ASSESSING THE ACCESSIBILITY, AFFORDABILITY, AND ACCEPTABILITY OF REFRACTIVE SERVICES AS BARRIERS TO UPTAKE OF THESE SERVICES IN KAKAMEGA MUNICIPALITY, KENYA

ABSTRACT Background information: Refractive errors and presbyopia remain a burden to the entire population. An estimated 76% of the 191 million blind people have preventable or treatable causes. Uncorrected Refractive Error (URE), the number one cause (51%) of moderate and severe vision impairment is easily preventable. Aim: The study aimed to evaluate the accessibility, affordability, and acceptability of refractive services in Kakamega Municipality. Methodology: A population-based descriptive cross-sectional study was undertaken in Kakamega municipality using a cluster sampling method and descriptive data analysis. Results: Out of 358 participants, 199 (55.6%) were male and 159 (44.4%) were female. The analysis shows affordability (18.3%) as the main reason for not using spectacles, followed by lack of quality care (3.4%), access to eye care (3.4%), awareness (2.5%), unpleasant past experiences (2.2%), importance not given to eye care issues (1.6%), lack of communication (0.9%), and disapproval from family members (0.9%). The study found that the affordable price range for spectacles varies between Kshs.5000 and less than Kshs.2000. More participants (38.0%) reported above Kshs.5000, while 29% indicated less Kshs.2000. The study found that affordability (p = 0.000), availability (p=0.004), and accessibility (p=0.005) of refractive services significantly influenced the uptake of these services. Conclusion: The study reveals that refractive services in Kakamega municipality are not easily accessible due to the lack of adequate services in government hospitals. Additionally, patients in the municipality struggle to afford spectacles due to the direct cost of spectacles and the lack of services in easily accessible public facilities. Keywords: Barriers Accessibility Affordability Availability Uptake Refractive services