ABSTRACT
In India, the number of people with disabilities is continuously growing over the past few decades. The figure is expected to increase due to population aging, with a resultant increase in chronic health conditions. The health of people with disabilities is a relatively neglected and ignored area. Further, the disabled face poor access to healthcare and frequently encounter discrimination or stigmatization. These situations make them more vulnerable to many comorbidities in their health, making severe compromises in their quality of life. Therefore, people with disabilities need special healthcare than people without disabilities. There is a need for sensitization of all health-care providers to ensure quality, affordable, and accessible health-care services for people with disabilities. To address the health-care needs of people with disabilities to the maximum, Ministry of Health, Government of India should incorporate appropriate guidelines in various national health programs and work together with a relevant ministry.
ABSTRACT
Purpose: An Accredited Social Health Activist (ASHA) available in community could be a potential primary eye care (PEC) worker. Training programme for ASHAs on PEC was undertaken & evaluated in a district of a capital city. Methods: ASHAs selected randomly from a district were imparted one day training on PEC & expected to refer patients to nearby Vision Centres (VC). Their knowledge was assessed before & after training and re-evaluated 1 year later. ASHAs were asked to conduct vision screening of 40+ population in their areas and ASHA referrals were noted by Optometrist in VC. Focus Group Discussions (FGD) of ASHAs were held to find barriers & facilitating factors in engaging ASHAs in PEC. Training was evaluated using Kirkpatrick's evaluation model for measuring reactions, learning, behaviour and results. Results: Mean knowledge score increased from 14.96 (±4.34) pre-training to 25.38 (±3.48) post- training and sustained at 21.75 (±4.16) at 1year. Monthly average OPD of vision centres increased by 23.6% after ASHA training. FGDs revealed that ASHAs were willing to work in eye care for awareness generation and patient facilitation but were hesitant in conducting vision screening. Conclusion: ASHAs can be trained as PEC workers provided they have adequate support.
ABSTRACT
Purpose: People with visual disability need assistive technology to improve their body functioning and performance. The purpose of the present study was to understand the awareness, use and barriers in accessing the assistive technology among young patients attending visual rehabilitation clinic of a tertiary eye care hospital in Delhi. Methods: A cross-sectional study was conducted on consecutively recruited patients registered for the first time in visual rehabilitation clinic of the community ophthalmology department of the tertiary eye centre during June and July 2018. A study tool consisting of 42 assistive technologies was developed. Patients were screened for distance visual acuity both presenting and binocular pinhole vision using an 'E' chart with two optotype (6/18, 6/60). Results: 85 patients (69.4% male) were enrolled from the VR clinic. 83.5% of the patients had a best corrected binocular vision acuity <6/18 to 1/60. There was good awareness of only 2 of the 42 devices (>67% of the participants): near optical magnifiers, walking long canes. There was moderate awareness of 10 devices (34-66% of the participants) and poor awareness of the rest (<33%). Likewise, participants reported moderate usage of 3 out of the 42 devices and poor usage of the remaining devices. Non-availability of devices was the most frequently reported barrier in the study. Conclusion: The awareness and utilization of assistive technologies for visual disability was poor in patients attending visual rehabilitation clinic. Hospitals could procure assistive technologies and introduce strategies to improve awareness as well as promote utilization.