title: Strategies to improve follow-up of children after surgery for cataract: findings from Child Eye Health Tertiary Facilities in sub-Saharan Africa and South Asia.
abstract: PurposeWe sought to conduct a systematic literature review on follow-up of children with ocular surgical management (primarily childhood cataract) in developing countries. Second, we sought to determine the current practices regarding follow-up for clinical, optical, low vision, rehabilitation, and educational placement among children receiving surgical services at Child Eye Health Tertiary Facilities (CEHTF) in sub-Saharan Africa (SSA) and South Asia.MethodsA systematic literature review was conducted. Separately, we conducted a cross-sectional study among CEHTF in SSA and South Asia (India, Nepal, and Bangladesh) to assess current capacities and practices related to follow-up and educational placement.ResultsThe articles that met the systematic review eligibility criteria could be grouped into two areas: factors and strategies to improve post-operative follow-up and educational placement of children after surgery. Among the 106 CEHTF in SSA and South Asia, responses were provided by 75 CEHTF. Only 59% of CEHTF reported having a Childhood Blindness and Low Vision Coordinator; having a coordinator was associated with having appropriate follow-up mechanisms in place. Educational referral practices were associated with having a low-vision technician, having low-vision devices, and having donor support for these services.ConclusionsThe systematic literature review revealed evidence of poor follow-up after surgical interventions for cataract and other conditions, but also showed that follow-up could be improved significantly if specific strategies were adopted. Approaches to follow-up are generally inadequate at most facilities and there is little external support for follow-up. Findings suggest that funding and supporting a coordinator would assist in ensuring that good practices for follow-up (cell phone reminders, patient tracking, and reimbursement of transport) were followed.
authors.affiliation: Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania.
authors.forename: E
authors.initials: E
authors.lastname: Kishiki
authors.affiliation: Light for the World, Veenendaal, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: van Dijk
authors.affiliation: Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, H53 OMB Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: P
authors.initials: P
authors.lastname: Courtright
mesh_terms: D017954:Africa South of the Sahara; D001071:Appointments and Schedules; D001208:Asia; D001766:Blindness / Q000534:rehabilitation; D002387:Cataract Extraction; D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005139:Eyeglasses / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge; D012051:Reimbursement Mechanisms; D062606:Tertiary Care Centers / Q000458:organization & administration*; D015354:Vision, Low / Q000534:rehabilitation