Establishing a school-based vision screening program in Myanmar: a qualitative study on the perspectives of school children with refractive error, teachers, optometrists and ophthalmologists

Authors

  • Soe Min Oo Department of Epidemiology, University of Public Health, Yangon, Myanmar
  • Myo Mon Mon Department of Medical Research, Ministry of Health and Sports, Myanmar
  • Khaing Lay Mon Department of Health Behavior and Communication, University of Public Health, Yangon

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20210781

Keywords:

Uncorrected refractive error, School children, School-based vision care program

Abstract

Background: Refractive error (RE) is one of the global leading causes of vision impairment among children. The World Health Organization outlined the school-based vision care program aided by school teachers as one solution. In Myanmar, although the prevalence of RE among school children is expected at about two million, a regular eye check-up program has not been established. This study aimed to explore the barriers, feasibility, and limitations of the children with RE and service providers to establish a program.

Methods: This qualitative study was conducted in eight public schools,that have been involved in the pilot school-based vision screening program, in Yangon.  Focus group discussions with school children and teachers from these schools, key informant interviews with optometrists and ophthalmologists, involved in the program, and working at Yangon Eye Hospital and North Okala General Hospital, were carried out from January to August 2020. Qualitative data analysis was manually performed using the grounded theory according to the pre-defined themes.

Results: Almost all school children showed positive perspectives but they expressed their psychosocial barriers of the cost, time, and care given by their parents on the next vision examination. All teachers mentioned optimism to be volunteers. The optometrist and ophthalmologists revealed the feasibility to establish the program despite having limitations in human resources, logistic requirements, and low awareness level on visual impairment of the children by parents.

Conclusions: This study highlighted that a school-based vision care program can be initiated in Myanmar despite having some barriers and limitations.

References

WHO. 2017. World Health Organization. Vision impairment and blindness. Available at https:// www. who.int/ news-room/fact-sheets/ detail/ blindness- and- visual- impairment. Accessed 1 January 2021.

Morjaria P, Bastawrous A. Helpful developments and technologies for school eye health programs. Community Eye Heal J. 2017;30(98):34-6.

IAPB. 2018. Standard School Eye Health Guidelines for Low and Middle-Income Countries. 2018. Available at https:// www. iapb. org/wp-content/ uploads/ Guidelines- School- Eye- Health-Programmes- English-Final. pdf. Accessed on 1 January 2021.

Dudovitz RN, Izadpanah N, Chung PJ, Slusser W. Parent, teacher, and student perspectives on how corrective lenses improve child wellbeing and school function. Matern Child Health J. 2016;20(5):974-83.

Bruce A, Sanders T, Sheldon TA. A qualitative study investigating the perceptions of parents of children who failed a vision screening at the age of 4-5 years. BMJ Paediatr Open. 2018;2(1):000307.

Burnett AM, Yashadhana A, Lee L, Serova N, Brain D, Naidoo K. Interventions to improve school-based eye-care services in low- and middle-income countries: a systematic review. Bulletin World Health Organization. 2018;96(10):682-94.

Yasmin S, Minto H, Chan VF. School eye health - Going beyond refractive errors. Community Eye Health J. 2015;28(89):14-5.

Khan I. A simple way to make learning easier for many children: eyeglasses. Global Partnership for Education. Available at https://www.globalpartnership.org/blog/simple-way-make-learning-easier-many-children-eyeglasses. Accessed on 1 January 2020.

HKI. Helen Keller International. Preventing childhood blindness in underserved populations in Indonesia. Available at: https:// www. unicef.org/ media/media_26673.html?p=printme. Accessed on 11 September 2020.

Kaur G, Koshy J, Thomas S, Kapoor H, Zachariah JG, Bedi S. Vision screening of school children by teachers as a community-based strategy to address the challenges of childhood blindness. J Clin Diagnostic Res. 2016;10(4):9-14.

Teerawattananon K, Myint CY, Wongkittirux K. Assessing the accuracy and feasibility of a refractive error screening program conducted by school teachers in pre-primary and primary schools in Thailand. PLoS One. 2014:0096684

Holguin AM, Congdon N, Patel N, et al. Factors associated with spectacle- wear compliance in school-aged Mexican children. Investig Ophthalmol Vis Sci. 2006;47(3):925-8.

Congdon N, Zheng M, Sharma A. Prevalence and determinants of spectacle non-wear among rural Chinese secondary schoolchildren: The Xichang pediatric refractive error study report 3. Arch Ophthalmol. 2008;126(12):1717-23.

Odedra N, Wedner SH, Shigongo ZS, Nyalali K, Gilbert C. Barriers to spectacle use in Tanzanian secondary school students. Ophthalmic Epidemiol. 2008;15(6):410-7.

Li L, Song Y, Liu X. Spectacle acceptance among secondary school students in rural China: The Xichang Pediatric Refractive Error Study (X-PRES) - Report 5. Investig Ophthalmol Vis Sci. 2008;49:2895-902.

Yabumoto C. ARVO Annual Meeting Abstract. April 2009 factors associated with spectacles-use compliance in a visual screening program for children from southern Brazil. Investig Ophthalmol Vis Sci J. 2009;50(13):89-95.

Li L, Lam J, Lu Y. Attitudes of students, parents, and teachers toward glasses use in rural China. Arch Ophthalmol. 2010;128(6):759-65.

HKI Report.2019. Prevalence of refractive error among school children in some states and regions of Myanmar. Hellen Keller International. 2019.

Ministry of Education.2015. Myanmar National Education Strategic Plan 2016-2021.

Ministry of Immigration and Population. The 2014 Myanmar Population and Housing Census. 2014.

Ministry of Health and Sports. 2017. Myanmar National Comprehensive School Health Strategic Plan (2017-2022). Available at: http:// mohs.gov.mm/su/hzqTZ. Accessed on 11 September 2020.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Heal Care. 2007;19(6):349-57.

Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research. Adm Policy Ment Heal Ment Heal Serv Res. 2015;42(5):533-44.

Heath H, Cowley S. Developing a grounded theory approach: A comparison of Glaser and Strauss. Int J Nurs Stud. 2004;41(2):141-50.

Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;117:94-99.

Sharma A, Congdon N, Patel M, Gilbert C. School-based approaches to the correction of refractive error in children. Surv Ophthalmol. 2012;57(3):272-83.

Puri S, Dang RS, Akshay. Evaluation of QOS (quality of services) by log frame analysis (LFA) and ocular morbidity in school children of Chandigarh. Int J Pharm Pharm Sci. 2014;6(9):55-8.

Priya A, Veena K, Thulasiraj R. Vision screening by teachers in Southern Indian schools: Testing a new “all class teacher” model. Ophthalmic Epidemiol. 2015;1-6:2014.

Arteaga LS, González GD, Enciso O, Phelan A, Muñoz GA, Kohler J. Reducing visual deficits caused by refractive errors in school and preschool children: Results of a pilot school program in the Andean region of Apurimac, Peru. Glob Health Action. 2014;7:22656.

Pereira SM, Blignault I, du Toit R, Ramke J. Improving access to eye health services in rural Timor-Leste. Rural Remote Health. 2012;12:2095.

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Published

2021-02-24

How to Cite

Oo, S. M., Mon, M. M., & Mon, K. L. (2021). Establishing a school-based vision screening program in Myanmar: a qualitative study on the perspectives of school children with refractive error, teachers, optometrists and ophthalmologists. International Journal Of Community Medicine And Public Health, 8(3), 1052–1058. https://doi.org/10.18203/2394-6040.ijcmph20210781

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Original Research Articles