02515nas a2200313   4500000000100000008004100001260003400042653005700076653002100133653002800154100001500182700001300197700001100210700001200221700001500233700001200248700001200260700001200272700001400284700001300298700001200311700001400323245017300337856009200510300001200602490000700614520155500621022002502176       2021                            d  bOxford University Press (OUP)10aPublic Health, Environmental and Occupational Health10aGeneral Medicine10aHealth (social science)1 aBechange S1 aJolley E1 aTobi P1 aMailu E1 aSentongo J1 aChulu T1 aAbony M1 aChege M1 aMulenga G1 aNgorok J1 aAdera T1 aSchmidt E00aUnderstanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study  uhttps://academic.oup.com/inthealth/article-pdf/14/Supplement_1/i57/43288574/ihab061.pdf  ai57-i630 v143 a<p>Background</p>

<p>Cataract is a major cause of visual impairment globally, affecting 15.2 million people who are blind, and another 78.8 million who have moderate or severe visual impairment. This study was designed to explore factors that influence the uptake of surgery offered to patients with operable cataract in a free-of-charge, community-based eye health programme.</p>

<p>Methods</p>

<p>Focus group discussions and in-depth interviews were conducted with patients and healthcare providers in rural Zambia, Kenya and Uganda during 2018–2019. We identified participants using purposive sampling. Thematic analysis was conducted using a combination of an inductive and deductive team-based approach.</p>

<p>Results</p>

<p>Participants consisted of 131 healthcare providers and 294 patients. Two-thirds of patients had been operated on for cataract. Two major themes emerged: (1) surgery enablers, including a desire to regain control of their lives, the positive testimonies of others, family support, as well as free surgery, medication and food; and (2) barriers to surgery, including cultural and social factors, as well as the inadequacies of the healthcare delivery system.</p>

<p>Conclusions</p>

<p>Cultural, social and health system realities impact decisions made by patients about cataract surgery uptake. This study highlights the importance of demand segmentation and improving the quality of services, based on patients’ expectations and needs, as strategies for increasing cataract surgery uptake.</p>
  a1876-3413, 1876-3405