Muma Shadrack, Naidoo Kovin Shunmugam, Hansraj Rekha
College of Health Sciences, Department of Optometry, University of KwaZulu-Natal, Durban, South Africa.
OneSight EssilorLuxottica Foundation, Paris, France.
Sci Rep. 2025 Jan 9;15(1):1515. doi: 10.1038/s41598-024-85006-7.
The global burden of uncorrected refractive error demands for adoption of different approaches inclined towards scaling effective refractive error coverage. While innovative approaches such as utilization of telemedicine is being adopted by social enterprises in different parts of the world to scale refractive error service delivery, commercial entrepreneurship still dominates the optical industry in Kenya with minimal focus on accessibility and affordability. However, to achieve effective refractive error coverage across the economic pyramid, integration of enterprises inclined towards fulfilling a social mission through innovative approaches such as telemedicine is desirable. This study thus developed a framework for the integration of refractive error services into the eye health ecosystem in Kenya, via social enterprise. This was an exploratory study which entailed a scoping review of current models used by social enterprises and development of a framework for the integration of refractive error services into the eye health ecosystem via social enterprises, through expert opinion. The data was collected through telephonic and online interviews with key opinion leaders. The preliminary framework developed was presented to the key opinion leaders for comments and inputs through the Delphi technique. Thereafter, the final proposed framework for integration of refractive error services into the eye health ecosystem in Kenya via a social enterprise was developed. All of the key opinion leaders 10 (100%) agreed that social enterprises are worthy of attention when it comes to scaling cost effective refractive error service delivery in Kenya. A total of (n = 28; 80%) Key Opinion leaders identified vision centres, (n = 28; 80.0%) cross-subsidization, (n = 32; 91.4%) skills development, (n = 35; 100%) partnership and (n = 35; 100%) technology as critical components in scaling effective refractive error coverage in a resource constrained country such as Kenya. There was consensus among all the key opinion leaders (n = 35; 100%) that social enterprises are well placed to implement innovative approaches such as telemedicine to scale effective refractive error coverage in Kenya. The framework developed integrates aspects such as technology, partnership, referral, cross-subsidization, skills development and vision centres. It is anticipated that through engagement of social enterprises, integration of critical aspects such as human resources, awareness/education, cost efficiency, research and service delivery could potentially be enhanced.
未矫正屈光不正的全球负担要求采用不同方法，以扩大有效的屈光不正服务覆盖范围。虽然世界各地的社会企业正在采用远程医疗等创新方法来扩大屈光不正服务的提供，但在肯尼亚，商业创业仍主导着光学行业，对可及性和可负担性的关注极少。然而，为了在整个经济金字塔中实现有效的屈光不正服务覆盖，通过远程医疗等创新方法致力于履行社会使命的企业进行整合是可取的。因此，本研究通过社会企业开发了一个将屈光不正服务整合到肯尼亚眼健康生态系统中的框架。这是一项探索性研究，包括对社会企业目前使用的模式进行范围审查，并通过专家意见制定一个通过社会企业将屈光不正服务整合到眼健康生态系统中的框架。数据通过与关键意见领袖的电话和在线访谈收集。通过德尔菲技术将初步制定的框架提交给关键意见领袖征求意见和建议。此后，最终提出了通过社会企业将屈光不正服务整合到肯尼亚眼健康生态系统中的框架。所有10位关键意见领袖（100%）都同意，在肯尼亚扩大具有成本效益的屈光不正服务提供方面，社会企业值得关注。共有28位（80%）关键意见领袖确定视力中心、28位（80.0%）交叉补贴、32位（91.4%）技能发展、35位（100%）伙伴关系以及35位（100%）技术是在肯尼亚这样资源有限的国家扩大有效屈光不正服务覆盖范围的关键要素。所有关键意见领袖（35位，100%）一致认为，社会企业非常适合实施远程医疗等创新方法，以扩大肯尼亚有效屈光不正服务的覆盖范围。所开发的框架整合了技术、伙伴关系转诊、交叉补贴、技能发展和视力中心等方面。预计通过社会企业的参与，人力资源、意识/教育、成本效益、研究和服务提供等关键方面的整合可能会得到加强。
