Interventions to improve school-based eye-care services in low- and middle-income countries: a systematic review

• Published in: Bulletin of the World Health Organization 2018-10, Vol.96 (10), p.682-694D
• Main Authors: Burnett, Anthea M, Yashadhana, Aryati, Lee, Ling, Serova, Nina, Brain, Daveena, Naidoo, Kovin
• Format: Article
• Language: English
• Subjects: Access; Accessibility; Attitude change; Attitudes; Blindness; Blindness - diagnosis; Blindness - prevention & control; Child; Childhood; Children; Communication; Community Participation; Compliance; Constraints; Cost analysis; Criteria; Data quality; Delivery scheduling; Developing Countries; Developmental delays; Documents; Education; Electronic publishing; Eye; Eye examinations; Eyewear; Full text; Head teachers; Health care policy; Health education; Health Education - organization & administration; Health information; Health promotion; Health services; Humans; Income; Inservice Training; Internet; Intervention; LDCs; Literacy; Low income groups; Medical screening; Misconceptions; Morbidity; National Health Programs - organization & administration; Online data bases; Parents; Parents & parenting; Patient Acceptance of Health Care; Principals; Quality of service; School based intervention; School Health Services - organization & administration; Schools; Socioeconomic Factors; Specialists; Spectacles; Stigma; Students; Systematic review; Systematic Reviews; Teachers; Time Factors; Training; Vision; Vision Screening - organization & administration; Visual impairment
• ISSN: 0042-9686; 1564-0604
• DOI: 10.2471/BLT.18.212332

To review interventions improving eye-care services for schoolchildren in low- and middle-income countries. We searched online databases (CINAHL, Embase®, ERIC, MEDLINE®, ProQuest, PubMed® and Web of Science ) for articles published between January 2000 and May 2018. Eligible studies evaluated the delivery of school-based eye-care programmes, reporting results in terms of spectacle compliance rates, quality of screening or attitude changes. We considered studies to be ineligible if no follow-up data were reported. Two authors screened titles, abstracts and full-text articles, and we extracted data from eligible full-text articles using the availability, accessibility, acceptability and quality rights-based conceptual framework. Of 24 559 publications screened, 48 articles from 13 countries met the inclusion criteria. Factors involved in the successful provision of school-based eye-care interventions included communication between health services and schools, the willingness of schools to schedule sufficient time, and the support of principals, staff and parents. Several studies found that where the numbers of eye-care specialists are insufficient, training teachers in vision screening enables the provision of a good-quality and cost-effective service. As well as the cost of spectacles, barriers to seeking eye-care included poor literacy, misconceptions and lack of eye health knowledge among parents. The provision of school-based eye-care programmes has great potential to reduce ocular morbidity and developmental delays caused by childhood vision impairment and blindness. Policy-based support, while also attempting to reduce misconceptions and stigma among children and their parents, is crucial for continued access.