Trial reportThe British journal of ophthalmology2023
Does an integrated school eye health delivery model perform better than a vertical model in a real-world setting? A non-randomised interventional comparative implementation study in Zanzibar.
Trial report in The British journal of ophthalmology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The trial behind it
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Who cites it
4 citing papers in PubMed.
- Preliminary effectiveness of musical messaging to improve child eye health service uptake in Zanzibar: a pilot randomised trial.BMJ open · 2025Trial
- Current status of school vision screening-rationale, models, impact and challenges: a review.The British journal of ophthalmology · 2025Review
- Priorities in school eye health in low and middle-income countries a scoping review.Eye (London, England) · 2024Article
- Contextual factors affecting integration of eye health into school health programme in Zanzibar: a qualitative health system research.BMC health services research · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFew studies on school eye health programmes have shown they were cost-effective. We compared the performance (Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM)) between an integrated model (IM) and a vertical model (VM) of school eye health delivery in Zanzibar.
methodsThe set of RE-AIM performance indicators of the IM (n=9) and VM (n=10) cohorts was compared. The VM implemented only the eye health interventions, while the IM had the eye health interventions conducted within the school feeding programme. Semistructured interviews were conducted with 36 stakeholders to understand the challenges and outcomes experienced when implementing both models.
resultsThe IM achieved higher screening coverage, voluntary follow-up rate, screening validity and spectacle compliance than VM. This was due to effective coordination between implementers, motivated teachers to prevent vision problems and related negative impacts in children, and activities implemented timeously post-training. Both models recorded low wearing compliance. All schools in the IM cohort completed screening activities, but two schools in the VM cohort did not. Both models ceased activities after the funding stopped. Local stakeholders emphasised that evidence from this study can be used to advocate for more resources for children's eye health.
conclusionsThe IM cohort achieved better reach, effectiveness, adoption rate and implementation performance than the VM cohort. The poor maintenance performance indicators in both arms postfunding call for improvement to the implementation strategy to ensure the sustainability of school eye health. In the optics of scaling up, an integrated approach is recommended.
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