Awareness and use of eye care services in Fiji.
OBJECTIVE
To determine the awareness, use, and barriers to use of eye services in Fiji's Central Province.


METHODS
A cross-sectional survey study design with random clusters of households was used. Semi-structured interviews were conducted (152 females and 22 males). For 267 household members, presenting distance and near visual acuities were measured, and the perception of and satisfaction with their vision were recorded.


RESULTS
Most (86%; 150/174) respondents were aware of at least one conventional eye care service. However, only 66% (121/183) of household members with previous eye problems had consulted one of these; the proportion was even lower for those in the older age groups (p < 0.01). Rural dwellers expressed satisfaction with their vision, despite being more likely to regard it as limiting their activities and being less likely to seek conventional care. A higher proportion of females were reported to have (or have had) eye problems (60:40) and were found to have bilateral visual impairment (60:40). Despite this, females and males attended the hospital eye clinic (47:53) or sought treatment from conventional services (51:49) nearly equally. The reasons given for not seeking conventional care were "fatalistic attitude" ("did not bother", "could manage", or accepted the condition: 57%), expense (12%), and fear (8%).


CONCLUSIONS
Central Province Fijians, particularly the old, rural, and female, under-utilise conventional eye care services. As in developing countries elsewhere, fatalistic attitudes to visual impairment are a significant contributor to this. To improve eye health, planning and implementation of eye care services must overcome under-utilisation by addressing local barriers to uptake through community participation in education and affirmative action.
du Toit
Rènée
R
Vision Cooperative Research Centre and the International Centre for Eye Care Education, University of New South Wales, Sydney, Australia. rdutoit@bigpond.com
Ramke
Jacqueline
J
Naduvilath
Thomas
T
Brian
Garry
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D005367:Fiji / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000592:standards; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data