SEARCHSYSTEMATIC_REVIEWophthalmology, public health

systematic_review·ophthalmology, public health, systematic review, epidemiology·PMC10230923

Integrating eye care in low-income and middle-income settings: a scoping review

BMJ Open · 5 authors, 5 centres

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AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

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TL;DR

The central finding is that integration is challenging due to barriers like inadequate human resources, poor referral systems, and limited financing, with a noted lack of people-centred approaches and rehabilitation services.

Full summary

693 CHARS

The database search identified 3889 papers, with 24 meeting inclusion criteria, describing studies across 12 countries. Analysis revealed most interventions incorporated multiple types (promotion, prevention, treatment) but none included rehabilitation. Key associated factors included building relationships and enhancing coordination, while significant barriers were ongoing support needs, worker retention, inadequate referral and information systems, poor supply chains, and limited financing. The review concludes that integration is complex and resource-limited, highlighting a need for people-centred approaches and further investigation into integrating vision rehabilitation services.

STUDY TYPE

systematic_review

SPECIALTY

ophthalmology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10230923

Integrating eye care in low-income and middle-income settings: a scoping review

BMJ Open

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ABSTRACT

Objectives Integrated people-centred eye care has been recommended as a strategic framework for reducing global vision impairment and blindness. The extent to which eye care has integrated with other services has not been widely reported. We aimed to investigate approaches to integrating eye care service delivery with other systems in low resource settings, and identify factors associated with integration. Design Rapid scoping review based on Cochrane Rapid Review and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources MEDLINE, Embase, Web of Science, Scopus and Cochrane Library databases were searched in September 2021. Eligibility criteria Papers with interventions involving eye care or preventative eye care integrated into other health systems, peer-reviewed in English, conducted in low-income or middle-income countries, and published between January 2011 and September 2021 were included. Data extraction and synthesis Two independent reviewers screened, quality appraised and coded included papers. A deductive–inductive iterative analysis approach was used with a focus on integrating service delivery. Results The search identified 3889 potential papers, of which 24 were included. Twenty papers incorporated more than one intervention type (promotion, prevention and/or treatment), but none included rehabilitation. Most articles involved human resources development yet rarely appeared to be people-centred. The level of integration was associated with building relationships and enhancing service coordination. Integrating human resources was challenged by the need for ongoing support and worker retention. In primary care settings, workers were often already at full capacity, had competing priorities, varying capabilities and limited motivation. Additional barriers included inadequate referral and information systems, poor supply chain management and procurement practices and finite financing. Conclusion Integrating eye care into low resource health systems is a challenging task, compounded by resource limitations, competing priorities and ongoing support needs. This review highlighted a need for people-centred approaches to future interventions, and further investigation into integrating vision rehabilitation services.

CITATION EXPORT

Ling Lee, Elise Moo, Tiffany Angelopoulos et al.. Integrating eye care in low-income and middle-income settings: a scoping review. BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2022-068348

AUTHORS

5 · 5 CENTRES

Ling Lee, Elise Moo, Tiffany Angelopoulos, Sarity Dodson, Aryati Yashadhana

1International Programs Division, The Fred Hollows Foundation Melbourne, Carlton, Victoria, Australia
2School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
3Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
4Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
5School of Population Health, University of New South Wales, Sydney, New South Wales, Australia