Full citation: Ramke J, Petkovic J, Welch V, Blignault I, Gilbert C, Blanchet K, Christensen R, Zwi AB, Tugwell P. Interventions to improve access to cataract surgical services and their impact on equity in low- and middle-income countries. Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No.: CD011307. DOI: 10.1002/14651858.CD011307.pub2
What is the aim of this
The aim of this Cochrane Review was to find out if there are ways to make it easier for people in low- and middle-income countries (LMICs) to have surgery, and to make surgery available fairly (no inequity) within LMICs.
Cochrane researchers collected and analysed all relevant studies to answer this question and found two studies.
The shows that offering free surgery may increase uptake of surgery in LMICs. There is no evidence on whether this might reduce the level of sight loss due to in the community, or whether this helps reduce inequity (makes things fairer). Help with transport, additional information or counselling may not improve uptake, again with no evidence on levels of blindness or inequity. The evidence was from two small studies in rural China.
What was studied in the
As people get older, the lens of the eye becomes cloudy leading to sight loss and blindness. The cloudy lens is known as a . Doctors can remove the and replace it with an artificial lens. This is usually successful surgery and restores sight.
Cataract surgery is distributed unfairly in the world. More people in LMICs have cataracts that cause sight loss and blindness because it is harder to getsurgery. When some people have less chance of good health care, such as surgery, this is known as inequity. There is also inequity within LMICs as poorer people and women also have less chance of having surgery.
To address this problem, Cochrane researchers wanted to find out if there are ways to improve the chances of gettingsurgery in LMICs and so lower the burden of . They also wanted to see if this makes it fairer (less inequity) and helps everyone to get an equal chance to have surgery. They planned to consider many different aspects including acceptability, affordability and availability of services.
What are the main results of the
The Cochrane researchers found two relevant studies. Both studies were from China and took place in a rural area. One gave people additional information and counselling and compared this with giving no additional information or counselling. The other looked at providing free surgery, and help with the costs of transport to hospital, compared with low-cost surgery and no help with transport. The findings were as follows.
• Offering more information or counselling may not improve referral and uptake of surgery (low-certainty evidence).
• Offering free surgery may increase the uptake of surgery (low-certainty evidence).
• There was no evidence on what happens to the levels of in the community.
How up-to-date is this
The Cochrane researchers searched for studies that had been published up to 12 April 2017.
© Peter Martin, Licence: CC BY-NC 2.0, Published in: Community Eye Health Journal www.cehjournal.org