IS THE CHILD-TO-CHILD APPROACH USEFUL IN IMPROVING UPTAKE OF EYE CARE SERVICES IN DIFFICULT-TO-REACH RURAL COMMUNITIES? EXPERIENCE FROM SOUTHWEST NIGERIA.
BACKGROUND
To determine if primary school pupils aged 9-14 years can be satisfactorily trained, using the child-to- parent approach, to assess vision, refer and motivate people to attend screening eye camps.


METHODS
Ninety pupils aged 9-14 years attending two purposively-selected primary schools were selected by simple random sampling. Using the child-to-parent approach and Snellens 6/60 illiterate E-chart, participants had a three-day knowledge and skill-based training followed by 2 days of community-based vision assessment and referral of those assessed. The adequacy and success of the training were assessed by comparing preand post-test scores.


RESULTS
Three hundred and thirty-six persons were referred and examined; of these, 142 (42.3%) persons were reviewed. Overall, there was significant improvement in knowledge. The accuracy of assessments was 82.1% for Right Eyes (RE), 83.3% for Left Eyes (LE) and 72.1% for presbyopia. The sensitivities for the RE, LE and presbyopia were 84.8%, 86.1% and 76.3% respectively. Similarly, the specificities were 44.4% for RE, 50.0% for LE and 68.6% for presbyopia. The performances were not significantly influenced by age, sex and locality.


CONCLUSIONS
Children aged 9-14 years in primary schools can be empowered, using the child-to-child approach, to assess vision and motivate members of their communities to utilize available eye care services.
Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.
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Ayorinde
International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London.
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Murthy
Department of Health Policy and Management, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Akinyemi