Barriers to accessing eye care services among visually impaired populations in rural Andhra Pradesh, South India.
OBJECTIVE
To understand the reasons why people in rural south India with visual impairment arising from various ocular diseases do not seek eye care.


METHODS
A total of 5,573 persons above the age of 15 were interviewed and examined in the South Indian state of Andhra Pradesh covering the districts of Adilabad, West Godavari and Mahaboobnagar. A pre-tested structured questionnaire on barriers to eye care was administered by trained field investigators.


RESULTS
Of the eligible subjects, 1234 (22.1%, N=5573)) presented with distant visual acuity < 20/60 or equivalent visual field loss in the better eye. Of these, 898 (72.7%, N=1234) subjects had not sought treatment despite noticing a decrease in vision citing personal, economic and social reasons. The analysis also showed that the odds of seeking treatment was significantly higher for literates [odds ratio (OR) 1.91, 95% confidence interval (CI) 1.38 to 2.65], for those who would be defined as blind by visual acuity category (OR 1.35, 95% CI 0.96 to 1.90) and for those with cataract and other causes of visual impairment (OR 1.50, 95% CI 1.11 to 2.03). Barriers to seeking treatment among those who had not sought treatment despite noticing a decrease in vision over the past five years were personal in 52% of the respondents, economic in 37% and social in 21%.


CONCLUSIONS
Routine planning for eye care services in rural areas of India must address the barriers to eye care perceived by communities to increase the utilization of services.
Kovai
Vilas
V
International Centre for Advancement of Rural Eye Care, LV Prasad Eye Institute, Hyderabad, India. vilaskovai@icare.stph.net
Krishnaiah
Sannapaneni
S
Shamanna
Bindiganavale Ramaswamy
BR
Thomas
Ravi
R
Rao
Gullapalli N
GN
D000293:Adolescent; D000328:Adult; D000368:Aged; D001766:Blindness / Q000453:epidemiology* / Q000628:therapy; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012424:Rural Population; D015354:Vision, Low / Q000453:epidemiology* / Q000628:therapy; D014792:Visual Acuity
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