2 research outputs found
Uptake of trichiasis surgical services in Tanzania through two villageābased approaches
AIM: To determine the effectiveness of villageābased strategies (using school teachers and village leaders) to increase the use of surgical services. METHODS: A cohort study was conducted in Tanzania using two village strategies (village leader and school teachers); trichiasis surgical uptake and the factors associated with uptake were measured after 1ā
year. RESULTS: The trichiasis surgical coverage at baseline was 16.9%; 200 patients who needed surgery were identified. One year later, we were able to reāexamine and interview 163 of these patients. The surgical uptake among these patients was 44.8% (95% CI 37.2% to 52.4%). Patients in the schoolāteacher programme had a 36.5% uptake compared with 52.1% for those in the villageāleader programme. No difference was observed in uptake by age or sex. Uptake was highest among those coming from multipleāgeneration households and those with more household wealth. Of the 90 people who still had not had surgery, 20 (22.2%) reported seeking surgery, but failing to receive it because of barriers at the provider side. CONCLUSIONS: Improved surgical uptake for trachomatous trichiasis was achieved by using villageābased promotion efforts and surgical services at existing health clinics. Even with free surgery at health clinics, indirect costs and social support barriers limit utilisation by the most vulnerable, the poorest and those living in singleāgeneration households. Problems at the provider level also create barriers for patients who need surgery