and low vision interventions and ensuring that they are properly screened appears to require community-based efforts.