Accepted for/Published in: JMIR Research Protocols
Date Submitted: Nov 29, 2019
Date Accepted: Aug 25, 2020
The technical feasibility of implementing primary eye care in a resource limited country: protocol for a mixed methods cross sectional study in Anambra State, Nigeria
ABSTRACT
Background:
Approximately 90% of the 253 million blind or visually impaired people worldwide live in low- and middle-income countries. Lack of access to eye care is why most people remain or become blind. The World Health Organisation Africa Region recently launched a primary eye care (PEC) package for sub-Saharan Africa (WHO AFRO PEC) for integration into the health system at the primary health care (PHC) level. This has the potential to increase access to eye care, but feasibility studies are needed to determine the extent to which the health system needs to be strengthened to deliver the package in PHC facilities.
Objective:
Objectives To assess the technical feasibility of implementing the WHO AFRO PEC package Africa in PHC facilities in Nigeria.
Methods:
The study has three components: 1: Delphi exercise to reach consensus among experts regarding the technical complexity of the WHO AFRO PEC package and the capacities needed to deliver it in PHC facilities; 2: development of PEC technical capacity assessment tools; 3: data collection: facility survey and semi-structured interviews with PHC staff and their supervisors and village health workers to determine the capacities available to deliver PEC in PHC facilities. Analysis will identify opportunities and capacity gaps and challenges to be addressed to deliver PEC.
Results:
Consensus was reached among experts regarding the technical complexity of the WHO AFRO PEC package and the capacities needed to deliver it as part of PHC. Quantitative tools (structured questionnaires, in-depth interviews, observation check lists) and topic guides based on agreed technical capacities have been developed and relevant stake holders have been identified A survey in 48 PHC facilities and interviews with health professionals and supervisors have been undertaken. Capacity gaps are being analysed.
Conclusions:
This study will determine the capacity of PHC to deliver the WHO AFRO PEC package as an integral part of the health system in Nigeria, with identification of capacity gaps. Although capacity assessments have to be context specific, the tools and findings will assist policy makers and health planners in Nigeria and similar settings who are considering implementing the package.
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