Eye Care Service Use and Associated Health-Seeking Behaviors Among Malawian Adults: Secondary Analysis of the Malawi Fifth Integrated Household Survey 2019-2020.

Background: The use of eye care services varies among different population groups. Objective: This study aimed to assess self-reported eye care use (ECU) and associated demographic factors among Malawian adults. Methods: This study used secondary data from the Malawi Fifth Integrated Household Survey 2019-2020, a nationally representative survey. The study included 12,288 households and 27,336 individuals 15 years and older. We entered age, sex, level of education, residency (urban/rural), and chronic disease into a logistic regression model, and used a confusion matrix to predict the model's accuracy. A P value <.05 was considered statistically significant. Results: About 60.6% (95% CI 60.0%-61.2%) of those with eye problems accessed formal care 2 weeks before the survey date. A logistic regression model showed that ECU was positively associated with education compared to none (odds ratio [OR] 6.6, 95% CI 5.927-7.366; P<.001), males compared to females (OR 1.2, 95% CI 1.104-1.290; P<.001), and urban residence compared to rural (OR 1.2, 95% CI 1.118-1.375; P<.001). ECU was negatively associated with age (OR 7, 95% CI 6.782-8.476; P<.001) and having chronic diseases (OR 0.6, 95% CI 0.547-0.708; P<.001). Conclusions: Social support, women empowerment, education, and mobile clinics are key strategic areas that would increase access to eye care in Malawi. Further studies can investigate ECU among the pediatric population.