The availability and accessibility of low vision services in Ashanti and Brong Ahafo Regions of Ghana.

Masters Degree. University of KwaZulu-Natal, Westville.Background: The prevalence of low vision on the African continent is generally high and varies across and within countries, as well as in people of different socioeconomic status. While regional studies on the prevalence of blindness and low vision in Ghana have been conducted, there is a lack of information on the availability and accessibility of low vision services in these regions. The aim of the study was to assess the availability and accessibility of low vision services in the Ashanti and Brong Ahafo regions of Ghana. Methods: This was a descriptive, quantitative, cross-sectional study design. Hand-delivered semi-structured questionnaires were used to collect information from eye care professionals selected from 58 eye care facilities within the Ashanti and Brong Ahafo regions of Ghana. In addition, face-to-face interviews were conducted with 29 low vision patients from the same regions. Results: Forty-four eye care facilities from the Ashanti region and 10 from the Brong Ahafo region responded to the questionnaire, giving an overall response rate of 93%. A total of 29 patients including 16 males and 13 females with a mean age of 33.79±17.42 years were interviewed from four different eye care facilities. Out of 50 eye care facilities who reported that they had low vision patients attending their clinics, 33 (66%) did not provide low vision services and 17 (34%) offered some form of this service. Eleven out of 15 (73.3%) patients reported that it was either difficult or very difficult to acquire optical low vision devices while 10 (83.3%) out of 12 patients reported the same about non-optical low vision devices. Of the 15 patients who responded to the questions on where they obtained their optical devices, 7 (47%) reported that they were donated to them, 2 (13%) obtained them from the market while 6 (40%) reported getting their devices from the hospitals or eye care facilities. For non-optical devices, the patients reported obtaining them from the market 5 (31%) and through donations 5 (31%). Others obtained them from the society for the blind 2 (15%), hospitals or eye clinics 2 (15%) and a resource centre 1 (8%). Barriers to the provision and uptake of low vision services included the lack of testing equipment, lack of assistive devices and high cost of services. Conclusions: Availability and accessibility of low vision services are limited in the Ashanti and Brong Ahafo regions. These findings should help to inform interventions to make low vision services available and accessible as well as to overcome the barriers to providing and utilising these services to minimise the impact of visual impairment

Profiling and factors associated with glaucoma diagnostic practice in sub-Saharan Africa-a cross sectional study of Nigerian and Ghanaian optometrists

Abstract Background Ghana and Nigeria are the two countries in Africa that currently run the Doctor of Optometry (OD) program in sub-Saharan Africa (SSA). Optometrists in these countries are licensed to provide glaucoma care. Despite the clinically relevant practice guidelines for glaucoma, there is no data on the practice patterns for glaucoma eye care in SSA, a region with the highest prevalence of glaucoma. This study aimed to profile glaucoma diagnosis adherence to practice guidelines among optometrists in two neighbouring anglophone countries (Nigeria and Ghana). Methods A web-based cross-sectional survey of practising optometrists was conducted in both countries. Each country data was weighted to reflect the total number of licensed and practising optometrists at the time of this survey. Descriptive analyses were performed against demography and practice factors using survey commands to adjust for sampling weights when estimating confidence intervals (CI) around prevalence estimates. Simple and multiple logistic regression analyses were performed to identify factors associated with glaucoma diagnosis. Results A total of 493 optometrists (238, 48.3% and 255, 51.7%) from Ghana and Nigeria respectively, responded to the survey-the first to document and compare the glaucoma diagnostic criteria between optometrists in Ghana and Nigeria. More Ghanaian than Nigerian optometrists diagnosed glaucoma and over 90% in both countries reported that they frequently performed either tonometry, visual field testing, or fundus examination during glaucoma diagnosis. Ghanaian optometrists were significantly more likely to diagnose glaucoma than Nigerian optometrists (adjusted odd ratio, AOR = 6.15, 95%CI:1.63–23.15, P = .007). Optometrists who have practiced for more than 10 years (AOR = 7.04; 95%CI:1.74–28.47, P = .006) and private practice optometrists (AOR = 3.33; 95%CI:1.13–9.83, P = .03) were more likely to diagnose glaucoma. Conclusions The study provides information for evaluating glaucoma assessment for optometrists in both countries. Optometrists in both countries are reasonably well-equipped to diagnose glaucoma and are practicing at an adequate level, but with room for improvement

Demographic factors associated with myopia knowledge, attitude and preventive practices among adults in Ghana: a population-based cross-sectional survey

Abstract Purpose Knowledge, positive attitude and good preventive practices are keys to successful myopia control, but information on these is lacking in Africa. This study determined the KAP on myopia in Ghana. Methods This was a population-based cross-sectional survey conducted among adults (aged 18 years and older) living across 16 regions of Ghana between May and October 2021. Data on socio-demographic factors (sex, age, gender, level of education, working status, type of employment, monthly income, and region of residence), respondents’ awareness, and knowledge, attitude and preventive practices (KAP) about myopia were collected. Composite and mean scores were calculated from eleven knowledge (total score = 61), eight attitude (48), and nine preventive practice items (33). Differences in mean scores were assessed using one-way analysis of variance (ANOVA) and standardized coefficients (β) with 95% confidence intervals (CI), using multiple linear regression to determine the associations between the dependent (KAP) and demographic variables. Results Of the 1,919 participants, mean age was 37.4 ± 13.4 years, 42.3% were aged 18–30 years, 52.6% were men, 55.8% had completed tertiary education, and 49.2% had either heard about myopia, or accurately defined myopia as short sightedness. The mean KAP scores were 22.9 ± 23.7, 33.9 ± 5.4, and 22.3 ± 2.8, respectively and varied significantly with many of the demographic variables particularly with age group, region, marital status, and type of employment. Multiple linear regression analyses revealed significant associations between region of residence and knowledge (β =—0.54, 95%CI:-0.87, -0.23, p < 0.001), attitude (β =—0.24, 95%CI:-0.35,-0.14, p < 0.001) and preventive practices (β = 0.07, 95%CI: 0.01, 0.12, p = 0.015). Preventive practices were also associated with type of employment (self-employed vs employee: β = 0.25, 95%CI: 0.15, 4.91, p < 0.05). Knowledge scores were significantly higher in those who lived in the Greater Accra (39.5 ± 18.5) and Eastern regions (39.1 ± 17.5) and lower among those who lived in the Upper West region (6.4 ± 15.6). Government employees and those with tertiary education had significantly higher mean knowledge scores compared with non-government employees (β = 4.56, 95%CI 1.22, 7.89, p = 0.007), and those with primary/no education (β = 18.35, 95%CI: 14.42, 22.27, p < 0.001). Conclusion Ghanaian participants had adequate knowledge of myopia but showed poor attitude and low preventive practices, which varied significantly between regions and were modified by socio-demographic factors. Further research into how education can be used to stimulate Ghanaians’ engagement in preventive practices is needed