Productivity of Primary Pediatric Eye Care: Are We There Yet?

Abstract

Aim: To investigate the productivity of primary pediatric eye care and associated barriers. Study Design: A cross-sectional study Place and Duration of Study: Primary health care facilities in Hai and Mwanga districts between August 2023 and July 2024 Methodology: This study involved health care workers in primary health facilities at Hai and Mwanga Districts. These Districts were purposively selected because of ongoing activities for pediatric eye health for years. Simple random sampling was implemented to get the 32 health facilities among 93 public health facilities in Hai and Mwanga districts. Health care workers on the selected facilities at RCH and OPD clinics were interviewed using a structured questionnaire. The register (for 2023) was used to record the number of eye cases in children under 5 years at each health facility to obtain productivity and health care workers on the selected facilities were interviewed using a structured questionnaire to investigate barriers for productivity. Results: A total of 30 health facilities were included, a total of 111 HCW’s were enrolled. Productivity of specific health facilities was calculated as: The number of children under five years eye visits annually per Catchment population for children under five years of age (per 100 population). The mean productivity was found to be 4.95(1.21) per 100 population with 95% confidence interval (2.48-7.43). Majority of health facilities (83.3%) had productivity of less than 10 per 100 population. The most common barriers mentioned are inadequate knowledge and skills, lack of screening tools, poor supervision, lack of medication and staff shortage. Conclusion: The findings of this study underscore persistent productivity challenges in primary pediatric eye care despite ongoing interventions. Productivity remains significantly low across health facilities, with less than 10 cases per 100 population of under-fives. Systemic barriers, including inadequate knowledge, lack of screening tools, poor supervision, medication shortages, and staffing constraints—continue to hinder effective service delivery. Addressing these limitations through targeted training, improved resource allocation, and enhanced oversight is essential for strengthening pediatric eye care services in Northern Tanzania.