Process Evaluation of the Hospital Based Community Eye Health Programme in Mfantseman Municipality by Operation Eyesight Universal

Abstract

Background: Visual impairment can negatively impact every aspect of the life of an individual. Globally, the prevalence of visual impairment is estimated to be 285 million, of which 39 million are blind. Adequate knowledge on eye care by primary health workers is very essential in integrating primary eye care services into public health care practices. This study describes the evaluation features and results of the Hospital Based Community Eye Health Programme (HBCEHP) in Mfantseman Municipality. Objective: The study aimed at determining whether the HBCEHP was implemented as planned and the moderating factors influencing its implementation in the Mfantseman Municipality. Method: The study used a cross–sectional study design. Medical Research Council framework was used to examine the Primary Eye Care (PEC) implementation and to identify enablers and barriers to the implementation. The process evaluation used mixed methods research approach to draw results from several sources including a survey on 29 Community Health Workers (CHWs), review of program’s documents and in-depth interviews with 12 key stakeholders. Results: The fidelity of implementation of the HBCEHP is estimated to be 73.12%. Evaluation data of the programme indicates that; since 2017, about 28,306 eye screening and 2,132 surgeries, and other forms treatment has been performed through the HBCEHP. So far, 36 CHWs have been trained on PEC. The barriers to implementation among many other health system challenges were poor sense ownership by the CHWs and occasional delays in the payment of allowances of CHWs. Conclusion: The fidelity of implementation of the HBCEHP in Mfantseman Municipality is rated above average with a score of 73.12%. However, key lesson from the process evaluation is that; there is the need to strengthen the existing health system practices within the Municipality.