Rapid assessment of healthcare institution capacities for surgical treatment of strabismus in non-epidemic conditions

Abstract

Strabismus is a motor-sensory anomaly, i.e., eye position and binocular vision anomaly. It occurs in both children and adults, and leads to a high risk of vision problems if not treated in time. Capacities of the Serbian healthcare system face significant challenges in providing surgical treatment for strabismus. This study was conducted as a combined, quantitative and qualitative cross-sectional study from early May to late June 2019 in secondary and tertiary healthcare institutions with ophthalmological organisational units. Out of 46 healthcare institutions that met the criteria for inclusion, 30 submitted the requested data. These 30 institutions employed 211 ophthalmology specialists, of which 14 (7%) stated that they had been trained to perform surgical treatment of strabismus, while two (1%) specialists were currently undergoing training. Of the overall number of healthcare institutions encompassed by this research, eight (27%) were providing these surgeries. Thirteen (43%) healthcare institutions had an adequate number of anaesthesiologists for their healthcare level. Eleven (37%) healthcare institutions listed a lack of adequately equipped facilities to perform surgical treatment of strabismus, i.e., lack of a dedicated operating room. Out of the total number of healthcare institutions, four (13%) had an adequate set of instruments for surgical strabismus treatment. Seven (23%) healthcare institutions listed that they were able to procure the necessary consumables for this type of surgery without hindrance. The healthcare system in the Republic of Serbia must be empowered in the segments that have been recognised as weak links in the provision of surgical treatment of strabismus. This means, primarily, educating ophthalmology specialists to perform these surgeries and referring doctors to specialisations in the field of anaesthesiology, reanimation and intensive care.