Abstract of Dissertation

Keyword : Eye health care; Refractive errors; Preventable blindness; Preventive eye care; Slum.

Objective : 1. To assess the knowledge, attitude and practices related to eye health among slum-dwellers. 2. To assess the causes of avoidable blindness and visual impairment as per people’s perception. 3. To assess slum-dwellers capacity and willingness to pay for spectacles. 4. To collect information on health providers that are delivering eye care services to slum communities.

Background : Visual impairment is a global public health problem, especially in the developing nations. Most common causes of preventable blindness are refractive errors and cataract. Seventy five percent to 80 percent of blindness can be avoided in 50 years and above of age group. Although refractive errors account for 19.7 percent among the age group of 50 years and above, it accounts for almost 80 percent in 5-15 years of age group. Eye care among urban poor suffers in the urban area, despite availability of many providers.

Methodology : A total of 321 respondents, 18 years and above were selected via multistage sampling technique and interviewed personally following a pre-structured questionnaire, designed to assess the knowledge, attitude and practice of eye health care among slum dwellers of Colony number 4 in Chandigarh. They were also assessed for their willingness to pay for a corrective measure as menial as a spectacle for rectifying their vision. Few of the main public and private eye care providers were interviewed in order to assess the provision of eye care service provider in the city.

Findings : Around three- fifth (63 %) of the respondents had heard at least about one eye care problem; blurred vision (54%) being the most common. More than two-third (71.3%) got the information from their family/friends. Almost four-fifth (78 %) were aware of places where to seek eye care services and 88 % preferred going to Government setup for the availability of low cost or free services (49 %). One- fourth (25 %) respondents believed that unhygienic conditions causes eye disease(s)/ problem(s). Of those who recently felt the need to seek consultation for eye care problem, 29 % did not go, owing to no time (29 %) to visit the facility. The mean paying capacity of 89 percent respondents willing to pay for corrective measure like a spectacle was Rs 595, with around three-fifth (58%) of the respondents having difficulty to arrange the money. Positive associations at p<0.05 were found between; Socio demographic variables like marital status, educational status, employment status and exposure to knowledge about any eye health problem / diseases. Association between decision maker’s willingness to pay for treatment was found to be highly significant with the monthly income (p=0.008). Government providers share the major burden of slum dwellers mainly due to easy accessibility and affordability. Private providers do organize eye camps as their social responsibility but sponsor a few patients only.

Recommendations : Present study concludes that there is need to generate awareness regarding preventive eye care among slum populations. Although, most of the respondents learn about various causes, preventions and treatments from their surroundings, but there is a need to assure that correct information reaches the masses through effective IEC and BCC and that they should benefit from the services made available by public and private eye care providers equally. Although the monthly income does not suffice the amount to be spent on corrective measures, yet in times of need, urban poor cut on their expenditure and consumption to meet the need. Hence, affordable options should be made available. Age plays an important role in people’s decision to follow preventive measures regarding eye care. Monthly income also decides the willingness to pay for treatment. There is an unequal distribution of specialized eye care services among public and private providers in Chandigarh, therefore an integrated and collaborative framework is needed to provide efficient eye health services.