Speaker
Description
Background: The magnitude and distribution of ocular morbidities as well as the success of mainstreaming primary eye care (PEC) into primary health care (PHC) are strongly influenced by community services utilisation, yet evidence in this area remains limited.
Objectives: Identify determinants of eye health service utilisation in Central Sidama zone, Ethiopia using the Andersen Behavioural Model of Health Service Use as a guiding framework.
Methods: A community-based cross-sectional study was conducted (March 23 - April 09, 2025), nested within a broader all-age population survey. A two-stage cluster random sampling method was employed and all adults aged ≥18 years were included. Data were collected through face-to-face interviews using a pretested questionnaire. A Generalized Linear Mixed Model (GLMM), adjusted for household level clustering, was employed to identify factors that determine eye health service utilisation.
Results: Data were obtained from 3,221/3456 (93.20%) adults. Median age was 35 years (interquartile range (IQR) 25–45); 1,731 (53.74%) were females. Only 66 (2.05%) and 414 (12.85%) utilised eye health and general healthcare services respectively in the preceding year. Among participants with current eye care need (1,576, 48.93%), only 58 (3.68%) sought care. Predisposing factors that predicted service use included older household head age (AOR=1.02; 95% CI: 1.00–1.04), employment (AOR=2.17; 95% CI: 1.00–4.69), being married (AOR=4.18; 95% CI: 1.40–12.52), and positive belief toward eye health (AOR=4.29; 95% CI: 2.33–7.91). Enabling factors were higher household dependency ratio (AOR=1.22; 95% CI: 1.01–1.47), and health insurance membership (AOR=2.07; 95% CI: 1.15–3.75). Need factors that necessitated service use were presence of non-vision impairing ocular morbidity (AOR=1.78; 95% CI: 1.02–3.11) and self-reported eye problems (AOR=7.58; 95% CI: 3.77–15.25).
Conclusion: Eye health service utilisation was low despite substantial unmet need. Demographic and attitudinal (predisposing), health insurance enrolment (enabling), and perceived and clinical (need) factors influenced eye health service use.
Recommendations: establishing equitably accessible PEC fully integrated within PHC, with efforts to improve awareness, reduce access barriers, and expand health insurance coverage, is crucial.
