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ORIGINAL ARTICLE
Year : 2020  |  Volume : 68  |  Issue : 5  |  Page : 841-846

Availability of eye care infrastructure and human resources for managing diabetic retinopathy in the western province of Sri Lanka


1 National Eye Hospital, Deans Road, Colombo 10 -, Sri Lanka
2 Professor of Public Health for Eye Care and Disability, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK

Correspondence Address:
Dr. Mapa Mudiyanselage Prabhath Nishantha Piyseana
Vitreo-Retina Unit, National Eye Hospital, Deans Road, Colombo 10
Sri Lanka
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1754_18

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Purpose: Blindness and visual impairment due to diabetic retinopathy (DR) are avoidable by early screening and timely treatment. The western province of Sri Lanka has the highest prevalence of diabetes mellitus (18.6%) in the country. DR had been given less attention in services expansion because of lack of evidence. The aim of this study was to assess the availability of human resources (HR) and infrastructure for DR in eye care facilities. Methods: A cross-sectional survey was conducted in 51 health care institutions by administering a validated questionnaire schedule and through semi-structured interviews. The data on infrastructure, HR and level of training, and skills were collected during the site visits by observation, frequency counting, and interviewing. Key findings of the interviews were recorded using categorical responses. Data analysis was done using MS-Excel® and STATA/IC®-Version 2-13.0 packages. Results: The response rate of the survey was 84.3% (43/51). There were 40 board-certified ophthalmologists and 6 vitreo-retinal surgeons in the region, of whom 77.5% (31/40) were in Colombo district. The highest population-adjusted DR-related infrastructure ratios were recorded from Colombo district. Mid-level cadres such as medical officers' mean skill score of DR screening and treatment was low (0.37, 95% CI 0.32-0.40). Conclusion: There is no systematic DR screening program, and HR and infrastructure distribution was not aligned to the population need in the western province. Urgent attention should be paid to expand the service delivery and mid-level HR training for DR screening and treatment in this region.


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