Evidence map›Paper›PMID 37853109›Full record

ArticleEye (London, England)2024

Travel time to cataract surgical services in Kenya, Malawi and Rwanda: demonstrating a standardised indicator of physical access to cataract surgery.

Ian McCormick, John M Nesemann, Jinfeng Zhao, Shaffi Mdala, Gatera Fiston Kitema, Nyawira Mwangi, Michael Gichangi, Kevin Tang, Matthew J Burton, Jacqueline Ramke

Abstract read
In one paragraph

Article in Eye (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ian McCormickInternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK. ian.mccormick@lshtm.ac.uk.ORCID http://orcid.org/0000-0002-7360-3844
John M NesemannInternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK.
Jinfeng ZhaoSchool of Population Health, University of Auckland, Auckland, New Zealand.
Shaffi MdalaKamuzu University of Health Sciences, Blantyre, Malawi.
Gatera Fiston KitemaOphthalmology Department, School of Health Sciences, University of Rwanda, Kigali, Rwanda.
Nyawira MwangiKenya Medical Training College, Nairobi, Kenya.
Michael GichangiOphthalmic Services Unit, Kenya Ministry of Health, Nairobi, Kenya.
Kevin TangDepartment of Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Matthew J BurtonInternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0003-1872-9169
Jacqueline RamkeInternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-5764-1306

Funding

Wellcome TrustWellcome Trust (Wellcome) 207472/Z/17/Z
6 · The paper itself

Abstract

backgroundTravel time can be used to assess health services accessibility by reflecting the proximity of services to the people they serve. We aimed to demonstrate an indicator of physical access to cataract surgery and identify subnational locations where people were more at risk of not accessing cataract surgery.

methodsWe used an open-access inventory of public health facilities plus key informants in Kenya, Malawi and Rwanda to compile a geocoded inventory of cataract facilities. For each country, gridded estimates of the population aged ≥ 50 years and a travel-time friction surface were combined and a least-cost-path algorithm applied to estimate the shortest travel time between each grid and the nearest cataract facility. We categorised continuous travel time by 1-, 2- and 3 h thresholds and calculated the proportion of the population in each category.

resultsAt the national level, the proportion of the population aged ≥ 50 years within 2 h travel time to permanent cataract surgical services was 97.2% in Rwanda (n = 10 facilities), 93.5% in Kenya (n = 74 facilities) and 92.0% in Malawi (n = 6 facilities); this reduced to 77.5%, 84.1% and 52.4% within 1 h, respectively. The least densely populated subnational regions had the poorest access to cataract facilities in Malawi (0.0%) and Kenya (1.9%).

conclusionWe demonstrated an indicator of access that reflects the distribution of the population at risk of age-related cataract and identifies regions that could benefit from more accessible services. This indicator provides additional demand-side context for eye health planning and supports WHO's goal of advancing integrated people-centred eye care.

Indexed as

Cataract ExtractionHealth Services AccessibilityTravelAgedCataractFemaleHumansKenyaMalawiMaleMiddle AgedRwandaTime Factors

Identifiers

PMID37853109
PMCPMC11269656

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.