Multicenter Study

. 2024 Sep;44(6):1148-1161.

doi: 10.1111/opo.13348. Epub 2024 Jun 16.

Strategies to address inequity of uncorrected refractive error in the Western Pacific: A modified Delphi process

Ian McCormick¹, Kelvin Tong^{1

2}, Nurliyana Abdullah^{3

4}, Carmen Abesamis-Dischoso⁵, Theresa Gende^{6

7}, Effendy Bin Hashim^{8

9}, S May Ho¹⁰, Isabelle Jalbert¹¹, Belmerio Jeronimo¹², Elenoa Matoto-Raikabakaba¹³, Koichi Ono¹⁴, Prabhath Nishantha Piyasena^{15

16}, Jaymie T Rogers¹⁷, John Szetu¹⁸, Minh Anh Tran¹⁹, Dennis Yan-Yin Tse²⁰, Ye Win²¹, Tiong Peng Yap²², Sangchul Yoon²³, Mayinuer Yusufu^{24

25}, Matthew J Burton^{1

26}, Jacqueline Ramke^{1

17}; Promoting Equity in Refractive Error Services in the Western Pacific Study Group

Collaborators, Affiliations

Collaborators

Promoting Equity in Refractive Error Services in the Western Pacific Study Group:
Anthea M Burnett, Aryati Yashadhana, Shelley O S Hopkins, Catherine L Jan, Hugh R Taylor, Hongshen Bi, Mengtain Kang, Ningli Wang, Xiaohui Yang, Chen-Wei Pan, Yan Wang, Min Wu, Hua Zhong, Haidong Zou, Harris Muzammil Ansari, Mundi Q Qoqonokana, Kendrick Shih, Yoshimune Hiratsuka, Ryo Kawasaki, Norsham Ahmad, Shah Farez Othman, Fakhruddin Shamseer Barodawala, Duratul Ain Hussin, Farziah Ngah, Mohd Zaki A Isa, Bariah Mohd Ali, Norhani Modidin, Tarati R Blair-Hunt, Rebecca W Findlay, Veeran Umish Morar, Philip R K Turnbull, Deepa Ben Kumar, John Farmer, Benjamin Zuvani, Yu-Chi Liu, Hon Shin Ong, Vu Tuan Anh

Affiliations

¹ International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
² Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
³ PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam.
⁴ Eccles Institute of Neuroscience, The John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia.
⁵ The Professional ODs Society, Pasig, Philippines.
⁶ Divine Word University, Madang, Papua New Guinea.
⁷ The Fred Hollows Foundation New Zealand, Madang, Papua New Guinea.
⁸ Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
⁹ Ministry of Health, Putrajaya, Malaysia.
¹⁰ The Fred Hollows Foundation, Melbourne, Victoria, Australia.
¹¹ School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia.
¹² Department of Ophthalmology, Guido Valadares National Hospital, Dili, Timor-Leste.
¹³ Colonial War Memorial Hospital, Suva, Fiji.
¹⁴ Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, Japan.
¹⁵ Directorate of Policy Analysis and Development, Ministry of Health, Colombo, Sri Lanka.
¹⁶ Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
¹⁷ School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.
¹⁸ The Fred Hollows Foundation New Zealand Regional Eye Centre, Honiara, Solomon Islands.
¹⁹ Department of Ophthalmology and Optometry, Hanoi Medical University, Hanoi, Vietnam.
²⁰ School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
²¹ Sight for All, Yangon, Myanmar.
²² IGARD Vision Therapy Centre, Singapore City, Singapore.
²³ Department of Medical Humanities and Social Sciences, College of Medicine, Yonsei University, Seoul, South Korea.
²⁴ Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Victoria, Australia.
²⁵ Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
²⁶ National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.

PMID: 38881170
PMCID: PMC7618279
DOI: 10.1111/opo.13348

Multicenter Study

Strategies to address inequity of uncorrected refractive error in the Western Pacific: A modified Delphi process

Ian McCormick et al. Ophthalmic Physiol Opt. 2024 Sep.

. 2024 Sep;44(6):1148-1161.

doi: 10.1111/opo.13348. Epub 2024 Jun 16.

