title: Eye care in Fiji: a population-based study of use and barriers.
abstract: OBJECTIVE
  To determine the use of medical services for eye problems in Fiji, and barriers to seeking that care.
  
  
  METHODS
  An interview-based questionnaire was administered as part of a population-based cross-sectional survey of adults selected by multistage random sampling from those aged ≥40 years living on Fiji's main island.
  
  
  RESULTS
  Participation rate was 73.0% (n = 1381). A current vision or eye problem was reported by 931 participants, and a further 235 recalled a previous difficulty. Urban dwellers (P = 0.002) and those aged ≥50 years (P = 0.017) were more likely to report a problem. Gender was not predictive (P = 0.215). "Blurred/poor vision" was the most common complaint (78.5%). Over half (53.3%) had not sought care for the problem most important to them. For current problems, being younger (P < 0.001) and from a household without paid income (P = 0.007) were predictive of being less likely to seek treatment. Gender was not (P = 0.416). The most frequently cited principal reason for not seeking care was "able to manage/accept the problem" (66.5%; of whom 84.7% claimed vision problems). Direct and indirect costs were mentioned as deterrents. "Thought nothing could be done" (P = 0.032) and "lack of awareness of service availability" (P = 0.026) were more common among rural dwellers. Of participants who sought care, 75.6% used government services. Most participants requiring spectacles or medication incurred costs for these. Satisfaction with overall care was independent of provider (P = 0.062) and user gender (P = 0.851).
  
  
  CONCLUSIONS
  With expanding service delivery, increased eye health promotion, and attention to the financing of treatments, improved service use ought to be possible in Fiji.
authors.affiliation: The Fred Hollows Foundation New Zealand, Auckland, New Zealand. grbrian@tpg.com.au
authors.forename: Garry
authors.initials: G
authors.lastname: Brian
authors.forename: Louise
authors.initials: L
authors.lastname: Maher
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Ramke
authors.forename: Anna
authors.initials: A
authors.lastname: Palagyi
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D005367:Fiji / Q000453:epidemiology; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data