Lived experience and lessons learned from the support of two secondary eye care units to improve cataract surgery and refractive services in two regions of Ethiopia: health system-strengthening support.

Background: Blindness and poor eyesight are significant public health issues globally and specifically in Ethiopia. In Ethiopia, there is limited access to cataract surgery and refractive error treatment centers. Therefore, this study aimed to evaluate the role of health system support in improving access to eye care services, particularly cataract surgery and refractive error treatment services in two secondary eye care units (SECUs).

Methods: A parallel mixed-lived experience study was conducted in two SECUs. A desk review of relevant project documents and health facility activity reports was performed for quantitative data. The study was conducted from 12 December 2022 to 30 January 2023. A total of 21 in-depth interview participants were included.

Results: Overall, 14 106 cataract surgeries were performed during the pilot project implementation period. Assela Teaching and Referral Hospital Eye Care Unit performed cataract surgery 20-30 times per week. Similarly, Debre Tabor Comprehensive Hospital performed cataract surgery 18-24 times per week. The refractive service of the two SECUs was planned to range from 15-30 to 60 per week, and the refractive services were increased from 50-60 per week in both eye care units.

Conclusions: This project has significantly helped the existing health system achieve the 2030 global target and has improved access to eye care services in selected SECUs. The use of cataract surgery and refractive error performance markedly increased from 0 to 100%.