Coverage, utilization and barriers to cataract surgical services in rural South India: results from a population-based study

Public Health. 2007 Feb;121(2):130-6. doi: 10.1016/j.puhe.2006.07.027. Epub 2007 Jan 9.


Objectives: To determine the cataract surgical coverage, utilization and barriers to cataract surgery in a rural taluk of south India.

Study design: A cross-sectional, community-based survey.

Methods: A house-to-house survey was carried out in 15 villages that were selected by cluster sampling during January to October, 2002. A total of 1505 people aged 50 years and above were tested for visual acuity (VA) and their eyes examined. Cataract surgical coverage was calculated for people and eyes, and for VA levels of <3/60 and <6/60. Information about details of cataract surgery and barriers to cataract surgery were collected using a pre-designed proforma.

Results: Cataract surgical coverage was 63% (people) and 51% (eyes) for VA<3/60 compared with 49% (people) and 36% (eyes) for VA<6/60. Of 109 operated eyes, 51.2% of operations were carried out in private hospitals and 33.3% in voluntary/charitable hospitals. Inability to afford the operation (22.9%) and fear of the operation (19.2%) were the main barriers to cataract surgery.

Conclusions: The reasons for underutilization of government hospitals are to be investigated. Awareness of low-cost cataract intraocular lens (IOL) non-governmental organization (NGO) surgery and free-of-cost NGO services available in the region needs to be raised. Barriers to cataract surgical services should be addressed by community-based health-education programmes to improve the uptake of existing services.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cataract / diagnosis
  • Cataract / epidemiology*
  • Cataract Extraction / economics
  • Cataract Extraction / statistics & numerical data*
  • Cluster Analysis
  • Cross-Sectional Studies
  • Female
  • Health Care Costs
  • Health Care Surveys
  • Health Services Accessibility / economics*
  • Hospitals, Proprietary / economics
  • Hospitals, Proprietary / statistics & numerical data
  • Hospitals, Public / economics
  • Hospitals, Public / statistics & numerical data
  • Hospitals, Voluntary / economics
  • Hospitals, Voluntary / statistics & numerical data
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Prevalence
  • Rural Health Services / classification
  • Rural Health Services / economics
  • Rural Health Services / statistics & numerical data*
  • Vision Screening
  • Visual Acuity