Barriers to the Uptake of Cataract Surgery in Sawankhalok District, Thailand
Keywords:
Healthcare failure, Socioeconomic barriers, Cataract surgery uptake, Thailand universal healthcareAbstract
Purpose: To assess the barriers influencing uptake of cataract surgery
Design: A concurrent mixed methods study
Methods: A total of 101 patients were scheduled for free cataract surgery organized by ‘People Eye Care
Foundation’ (Non-governmental organization program) which provided free treatment, transportation and administered
the registration process in Sawankhalok district. All patients were diagnosed with blinding cataracts or severe cataracts
and cataract surgery was performed in 100% of the patients within 2 days. Five patients were interviewed in person,
using a semi-structured questionnaire and an in-depth interview.
Results: All 5 patients interviewed were diagnosed at Sawankhalok hospital or public health centers and were
aware of their severe cataracts for more than 3 years. The patients were asked why they had not considered going to
the nearby government cataract center hospitals which are free of charge. The following three major barriers emerged
(a) Low income limits the affordability of transportation (b) A misconception that it would require multiple visits and
long waiting time before receiving surgery (c) Poor eyesight is not a major concern.
Conclusion: Socioeconomic factors and a lack of personal knowledge and understanding of the Thai health care
system were reasons for not seeking cataract surgery at the nearby government hospital. The patients were willing
to wait for a long time for the cataract surgery program provided by Non-governmental organization. An integrated
community approach to improve awareness and an update of transfer systems is recommended
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