Dataset Information

Eye care utilization pattern in South Africa: results from SANHANES-1.

ABSTRACT: BACKGROUND:Eye examinations are recommended for all persons throughout life. However, there is disparity in the uptake of eye care services in different populations. Using data from a nationally representative population-based cross-sectional study (the South African National Health and Nutrition Examination Survey, [SANHANES-1]), this paper investigates the utilization of eye care services and its associated factors in South Africa. METHODS:Participants aged 15?years and older who participated in interviews and clinical examination were enrolled in the SANHANES from 2011 to 2012. Eye care utilization was assessed from participants' responses to whether they had their eyes examined by a medical professional and when they were last examined. Data were analysed using multiple logistic regression models employing a hierarchical approach to add predisposing (e.g. age, sex), enabling (e.g. health insurance) and need (e.g. hypertension) factors sequentially. RESULTS:The study sampled 3320 participants, with 64.9% being females. 73.4% (95% CI [69.7-76.7]) of participants had never had an eye examination. After statistical adjustment, age groups (compared with 15-29?years: 30-44?years Odds Ratio [OR]?=?1.76; 45-59?years OR?=?2.13; 60-74?years OR?=?2.74; ?75?years OR?=?3.22), ethnicity (compared with African descent: white OR?=?4.71; mixed-race OR?=?1.87; Indian OR?=?7.67), high risk alcohol use (OR?=?1.83), wealth index (compared with lowest quintile: third quintile OR?=?1.75; fourth quintile OR?=?2.23; fifth quintile OR?=?2.49), health insurance (OR?=?2.19), diabetes (OR?=?1.75), high cholesterol (OR?=?2.51), having assessed healthcare in the past 5?years (OR?=?2.42), and self-reported vision problems (OR?=?1.51) were significantly associated with eye care utilization. CONCLUSION:Almost three-quarters of South Africans sampled were not utilizing eye care services. It is imperative to strengthen current public health measures (including eye health promotion programs) to address the alarmingly low uptake of eye care services as well as the disparities in eye care utilization in South Africa.

SUBMITTER: Akuffo KO

PROVIDER: S-EPMC7430111 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Eye care utilization pattern in South Africa: results from SANHANES-1.

Akuffo Kwadwo Owusu KO Sewpaul Ronel R Dukhi Natisha N Asare Akosua Kesewah AK Kumah David Ben DB Addo Emmanuel Kofi EK Agyei-Manu Eldad E Reddy Priscilla P

BMC health services research 20200817 1

<h4>Background</h4>Eye examinations are recommended for all persons throughout life. However, there is disparity in the uptake of eye care services in different populations. Using data from a nationally representative population-based cross-sectional study (the South African National Health and Nutrition Examination Survey, [SANHANES-1]), this paper investigates the utilization of eye care services and its associated factors in South Africa.<h4>Methods</h4>Participants aged 15 years and older wh ...[more]

PMID: 32807155

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Project description:PURPOSE:The study aimed to assess the proportion of eye care service utilization and associated factors among older adults age ≥ 40 years in Hawassa city, South Ethiopia, June 2019. METHOD:A community-based cross-sectional study was conducted among adults aged 40 years and above who permanently live in Hawassa city from April 25 to May 30, 2019. Multistage sampling technique was used to select 704 participants. An interviewer-administered questionnaire was used to collect the data. The collected data was entered to EPI info version 7 & was analyzed by SPSS version 20. Binary logistic regression model was used to identify actual predictors of eye care service utilization. All variables were entered to multivariable analysis and variables with p-value < 0.05 were considered as statistically significant. RESULT:A total of 668 adults participated with a response rate of 94.9%. The median (±IQR) age of study respondents was 48(±10) years and 52.7% were females. The proportion of eye care service utilization within the past 2 years was found to be 23.8% [95% CI: 20.5%-27.1%]. Having history of eye disease [AOR = 9.8, 95% CI: 6.1-15.6], having awareness of regular eye checkup importance [AOR = 7.3, 95% CI:4.4-12.2], older age (age ≥65 years) [AOR = 5.0, 95% CI:1.9-13.3] and higher family monthly income (income ≥6000 ETB) [AOR = 3.0, 95% CI:1.5-5.7] and income 4001-5999 ETB [AOR = 2.9, 95% CI: 1.4-5.9] were positively associated with eye care service utilization. CONCLUSION AND RECOMMENDATION:The proportion of eye care service utilization among older adults in Hawassa city was low. Having a history of eye disease, having awareness about regular eye checkup importance, older age and higher family monthly income were significantly associated with utilization of eye care service. Therefore, it is recommended to provide eye health education for the community to increase awareness about eye care service utilization which can improve eye care service utilization.

Project description:BackgroundThe effect of the rapid scale-up of vertical antiretroviral treatment (ART) programs for HIV in sub-Saharan Africa on the overall health system is under intense debate. Some have argued that these programs have reduced access for people suffering from diseases unrelated to HIV because ART programs have drained human and physical resources from other parts of the health system; others have claimed that the investments through ART programs have strengthened the general health system and the population health impacts of ART have freed up health care capacity for the treatment of diseases that are not related to HIV. To establish the population-level impact of ART programs on health care utilization in the public-sector health system, we compared trends in health care utilization among HIV-infected people receiving and not receiving ART with HIV-uninfected people during a period of rapid ART scale-up.Methods and findingsWe used data from the Wellcome Trust Africa Centre for Population Health, which annually elicited information on health care utilization from all surveillance participants over the period 2009-2012 (N = 32,319). We determined trends in hospitalization, and public-sector and private-sector primary health care (PHC) clinic visits for HIV-infected and -uninfected people over a time period of rapid ART scale-up (2009-2012) in this community. We regressed health care utilization on HIV status and ART status in different calendar years, controlling for sex, age, and area of residence. The proportion of people who reported to have visited a public-sector primary health care (PHC) clinic in the last 6 months increased significantly over the period 2009-2012, for both HIV-infected people (from 59% to 67%; p<0.001), and HIV-uninfected people (from 41% to 47%; p<0.001). In contrast, the proportion of HIV-infected people visiting a private-sector PHC clinic declined from 22% to 12% (p<0.001) and hospitalization rates declined from 128 to 82 per 1000 PY (p<0.001). For HIV-uninfected people, the proportion visiting a private-sector PHC clinic declined from 16% to 9%, and hospitalization rates declined from 78 to 44 per 1000 PY (p<0.001). After controlling for potential confounding factors, all trends remained of similar magnitude and significance.ConclusionsOur results indicate that the ART scale-up in this high HIV prevalence community has shifted health care utilization from hospitals and private-sector primary care to public-sector primary care. Remarkably, this shift is observed for both HIV-infected and -uninfected populations, supporting and extending hypotheses of 'therapeutic citizenship' whereby HIV-infected patients receiving ART facilitate primary care access for family and community members. One explanation of our findings is that ART has improved the capacity or quality of primary care in this community and, as a consequence, increasingly met overall health care needs at the primary care level rather than at the secondary level. Future research needs to confirm this causal interpretation of our findings using qualitative work to understand causal mechanisms or quasi-experimental quantitative studies to increase the strength of causal inference.

Dataset Information

Eye care utilization pattern in South Africa: results from SANHANES-1.

Publications

Eye care utilization pattern in South Africa: results from SANHANES-1.

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