title: Barriers to accessing eye care services among visually impaired populations in rural Andhra Pradesh, South India.
abstract: 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.
authors: International Centre for Advancement of Rural Eye Care, LV Prasad Eye Institute, Hyderabad, India. vilaskovai@icare.stph.net
authors: Vilas
authors: V
authors: Kovai
authors: Sannapaneni
authors: S
authors: Krishnaiah
authors: Bindiganavale Ramaswamy
authors: BR
authors: Shamanna
authors: Ravi
authors: R
authors: Thomas
authors: Gullapalli N
authors: GN
authors: Rao
mesh_terms: 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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