PLOS ONE · 8 authors, 6 centres
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This qualitative study in Northwest Ethiopia found that parents had limited knowledge of childhood eye disease causes, held misconceptions about strabismus and spectacle use, and rarely sought routine eye care for their children. These knowledge gaps and negative attitudes likely delay timely treatment and contribute to preventable childhood blindness. The findings highlight the need for targeted health education and improved access to eye care services.
**Background:** Most causes of childhood blindness in low-income countries are treatable or avoidable. Parents play a crucial role in making decisions about their child's eye care, but their awareness and perceptions of eye problems are poorly understood. This study aimed to determine parental knowledge, attitudes, and practice (KAP) regarding child eye health (CEH) in Northwest Ethiopia.
**Methods:** A cross-sectional, qualitative study was conducted in June 2022 in the North Gondar Zone of the Amhara region, Ethiopia. Seven focus group discussions (FGDs) were carried out with 71 parents of children under 12 years old. Participants were purposively selected from two woredas to ensure diversity in demographics and employment (e.g., farmers, teachers, health extension workers). A semi-structured discussion guide explored knowledge (e.g., CEH information, child eye problems), attitudes (e.g., barriers to care, spectacle use, impact of blindness), and practice (e.g., prevention, treatment, cultural practices). FGDs lasted 60–90 minutes, were tape-recorded, transcribed, and translated into English. Data were analyzed using a thematic phenomenological approach.
**Key Results:** The mean age of participants was 41.1 years (±11.1); 77% were male, 75% had at least high school education, and 86% were Orthodox Christian. Seven major themes emerged: - **Knowledge:** Participants obtained CEH information from health professionals and media (radio, advertisements) but felt it was inadequate. They identified trachoma, glaucoma, trauma, and dirt as causes of poor eyesight but were unaware of common causes of childhood blindness like vitamin A deficiency and measles. Signs of vision impairment recognized included difficulty reading at night, falling, and poor school performance. However, almost all participants did not know when to seek care; only “pain and redness” prompted treatment. - **Attitudes:** Main barriers to accessing CEH services were financial constraints, lack of awareness, long distances, poor transportation, long wait times, and substandard quality at health facilities. Use of eyeglasses was stigmatized, with many perceiving them as harmful, causing vision deterioration, or labeling children. A minority viewed spectacles as beneficial for vision. - **Practice:** No participant had taken their child for a routine eye examination. Prevention strategies were hygiene, eating a balanced diet (e.g., carrots), and avoiding sunlight. Cultural practices included using traditional medicine (e.g., “Alemochie” for measles) due to its accessibility and affordability; health extension workers noted that visiting traditional healers was common.
**Clinical Implications:** The study reveals critical gaps in parental KAP that likely contribute to preventable childhood blindness. Awareness of treatable conditions like amblyopia and strabismus is low, and misconceptions about spectacle use and disease causes hinder early intervention. The findings suggest five key actions: (1) improve CEH knowledge via trusted sources (media, health champions); (2) directly address myths about blindness and spectacle use; (3) educate parents on when to seek care; (4) improve capacity and quality of CEH services; and (5) establish collaboration between traditional healers and modern eye care. These interventions could be delivered through mass and social media, training of primary and secondary health workers, and community outreach. Limitations include a predominance of male participants and focus on one region in Ethiopia.