Table 4

Results of in-depth interview with eye care managers
Discussion themes Quotations
Feeling about the service “… Still the service needs to be developed; surgeons are not using their potential
“…The service is not satisfactorythe backlog is still huge and attention for eye care is very poor
Challenges
Distribution of services Eye care professionals are distributed disproportionatelyno one is willing to go to the district secondary eye units
Cataract surgeons were trained to address the need of rural communities in responses to shortage of ophthalmologists, but only few were happy to work in the secondary eye units, and most relocate to the major towns
Expectation of the cataract surgeons is very high
Poor community awareness The community is not aware of the servicethey do not know that cataract surgery service is provided regularly at their nearest health facilityit is always thought the service is provided by external body through campaigns
The eye care promotion messages are not reaching to the community in need of the servicethey just do not understand what we are talking aboutbecause health promotion materials and messages are delivered in Amharicnot in their local language
Limited/no government support Government officials consider eye care as vertical NGO driven programthey just do not have any idea how huge the problem isthere is no sense of ownership
Poor referral and reporting system There is no appropriate referral system in eye carethe eye units are not linked both horizontally and vertically
“…There is very poor reporting system, cataract surgery is usually under reporteddifferent institutions provide the servicebut we rarely get the reportif you have to know how much is really done, you should go and ask every health facility
Surgical Supplies supplies are not available in the local market
“… we have to import everythingthe offices concerned are slow in processing the clearancethere are times when we are forced to transfer the supplies to other African countries
Solutions
Community awareness “… Promotion of cataract surgery service should be done using local languages and appropriate media
“…Involve IECWs and local village leaders in mobilizing the service
We should target improving the awareness of government officials
Community based programs We need to establish comprehensive and regular outreach program
“…outreach service should be available to access the underserved communities” “…community based screening should be strengthened
Future plans to improve service “…establish primary eye care system and linking it with the existing secondary eye units, five primary eye units to one secondary eye unit
“…Improve the CSR, throughfast track strategy’… planned to perform 6000 cataract surgery per year on top of the existing number and then improving the number every year

Habtamu et al.

Habtamu et al. BMC Health Services Research 2013 13:480   doi:10.1186/1472-6963-13-480

Open Data