Worldwide rural people have lack of access to eye care services leading to suboptimal uses of existing services. In Bangladesh, eye care services virtually not exist in the rural area and upazila (sub district) level, and eye care is mostly provided in secondary level hospitals located in district towns. Therefore, the BRAC Vision Centre is the first point of eye care facility in the community that provides comprehensive eye care services provided by the vision technicians, graduated as mid-level ophthalmic personnel (MLOP). This study was performed to explore both user and provider perspective on the eye healthcare in rural community and patients perceptions on BRAC vision centre.
The study was an explorative in nature conducted in Mymensingh, Dinajpur and Khulna district where BRAC vision centre is currently operating. Participants involved community people, patients and their close relatives, respective programme personnel, and representatives from Banglades National Society for the Blind Hospital. Participants were asked about eye healthcare seeking practices, satisfaction of the eye care services at vision centre, referral services, constraints and sustainability.
People usually received eye care services from vision centre, private chambers, pharmacy shop, private/community/national eye hospitals, traditional healers, homeopaths and eye camp. The most frequently cited Exploring user and Provider Perspective on Eye Health Care Services of BRAC barriers for seeking eye care include cost, distance, accessibility, preference for traditional practitioners and prior experience. Over 20 of the participants and almost all of the relatives (16) expressed overall satisfaction with the service provided by the vision centre technicians. There were several reasons for dissatisfaction such as providers qualification, long waiting time for telemedicine (≥1 hour), price and delay in delivery (≥ 7 days) of spectacles.
The vision centres fulfill an essential role in delivering primary eye healthcare to the rural population of Bangladesh. However, quality assurance is the issues that need to be addressed urgently. A salient massage from this study is that community based primary eye care centre like the vision centre could be sustainable through proper advertising, implementing effective eye health and awareness campaigns, full-time consultancy from the eye specialists and increasing integration with other programmes and organisations.