Eye Care Service Use and Associated Health-Seeking Behaviors Among Malawian Adults: Secondary Analysis of the Malawi Fifth Integrated Household Survey 2019-2020

Abstract

Background: The use of eye care services varies among different population groups.

Objective: This study aimed to assess self-reported eye care use (ECU) and associated demographic factors among Malawian adults.

Methods: This study used secondary data from the Malawi Fifth Integrated Household Survey 2019-2020, a nationally representative survey. The study included 12,288 households and 27,336 individuals 15 years and older. We entered age, sex, level of education, residency (urban/rural), and chronic disease into a logistic regression model, and used a confusion matrix to predict the model's accuracy. A P value <.05 was considered statistically significant.

Results: About 60.6% (95% CI 60.0%-61.2%) of those with eye problems accessed formal care 2 weeks before the survey date. A logistic regression model showed that ECU was positively associated with education compared to none (odds ratio [OR] 6.6, 95% CI 5.927-7.366; P<.001), males compared to females (OR 1.2, 95% CI 1.104-1.290; P<.001), and urban residence compared to rural (OR 1.2, 95% CI 1.118-1.375; P<.001). ECU was negatively associated with age (OR 7, 95% CI 6.782-8.476; P<.001) and having chronic diseases (OR 0.6, 95% CI 0.547-0.708; P<.001).

Conclusions: Social support, women empowerment, education, and mobile clinics are key strategic areas that would increase access to eye care in Malawi. Further studies can investigate ECU among the pediatric population.

Keywords: ECU; Malawi; access to health; education; empowerment; eye; eye care; eye care use; eye service; health service use; health service utilization; health-seeking behavior; ophthalmology; pediatric; social support; sociodemographic determinant; use; utilization; visual; visual impairment; women empowerment.