Authors

Collaborators

Promoting Equity in Refractive Error Services in the Western Pacific Study Group:
Anthea M Burnett, Aryati Yashadhana, Shelley O S Hopkins, Catherine L Jan, Hugh R Taylor, Hongshen Bi, Mengtain Kang, Ningli Wang, Xiaohui Yang, Chen-Wei Pan, Yan Wang, Min Wu, Hua Zhong, Haidong Zou, Harris Muzammil Ansari, Mundi Q Qoqonokana, Kendrick Shih, Yoshimune Hiratsuka, Ryo Kawasaki, Norsham Ahmad, Shah Farez Othman, Fakhruddin Shamseer Barodawala, Duratul Ain Hussin, Farziah Ngah, Mohd Zaki A Isa, Bariah Mohd Ali, Norhani Modidin, Tarati R Blair-Hunt, Rebecca W Findlay, Veeran Umish Morar, Philip R K Turnbull, Deepa Ben Kumar, John Farmer, Benjamin Zuvani, Yu-Chi Liu, Hon Shin Ong, Vu Tuan Anh

Affiliations

¹ International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
² Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
³ PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam.
⁴ Eccles Institute of Neuroscience, The John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia.
⁵ The Professional ODs Society, Pasig, Philippines.
⁶ Divine Word University, Madang, Papua New Guinea.
⁷ The Fred Hollows Foundation New Zealand, Madang, Papua New Guinea.
⁸ Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
⁹ Ministry of Health, Putrajaya, Malaysia.
¹⁰ The Fred Hollows Foundation, Melbourne, Victoria, Australia.
¹¹ School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia.
¹² Department of Ophthalmology, Guido Valadares National Hospital, Dili, Timor-Leste.
¹³ Colonial War Memorial Hospital, Suva, Fiji.
¹⁴ Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, Japan.
¹⁵ Directorate of Policy Analysis and Development, Ministry of Health, Colombo, Sri Lanka.
¹⁶ Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
¹⁷ School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.
¹⁸ The Fred Hollows Foundation New Zealand Regional Eye Centre, Honiara, Solomon Islands.
¹⁹ Department of Ophthalmology and Optometry, Hanoi Medical University, Hanoi, Vietnam.
²⁰ School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
²¹ Sight for All, Yangon, Myanmar.
²² IGARD Vision Therapy Centre, Singapore City, Singapore.
²³ Department of Medical Humanities and Social Sciences, College of Medicine, Yonsei University, Seoul, South Korea.
²⁴ Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Victoria, Australia.
²⁵ Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
²⁶ National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.

PMID: 38881170
PMCID: PMC7618279
DOI: 10.1111/opo.13348

Abstract

Purpose: Uncorrected refractive error is the leading cause of vision impairment globally; however, little attention has been given to equity and access to services. This study aimed to identify and prioritise: (1) strategies to address inequity of access to refractive error services and (2) population groups to target with these strategies in five sub-regions within the Western Pacific.

Methods: We invited eye care professionals to complete a two-round online prioritisation process. In round 1, panellists nominated population groups least able to access refractive error services, and strategies to improve access. Responses were summarised and presented in round 2, where panellists ranked the groups (by extent of difficulty and size) and strategies (in terms of reach, acceptability, sustainability, feasibility and equity). Groups and strategies were scored according to their rank within each sub-region.

Results: Seventy five people from 17 countries completed both rounds (55% women). Regional differences were evident. Indigenous peoples were a priority group for improving access in Australasia and Southeast Asia, while East Asia identified refugees and Oceania identified rural/remote people. Across the five sub-regions, reducing out-of-pocket costs was a commonly prioritised strategy for refraction and spectacles. Australasia prioritised improving cultural safety, East Asia prioritised strengthening school eye health programmes and Oceania and Southeast Asia prioritised outreach to rural areas.

Conclusion: These results provide policy-makers, researchers and funders with a starting point for context-specific actions to improve access to refractive error services, particularly among underserved population groups who may be left behind in existing private sector-dominated models of care.

Keywords: access; equity; financial protection; refraction; refractive error; spectacles.

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Conflict of interest statement

Conflict of Interest statement

The authors have no conflicts of interest to declare.

References

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Strategies to address inequity of uncorrected refractive error in the Western Pacific: A modified Delphi process

Collaborators

Affiliations

Strategies to address inequity of uncorrected refractive error in the Western Pacific: A modified Delphi process

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical