School of Medicine and Clinical Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia.
Faculty of Health Sciences, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.
BMJ Open. 2023 Feb 24;13(2):e070297. doi: 10.1136/bmjopen-2022-070297.
To assess the availability of refractive error correction services (RECS) in selected Zambian hospitals.
Between October 2021 and March 2022, we conducted a cross-sectional study design among 20 eye health service providers selected from 20 public health facilities offering RECS in 20 districts from 8 provinces of Zambia. A stratified random sampling technique was used to select study participants. A questionnaire was developed based on the access to healthcare services framework and distributed via email to respondents to collect their perspectives on the availability of RECS.
All 20 respondents returned the completed questionnaires. Most facilities met the Ministry of Health recommended equipment requirement, though tonometers were lacking in some facilities. Out of the 20 facilities, 75% reported having optometry technologists as the main staff offering eye health services; 10% had an ophthalmologist; no facility had an optometrist; none conducted school-based programmes and only 1 facility (5%) was able to dispense spectacles soon after refraction because it had a spectacle manufacturing workshop.
These findings show limited availability of RECS in the 20 health facilities. They also confirm that challenges in staffing levels, insufficient equipment and low rate of spectacle dispensing negatively affect availability of these services. Furthermore, insufficient infrastructure undermines service delivery. Addressing these challenges is cardinal to improving RECS delivery and enhancing universal eye healthcare coverage in Zambia.
评估赞比亚部分医院的屈光不正矫正服务（RECS）提供情况。
2021 年 10 月至 2022 年 3 月期间，我们在赞比亚 8 个省的 20 个地区的 20 个提供 RECS 的公立卫生机构中，对 20 名眼保健服务提供者进行了横断面研究设计。采用分层随机抽样技术选择研究参与者。根据医疗保健服务获取框架制定了调查问卷，并通过电子邮件分发给受访者，以收集他们对 RECS 提供情况的看法。
所有 20 名受访者均返回了填写完整的问卷。大多数设施均符合卫生部推荐的设备要求，但有些设施缺乏眼压计。在这 20 家机构中，75%的机构报告说有验光技师作为提供眼保健服务的主要人员；10%的机构有眼科医生；没有机构有验光师；没有机构开展基于学校的项目，只有 1 家机构（5%）能够在验光后立即配镜，因为它有一个眼镜制造车间。
这些发现表明，在这 20 家卫生机构中，RECS 的提供情况有限。它们还证实，人员配备水平、设备不足和低配镜率等挑战对这些服务的提供产生负面影响。此外，基础设施不足也会影响服务的提供。解决这些挑战对于改善 RECS 的提供和提高赞比亚全民眼保健覆盖率至关重要。
