Factors affecting utilization of eye care services at Benedictine Eye Hospital, Tororo district, Eastern Uganda

Abstract

: Utilization of eye care services is significantly influenced by the individual’s health seeking behavior, which has been shown to affect the use, time taken to access care and the nonuse of the orthodox health care. Research into utilization of eye care services plays an important aspect in providing data on availability and use of these services by the community. In addition, these data provide eye health risks, and the risk factors associated with poor utilization of eye care services; thereby informing the best practices for eye care program. The aim of this study was to determine factors associated with utilization of eye care services and establish the pattern of use of eye care services among the patients attending Benedictine Eye Hospital to inform appropriate planning of eye care services. Study methods: A cross-sectional descriptive and analytical study was done at Benedictine Eye Hospital, located in Tororo district, Uganda. The study used quantitative methods of data collection in which a structured questionnaire was administered to each participant by trained research assistants using an appropriate language best known by both the research assistant and study participant. Data collected was entered in MS – excel and then exported to STATA version 14.2 (STATA Corporation, College Station, TX) for analysis. Results: We studied 260 participants. The age range was 18 to 88 years. The common eye conditions they presented with in the order of importance included: cataract 74(28.7%), glaucoma 21(8%), corneal disease 20(7.7%), allergic conjunctivitis (16.9%), Eye trauma 12(4.6%), conjunctiva growth 12(4.6%), Uveitis 10(3.8%), refractive error 5(1.9%), retinal disease 5(1.9%) and other eye conditions (21.9%). The mode of payment for services was out of pocket among 235(90.4%), Insurance scheme among 24(9%) and none for 1(0.6%). One hundred thirty five (51.9%) respondents sought care from alternative sources before coming to the hospital. Other places the participants sought care from included pharmacy or drug shop 44(32.6%), general clinic 35(25.9%), general hospital 35(25.9%), other eye clinics 11(8.2%), herbal treatment 5(3.7%) and traditional healer 5(3.7%). Peasant farmers and business or commercial farmers were more likely to present to the eye hospital with eye symptom duration of greater than one month ( OR=4.5, CI 1.07-18.97 P=0.04) and (OR=4.4 CI 1.30-14.91, P=0.018) respectively. There were 57(21.9%) of participants who indicated that they would decline surgery even when indicated and the reasons for this were fear of pain reported by 36(63.2%), fear of the procedure 11(19.2%), eye may become spoilt 9(15.8%) and the eye cannot be operated 1(1.8%). Conclusion: The people attending Benedictine Eye Hospital from Tororo district are largely aware about the services that are available at the eye care facility and some of the priority eye diseases. The use of the services, however, is affected by factors related to their attitudes and practices. Recommendation: There is need to create awareness about eye disease service availability and importance of appropriate regular eye checkup amongst the people in the Tororo community in Eastern Uganda.