SynthesisInternational ophthalmology2025
Barriers to cataract surgery uptake in Africa: a systematic review.
Synthesis in International ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo synthesise evidence on barriers to cataract surgery uptake in Africa across patient, community, and health system levels, describe regional variation, and identify evidence gaps.
methodsWe conducted a systematic review of multiple databases for studies published from January 2000 to March 2025. Searches combined controlled vocabulary and free text terms for cataract surgery, access or uptake, and African countries. Two reviewers independently screened titles, abstracts, and full texts with consensus resolution. Eligible studies enrolled African populations and explicitly reported barriers, facilitators, or determinants of uptake. Data were extracted into a piloted template and thematically synthesised, with random-effects meta-analysis of proportions where data permitted. Reporting followed the PRISMA 2020 guidelines; the study was prospectively registered (PROSPERO CRD420251145721).
resultsFollowing the screening of 737 records, a total of 108 studies were included, spanning Rapid Assessment of Avoidable Blindness surveys, cross-sectional, qualitative, and mixed-methods designs. Patient-level barriers most frequently reported were direct and indirect costs (surgery, travel, accommodation, income loss), limited awareness, fear of surgery or poor outcomes, gender inequities, and cultural beliefs. Community-level barriers included transportation constraints, weak referral pathways, and inconsistent outreach efforts. System-level barriers comprised workforce shortages, limited theatre capacity, equipment or consumable shortfalls, scheduling inefficiencies, and reliance on out-of-pocket financing with limited insurance or subsidies. Rural, urban, and regional disparities were consistent.
conclusionBarriers to cataract surgery uptake in Africa are multifactorial and interlinked. Evidence supports multi-component strategies, including patient education, targeted financial and transportation support, strengthened referral and outreach, service decentralisation, and health system investment, to improve equitable access and accelerate progress toward eye health targets.
Indexed as
Identifiers
41385021What OpenQuestion holds
Registered trials
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.