School of Medicine and Health Sciences Poster Presentations

Title

Comparison of Helicopter and Land Outreach for Cataract Screening in eSwatini

Document Type

Poster

Abstract Category

Prevention and Community Health

Keywords

Cataract, Screening, Outreach, Cost

Publication Date

Spring 5-1-2019

Abstract

Background: eSwatini is a tiny kingdom (population: 1.367 million) in Southern Africa where much of the country's population lives in rural and hard to reach towns. Cataracts are the leading cause of blindness in most sub-Saharan African nations, including eSwatini. As in most Sub Saharan Africa, the percentage of cases attributed to cataracts is the leading cause expected to be near 50% (Pons 2012). Cataract outreach and screening programs aim to increase the Cataract Surgical Rate (CSR or the number of cataract surgeries per million people per year) in a clinic or hospital as indicated in the WHO and IAPB's Vision 2020: Right to Sight Report Objectives: To analyze the cost to the clinic and cost saved by patients by using helicopter transport to access rural towns and screen for cataracts and to explore the sustainability of the program as well as its success over other screening programs in achieving the goals laid out by Vision 2020. Methods: Methods included retrospective, hospital-based review of all financial records of outreach activity, literature review, and site visits over a period of two months. Results: The operating cost of outreach efforts for screening was E 992.27 per patient, and patient transport costs were E 311.43 per patient. For 201 surgery recipients, Good Shepherd Eye Clinic was able to save each patient E 983.81 at a cost to the program of E 1,303.70. 41% of patients identified with operable cataract presented for surgery. The patients identified by the Sight Flight Outreach program in 2017 accounted for 23% of the cataract surgeries performed by Good Shepherd Eye Clinic in that year. Conclusion: The Sight Flight program provides significant reduction in financial barriers to eliminating preventable blindness in Swazi citizens, contributing to an increased CSR in eSwatini. The efforts specifically target Swazi citizens whose rates of cataract surgery have not been increasing at the same rate as citizens of Mozambique at Good Shepherd. The program can stand to improve the number of eligible patients who arrive for surgery both to increase CSR of the country and to aid in sustainability of the program by driving down cost per patient by more than half. Given that costs, transportation, and logistics were covered by the program, it is advised that further investigation of non-monetary barriers be investigated.

Open Access

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Presented at Research Days 2019.

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Comparison of Helicopter and Land Outreach for Cataract Screening in eSwatini

Background: eSwatini is a tiny kingdom (population: 1.367 million) in Southern Africa where much of the country's population lives in rural and hard to reach towns. Cataracts are the leading cause of blindness in most sub-Saharan African nations, including eSwatini. As in most Sub Saharan Africa, the percentage of cases attributed to cataracts is the leading cause expected to be near 50% (Pons 2012). Cataract outreach and screening programs aim to increase the Cataract Surgical Rate (CSR or the number of cataract surgeries per million people per year) in a clinic or hospital as indicated in the WHO and IAPB's Vision 2020: Right to Sight Report Objectives: To analyze the cost to the clinic and cost saved by patients by using helicopter transport to access rural towns and screen for cataracts and to explore the sustainability of the program as well as its success over other screening programs in achieving the goals laid out by Vision 2020. Methods: Methods included retrospective, hospital-based review of all financial records of outreach activity, literature review, and site visits over a period of two months. Results: The operating cost of outreach efforts for screening was E 992.27 per patient, and patient transport costs were E 311.43 per patient. For 201 surgery recipients, Good Shepherd Eye Clinic was able to save each patient E 983.81 at a cost to the program of E 1,303.70. 41% of patients identified with operable cataract presented for surgery. The patients identified by the Sight Flight Outreach program in 2017 accounted for 23% of the cataract surgeries performed by Good Shepherd Eye Clinic in that year. Conclusion: The Sight Flight program provides significant reduction in financial barriers to eliminating preventable blindness in Swazi citizens, contributing to an increased CSR in eSwatini. The efforts specifically target Swazi citizens whose rates of cataract surgery have not been increasing at the same rate as citizens of Mozambique at Good Shepherd. The program can stand to improve the number of eligible patients who arrive for surgery both to increase CSR of the country and to aid in sustainability of the program by driving down cost per patient by more than half. Given that costs, transportation, and logistics were covered by the program, it is advised that further investigation of non-monetary barriers be investigated.