Appropriateness of Ophthalmic Cases Presenting to a Nigerian Tertiary Health Facility: Implications for Service Delivery in a Developing Country

ABSTRACT

To assesswhether the ophthalmic cases presenting at aNigerian tertiary eye unit are appropriate for such level of care and also drawnecessary implications for service delivery. Data on 1;321 consecutive new patients that presented at the ophthalmic clinic of the University of Teaching Hospital; Ilorin; Nigeria between February and July 2005 were reviewed on demographics; referral routes; and reasons for patronage; diagnoses and disease categories. Information on the general situation of health infrastructures prevailing at the surrounding health facilitieswas collected fromkey-informants. One thousand and ninety-one (82.6) presentedwithout any referral and 1;095 (82.9) patronized in order to access perceived good quality of eye care service being rendered. However; only a small proportion of their ailments (191; 14.5) actually required attention at the tertiary level of eye care. The key informants painted a picture of severely-challenged general and health infrastructures particularly at the primary health care facility level An overwhelming majority of ophthalmic patients directly accessed eye care at the tertiary level; even though most of their ailments could have been satisfactorily treated at the lower facilities of health care were the latter to be functioning optimally. A better coordinated and strengthened health care system; particularly at the primary and secondary health care facilities would ease the burden of inappropriate presentations on tertiary health facilities inNigeria