ArticleBMC ophthalmology2015
Factors affecting cataract surgical coverage and outcomes: a retrospective cross-sectional study of eye health systems in sub-Saharan Africa.
Article in BMC ophthalmology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Barriers to cataract surgery uptake in Africa: a systematic review.International ophthalmology · 2025Pooled it
- The outcomes of paediatric cataract surgery with intraocular lens insertion in sub-Saharan Africa: a systematic review.Systematic reviews · 2024Pooled it
- Pooled it
- Pooled it
- A qualitative study on the effect of a decision aid on knowledge of cataract surgery in patients in developing countries.International ophthalmology · 2024Trial
- Clinic-based burden of glaucoma among Sahrawi refugees in the Tindouf camps.BMJ open ophthalmology · 2026Article
- The effect of eye health system strengthening on the productivity of services: a before-and-after evaluation conducted in seven counties in Kenya.Frontiers in health services · 2026Article
- Under-reporting difficulties in seeing among older people with clinically assessed vision impairment: an exploration of 12 surveys from sub-Saharan Africa.International health · 2025Article
- [Cataract surgery in sub-Saharan Africa-Possibilities and limits].Die Ophthalmologie · 2025Article
- Article
- Prevalence and management of cataracts among older adults in Sub-Saharan Africa: a scoping review.BMC ophthalmology · 2024Article
- Travel time to cataract surgical services in Kenya, Malawi and Rwanda: demonstrating a standardised indicator of physical access to cataract surgery.Eye (London, England) · 2024Article
- Decline in unmet needs for cataract surgery among the ageing population in India: findings from LASI, wave-1.Frontiers in health services · 2024Article
- Cataract Surgery Visual Outcome and Associated Factors Among Adults Attended Jimma University Medical Center, Jimma, Southwest Ethiopia.Clinical ophthalmology (Auckland, N.Z.) · 2023Article
- Evidence on cataract in low- and middle-income countries: an updated review of reviews using the evidence gap maps approach.International health · 2022Review
- Understanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study.International health · 2022Article
- Global, regional, and national years lived with disability due to blindness and vision loss from 1990 to 2019: Findings from the Global Burden of Disease Study 2019.Frontiers in public health · 2022Article
- Article
- Evidence for national universal eye health plans.Bulletin of the World Health Organization · 2018Article
- What are the priorities for improving cataract surgical outcomes in Africa? Results of a Delphi exercise.International ophthalmology · 2018Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecently there has been a great deal of new population based evidence on visual impairment generated in sub-Saharan Africa (SSA), thanks to the Rapid Assessment of Avoidable Blindness (RAAB) survey methodology. The survey provides information on the magnitude and causes of visual impairment for planning services and measuring their impact on eye health in administrative "districts" of 0.5-5 million people. The survey results describing the quantity and quality of cataract surgeries vary widely between study sites, often with no obvious explanation. The purpose of this study was to examine health system characteristics that may be associated with cataract surgical coverage and outcomes in SSA in order to better understand the determinants of reducing the burden of avoidable blindness due to cataract.
methodsThis was a descriptive study using secondary and primary data. The outcome variables were collected from existing surveys. Data on potential district level predictor variables were collected through a semi-structured tool using routine data and key informants where appropriate. Once collected the data were coded and analysed using statistical methods including t-tests, ANOVA and the Kruskal-Wallis analysis of variance test.
resultsHigher cataract surgical coverage was positively associated with having at least one fixed surgical facility in the area; availability of a dedicated operating theatre; the number of surgeons per million population; and having an eye department manager in the facility. Variables that were associated with better outcomes included having biometry and having an eye department manager in the facility.
conclusionsThere are a number of health system factors at the district level that seem to be associated with both cataract surgical coverage and post-operative visual acuity outcomes. This study highlights the needs for better indicators and tools by which to measure and monitor the performance of eye health systems at the district level. It is unlikely that epidemiological data alone is sufficient for planning eye health services within a district and health managers and study coordinators need to consider collecting supplementary information in order to ensure appropriate planning can take place.
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