ArticleInternational journal for equity in health2026
Service users' perspectives on primary eye care services following performance-based financing in Rwanda: an exploratory qualitative study.
Article in International journal for equity in health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVisual impairment is a major global public health concern, disproportionately affecting populations in low- and middle-income countries (LMICs), where access to eye care services remains limited. In 2019, the Rwandan Ministry of Health integrated eye care services into the Performance-Based Financing (PBF) framework to improve accessibility, service quality, and utilization. However, service users' perspectives on this initiative remain underexplored. This study aimed to examine service users' perceptions of accessibility, quality, affordability, satisfaction, and challenges in accessing eye care services at primary healthcare facilities.
methodsAn exploratory qualitative study was conducted in six purposively selected health centers in Rwanda. A total of 72 participants were recruited using maximum variation sampling, including older adults, individuals with disabilities, and participants from different socioeconomic backgrounds. Data were collected through six focus group discussions (FGDs), each comprising 8-12 participants. Discussions explored perceptions of accessibility, quality, affordability, satisfaction, and recommendations for improvement. Audio recordings were transcribed, translated into English, and analyzed inductively using Dedoose software. Trustworthiness was ensured through prolonged engagement, member checking, peer debriefing, and triangulation.
resultsParticipants reported that the decentralization of eye care services to health centers improved geographical access and reduced travel time. However, financial barriers remained a major constraint, particularly due to the cost of eyeglasses and certain medications not fully covered by Community-Based Health Insurance (CBHI). Users also described inconsistencies in service quality, including frequent stock-outs of essential supplies, limited equipment, and variability in the availability of eye care personnel. Despite these challenges, many participants expressed satisfaction with provider attitudes and interpersonal care, highlighting respectful and supportive interactions with health workers. At the same time, dissatisfaction was reported due to systemic inefficiencies such as limited service days, understaffing, long waiting times, and referral-related burdens.
conclusionsFindings indicate that decentralization may have contributed to improved geographic accessibility and perceived service responsiveness; however, these improvements are uneven and remain constrained by financial and system-level barriers. Addressing these barriers through expanded service packages, reliable supply chains, human resource strengthening, CBHI coverage, and community education is critical to optimize equitable eye-care delivery.
Indexed as
Identifiers
What 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.