Barriers to uptake of refractive error services in a rural community in Enugu, south-East, Nigeria

Abstract

Background: Uncorrected refractive error remains a leading cause of visual impairment. The utilization of refractive error care services in many Nigerian communities is poor in spite of its availability. Objective: To determine the barriers to uptake of refractive errors care services in a rural community in Enugu State, Nigeria. Methods: A descriptive, cross-sectional, population-based survey with mixed method was adopted. The study instruments were a pre-tested, researcher-administered questionnaire and focus group discussion (FGD). Quantitative data were subjected to descriptive and comparative statistics and FGD was analyzed using ATLAS.ti. P value <0.05 was considered significant. Results: A total of 522 adults comprising 307(58.8%) males and 215(41.2%) females aged 43 ± 31.6 years participated in the study. Lack of felt need 235(45.02%), affordability 200(38.31%), stigmatization 184(35.25%) and distance to health care facility 88(16.86%) were the major factors that hindered the uptake of refractive errors care services in Amorji community. Age significantly associated with lack of felt need (P=0.001) and affordability (P=0.001). Educational status significantly associated with stigmatization (P=0.002) and lack of felt need (P=0.021). Results from FGDs were in agreement with those obtained from the questionnaire-based part of the study. Conclusion: The major factors that militated against the uptake of refractive care services in the community were lack of felt need, affordability, stigmatization and distance from health care facility. Good health education, planning and implementation of eye care services programmes may improve the uptake of refractive care services in such rural community.