Eye care in Timor-Leste: a population-based study of utilization and barriers.
BACKGROUND
To determine utilization of Western-style conventional health services for eye problems in Timor-Leste, and barriers to seeking that care.


METHODS
An interview-based questionnaire was administered as part of a population-based cross-sectional survey of 50 clusters (urban and rural) of 30 people aged > or =40 years.


RESULTS
Of 1470 people enumerated, 1414 were examined (96.2%). A total of 1293 (91.4%) reported at least one previous or present eye problem, mostly (88.6%) blurred/poor vision, for near and/or distance. Men (OR 1.6, 95% CI 1.1-2.3), literates (OR 2.1, 95% CI 1.4-3.5), urban dwellers (OR 4.1, 95% CI 2.6-6.4) and those in paid employment compared with being a farmer (OR 3.0, 95% CI 1.5-5.9) were more likely to have reported a problem. A total of 858 (66.4%) sought Western-style care for its remedy. Non-utilization was associated with being illiterate (OR 3.7, 95% CI 2.9-4.8), a rural dweller (OR 3.8, 95% CI 3.0-4.9), unemployed (OR 1.6, 95% CI 1.1-2.2) or a farmer (OR 5.2, 95% CI 3.5-7.6) compared with being in paid employment, having moderately impaired compared with non-impaired near vision (OR 1.4, 95% CI 1.1-1.8), and red/itchy/painful eyes compared with blurred vision (OR 2.3, 95% CI 1.6-3.2), but not age, gender or poor distance vision. Lack of awareness of service availability was the most frequent reason for not seeking treatment (32.9%), especially for rural respondents. Attitudinal reasons were also prevalent (32.5%), with social (11.8%), economic (11.5%) and service-related (9.0%) issues less so.


CONCLUSIONS
If eye health is to improve in Timor-Leste, there must be better appreciation of it, and increased availability, accessibility and awareness of services.
Palagyi
Anna
A
The International Centre for Eyecare Education, Sydney, New South Wales, Australia.
Ramke
Jacqueline
J
du Toit
Renee
R
Brian
Garry
G
D000328:Adult; D000368:Aged; D000383:Agriculture / Q000706:statistics & numerical data; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007214:Indonesia; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000706:statistics & numerical data; D014786:Vision Disorders / Q000503:physiopathology / Q000628:therapy*