Task sharing in the eye care workforce: Screening, detection, and management of diabetic retinopathy in Pakistan. A case study

Article


Shah, Mufarriq, Noor, Ayesha, Deverell, Lil, Ormsby, Gail M., Harper, C. Alex and Keeffe, Jill Elizabeth. 2018. "Task sharing in the eye care workforce: Screening, detection, and management of diabetic retinopathy in Pakistan. A case study." International Journal of Health Planning and Management. 33 (3), pp. 627-636. https://doi.org/10.1002/hpm.2508
Article Title

Task sharing in the eye care workforce: Screening, detection, and management of diabetic retinopathy in Pakistan. A case study

ERA Journal ID13593
Article CategoryArticle
AuthorsShah, Mufarriq, Noor, Ayesha, Deverell, Lil, Ormsby, Gail M., Harper, C. Alex and Keeffe, Jill Elizabeth
Journal TitleInternational Journal of Health Planning and Management
Journal Citation33 (3), pp. 627-636
Number of Pages10
Year2018
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0749-6753
1099-1751
Digital Object Identifier (DOI)https://doi.org/10.1002/hpm.2508
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1002/hpm.2508
Abstract

Purpose: Diabetic retinopathy (DR) is a preventable cause of vision loss. Reducing vision loss due to DR and providing access to eye care services for people with diabetes have been severely constrained by a shortage in the number of ophthalmologists. This study aimed to explore the potential for task sharing in the eye care workforce for screening, detection, and management of DR. Methods: Using purposive sampling, 24 participants were recruited from four selected hospitals in 2 provinces in Pakistan. Face-to-face interviews were conducted to explore the potential for task sharing in DR management. Results: Amongst 24 participants recruited, 22 (91.7%) including administrators (n = 3), ophthalmologists (n = 10), optometrists (n = 3), mid-level eye care workers (n = 4), and endocrinologist (2) participated in the study. All participants indicated the need for an organised screening program for DR detection through task sharing. Participants suggested that people with diabetes can be sent directly to an optometrist for initial eye exams, rather than making them wait to be examined by an ophthalmologist. Factors favouring task sharing included the name task sharing rather than task shifting and a high demand for eye care services. Major barriers to implementation of task sharing included the lack of a trained eye care workforce in the healthcare system and the lack of coordination amongst health professionals and policy makers. Conclusion: Participants were accepting task sharing approach and believed that task sharing could improve access to eye care services for people with diabetes and better utilise the services of eye and healthcare providers.

Keywordsdiabetes; diabetic retinopathy; Pakistan; task sharing
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Byline AffiliationsPakistan Institute of Community Ophthalmology, Pakistan
Khyber Medical University, Pakistan
Swinburne University of Technology
Avondale College of Higher Education, Australia
University of Melbourne
LV Prasad Eye Institute, India
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