ABSTRACT
Integration of primary eye-care (PEC) into the existing primary healthcare (PHC) system is efficient in reaching rural communities. Baseline assessment of human and material resources for primary eye- care delivery in a rural local government area of southwestern Nigeria with projected population of 126 625 was conducted. Data on number and cadre of all PHC facilities and health-workers were collected. All facilities were visited and materials required for basic PEC inspected. Forty-one (42.3%) community health extension workers, 42 (43.3%) health assistants, 3 (3.1%) community officers of health and 11 (11.2%) registered nurses administered PHC in 27 health facilities. No worker had training in PEC and none of the centres had all the materials for basic PEC delivery. Although procurement of materials and training of health-workers in basic PEC delivery is required, the healthcare facilities and workers currently available are adequate to commence integration of PEC into the PHC system.
La integración de la atención primaria visual (APV) en el sistema existente de atención primaria de la salud (APS) alcanza eficientemente las comunidades rurales. Partiendo de una línea de base, se llevó a cabo una evaluación de los recursos humanos y materiales para la administración de la atención primaria visual en un área gubernamental local rural del sudoeste de Nigeria, para una población de 126 625, según la previsión. Se recogieron datos sobre las cifras y los cuadros de todas las instalaciones para la atención primaria de la salud (APS) y los trabajadores de la salud. Se visitaron todas las instalaciones y se inspeccionaron los materiales requeridos para la APS básica. Cuarenta y un (42.3%) trabajadores de extensión comunitaria de la salud, 42 (43.3%) asistentes de salud, 3 (3.1%) funcionarios de salud de la comunidad y 11 (11.2%) enfermeras graduadas, estuvieron encargados de administrar la APS en 27 instalaciones de salud. Ninguno de los trabajadores tenía entrenamiento en APV y ninguno de los centros disponía de todos los materiales para brindar APV básica. Si bien se requiere obtener materiales y entrenamiento de los trabajadores de la salud, las instalaciones de atención a la salud y los trabajadores de la salud de que se dispone en la actualidad, son adecuados para comenzar la integración del la APV en el sistema de APS.
Subject(s)
Humans , Community Health Workers/supply & distribution , Eye Diseases/therapy , Health Services Accessibility , Primary Health Care , Rural Health Services , Bandages/supply & distribution , Cross-Sectional Studies , Developing Countries , Nigeria , Ophthalmic Solutions/supply & distribution , Primary Health Care/statistics & numerical data , Rural Health Services/statistics & numerical dataABSTRACT
OBJECTIVE: To evaluate the baseline visual outcome of cataract surgeries and improve on these towards achieving one of the objectives of vision 2020. DESIGN: A retrospective study. SETTING: Hospital-based, utilizing 3 eye centres in Osun State, Nigeria between January 2000 and December 2002. METHODS: Records of 283 hospital-elective-cataract-surgeries only of all ages in 3 centres were evaluated. RESULTS: Mean age was 62.2 years. Fifty-eight 58% were blind before while only 6.3% remained blind post op. With best correction, visual outcome was good in 47.5%, moderate in 37.6% and poor in 15%. The commonest co-morbidity was glaucoma 33 (71.7%). The most common intra operative complications were vitreous loss 61 (27.35%) and posterior capsular rupture (6.28%). Capsular opacity (6.28%) was commonest post operatively with significantly poor visual outcome (χ(2)= 51.46, p-value = <0.05). Causes of poor visual outcome were uncorrected refractive error (59.37%), co-morbidity (24.22%), and surgery related complications (16.41%). Visual outcome was significantly better with IOL or prescribed glasses (χ(2)=19.66, p-value <0.05) and better still with ECCE +IOL (χ(2)=8.46, p-value <0.05). Poor visual outcome was significantly associated with co-morbidity (χ(2) = 23.88, p-value <0.05), surgical complications (χ(2)= 51.46, p-value = <0.05). CONCLUSION: The baseline cataract visual outcome was poor due to delay in correction of refractive error, comorbidities, and surgical complications. Good outcome could be attained by routinely ensuring different methods of adequate postoperative visual rehabilitation. Skills acquisition, availability of adequate equipments, establishment of a good records system to achieve effective evaluation and monitoring of outcome cannot be over emphasized.
