Exploring the service users’ experiences of a community-based intervention to improve follow-up at Bharatpur Eye Hospital in Nepal: A Qualitative Study. (Preprint)

Abstract

Follow-up to eye care services for children especially in the context of Nepal is essential for ensuring a continuum of care. Hence, as a continued effort, we designed this study to explore the service users’ experience of this community-based intervention to improve follow-up at Bharatpur Eye Hospital (BEH) in Nepal.

This study aimed to explore the experiences and perceptions of service users about the community-based follow-up intervention for eye-care services implemented by BEH in Nepal.

A qualitative study utilizing an in-depth interview approach was used. Participants were purposively selected for this research study. Participants who were part of a quasi-experimental study conducted to improve follow-up services in BEH and their service catchment area were chosen. Those participants who had not attended even a single follow-up visit and those who attended at least one follow-up were recruited for this qualitative study. Based on the distance from the base hospital and the follow-up status 65 participants were initially found eligible for the qualitative study. However, only 17 participants were available and consented. Topic guides were developed for the purpose of in-depth interviews specifically for participants, who had not attended even the first follow-up visits and those who attended at least one follow-up visit. Two ophthalmic assistants, who were not a part of the main intervention study, conducted the interviews.

Seventeen service users whose children were receiving services from BEH hospital participated in the qualitative study. We identified four key themes that provided invaluable information about the barriers and facilitators to follow-up as well as the experiences (positive/negative) of the participants that needs to be considered in any future initiatives to improve follow-up in Nepal.

It highlights the need for systematic development of interventions to address the unmet need for eye care services in the community through innovative scalable solutions. As a next step, the BEH team will be working to develop such scalable solutions for Nepal. Such interventions will also need to be optimized for similar settings and countries to meet the goals of universal health coverage, vision 2030 and sustainable development goals worldwide.