Childhood eye care services in South Darfur State of Sudan: Learner and parent perspectives

Abstract

Purpose: Most causes of childhood visual impairment are either treatable or preventable. Eye health education plays an important role in reducing avoidable causes of visual impairment as well as to help ensure a healthy and educated community. The main objective of this study was to assess the Knowledge, Attitudes and Practices of the students and their parents on childhood eye services and barriers for accessing child eye care. Methods: The study was conducted in South Darfur State of Sudan between January and February 2015. Both quantitative and qualitative methods were used to collect data from eight secondary schools. Four schools for boys and four schools for girls were randomly selected from a list of 21 districts of South Darfur State and the Knowledge, Attitudes and Practices surveys were conducted with the students to collect quantitative data. In addition, seven focus group discussions were conducted with the children’s parents to collect qualitative data. Results: The majority (57.5%) of the students reported that they knew about refractive error; however, 33.07% reported never hearing about refractive error. About 70.3% of the respondents believed that uncorrected refractive error leads to visual impairment, 21% believed refractive error did not cause visual impairment and 30.5% reported that wearing spectacles was not effective in the treatment of refractive error. With regard to the information about eye healthcare, 88.1% of the participants reported they did not have enough information about eye care. The reported need for more information about prevention, treatment and symptoms was 34.0%, 31.4% and 17.5%, respectively. With regard to barriers, 80.6% of the students reported never having had their eyes tested. The most cited barriers were cost, fear of wearing spectacles and fear of an eye examination. In addition, 72.6% of students reported that their health insurance did not cover eye care services. Most (53.6%) of the parents believed that the cause of refractive error in children was poor nutrition. Common themes arising from the focus group discussions included parents reporting that they looked for traditional treatment for their children and preferring to receive child eye information from an eye specialist and through the television and radio. The most frequently cited barriers by the parents were high cost of the treatment, lack of eye care specialists, lack of awareness about child eye diseases and mistrust in eye care providers. Conclusion: The level of knowledge and practices about eye care and refractive error is low and perceptions about spectacles as a method for treatment for refractive error were fraught with misconceptions amongst students. There is a need for structured educational programmes to raise awareness regarding the effect and treatment modalities for childhood eye disease and visual impairment in order to address the barriers for accessing childhood eye care.