Resources, services, patients and staff perception of eye care at the primary health care level in the Kingdom of Saudi Arabia

ABSTRACT

Incorporating a primary eye care system into the delivery of eye care services was determined to be the most efficient and cost effective method of dealing with the major preventable and curable causes of blindness, and the large backlog of eye patients in the Kingdom of Saudi Arabia, as identified by the 1984 King Khaled Eye Specialist Hospital National Eye Survey. Primary health care centers [PHCCs] located in rural and urban areas of the country offer a vital first line of defense in the fight against blindness. A total of 116 PHCCs were selected by an equal-proportion allocation formula from a total of 1.663 existing in 1990 throughout the Kingdom. This 7% sample was further divided into urban and rural, proportional to each of the five provinces. Four different types of questionnaires were developed inviting responses by staff, as well as from patients, attending these centers. Responses to these questionnaires revealed some strengths and many weaknesses of these resources and services in relation to equipment, staffing, supplies, staff training, patient education, etc. Findings showed that a considerable number of PHCCs lacked basic, inexpensive medical equipment and drugs essential for the diagnosis and treatment of common eye disorders [e.g., visual acuity charts were lacking in 37.9%, handheld magnifying lenses in 81.6%, and Schiotz tonometers in 99.0%]. The PHCCs also scored low in continuing staff medical education. When comparing provinces, PHCCs in the Eastern Province show considerably more development than those in the remainder of the country. Conclusions: The information provided by this survey emphasizes the importance of utilizing the existing, primary health care system in a more efficient and cost effective way. Currently, most eye problems are managed in secondary or tertiary health care facilities, with only limited bendfit derived from the existing primary health care centers where the majority of common, less complicated problems can be managed. The survey results may be utilized to review the effectiveness of the existing primary health care system as the first line of defense against blindness and enhance their ability to absorb a large proportion of eye problems