title: Barriers to spectacle use in Tanzanian secondary school students.
abstract: OBJECTIVE
  Screening school students for refractive errors is a component of many primary eye care programs. In 2004 a trial of two approaches of spectacle-delivery to Tanzanian secondary school students found that only one third of students were using their spectacles at three months. Barriers to spectacle use were investigated using questionnaires and focus group discussions.
  
  
  METHODS
  At the three months follow-up survey a questionnaire explored satisfaction with spectacles and the attitudes of trial participants (median age 15 years). Attitudes and reactions of friends, teachers and families were also explored. Students also discussed their experience with spectacle use and reasons for non-use in 8 focus groups divided by intervention, sex and spectacle use.
  
  
  RESULTS
  In general, students seemed happy with the appearance of their spectacles and the beneficial impact on their vision. Peer pressure and parental concerns about safety of spectacle use, cost of purchasing spectacles and difficulties in accessing good local optical services were identified as the main barriers. Students criticized prescribing practices of local opticians and favored alternative and traditional treatments for visual impairment.
  
  
  CONCLUSIONS
  To increase the effectiveness of school vision screening in Tanzania, barriers such as peer pressure or concerns about safety need to be addressed, in addition to provision of affordable, good quality spectacles. Barriers to spectacle use in children are likely to exist in all populations, but may vary in their nature and importance and therefore should be investigated in existing and new screening programs.
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Nita
authors.initials: N
authors.lastname: Odedra
authors.forename: Susanne H
authors.initials: SH
authors.lastname: Wedner
authors.forename: Zachayo S
authors.initials: ZS
authors.lastname: Shigongo
authors.forename: Kija
authors.initials: K
authors.lastname: Nyalali
authors.forename: Clare
authors.initials: C
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D005139:Eyeglasses / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D015995:Prevalence; D012030:Refractive Errors / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D013636:Tanzania / Q000453:epidemiology; D015351:Vision Screening; D014792:Visual Acuity