Utilization of community-based rehabilitation services for incurably blind persons in a rural population of southern India.
OBJECTIVE
To identify barriers in utilisation of community based rehabilitation (CBR) services for incurably blind persons in rural South India.


METHODS
A community-based rehabilitation programme for incurably blind persons was initiated in Theni district of southern Tamil Nadu in south India. After door-to-door enumeration and preliminary ocular screening by trained workers at the village, identified blind persons were categorised as either curable or incurable by an ophthalmologist. Trained workers provided rehabilitation, including mobility training (OM), training to perform activities of daily living (ADL), and economic rehabilitation for the incurably blind in their respective villages.


RESULTS
Of the 460,984 persons surveyed, 400 (0.09%) were certified as incurably blind including 156 (39.00%) persons blind from birth. Social rehabilitation was provided for 268 (67.00%) incurably blind persons. Economic rehabilitation was provided to 96 persons, and integrated education to 22 children. Nearly one-fifth (n=68, 17.00%) of incurably blind persons refused the services provided. The major reasons for refusal included old age and other illnesses (41.18%), and multiple handicaps (19.12%). Twenty-seven (6.75%) persons had either migrated or died, and 29 (7.25%) persons were already able to function independently.


CONCLUSIONS
Although CBR programmes provide useful services to the incurably blind, a better understanding of barriers is required to improve service utilisation. Developing a standardised data collection format for every CBR programme can result in the creation of a national database of ophthalmic diseases.
Aravind Medical Research Foundation, Madurai, Tamil Nadu, India.
Valaguru
V
Vijayakumar
Dipankar
D
Datta
Arumugam
A
Karthika
Ravilla D
RD
Thulasiraj
Praveen K
PK
Nirmalan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services / Q000706:statistics & numerical data*; D003906:Developing Countries; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012046:Rehabilitation / Q000523:psychology; D012424:Rural Population / Q000706:statistics & numerical data*; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000523:psychology / Q000534:rehabilitation*