Abstract :

AIM: The purpose of this study was to compare the availability and distribution of the various cadres of eye care workforce in Orlu, a sub-urban setting and Owerri metropolis, an urban setting in Imo State, in South Eastern Nigeria, using Vision 2020 standards as benchmarks with Literature review.

Methodology: Two areas in Imo State, namely Orlu and Owerri metropolis were used in this study. This was both a quantitative and qualitative cross-sectional survey. The quantitative data was assessed by distributing interviewer-administered questionnaires to the different categories of eye care workers (ECWs) in the various public health care facilities used in the study. The questionnaires contained sub-sections on the subjects’ sex, age, religion, marital status, level of education, years in service, location of residence, and training in eye care. The qualitative research covered training in eye careappropriateness to job postings as well as sponsorship to updates and workshops/refresher courses  by the various cadres  of eye care workers in the health care facilities under study, using focus group discussions (FGDs) and in-depth interviews (IDIs) .The qualitative interviews of the participants covered the state of study, the study area, type of health facility, sex, type of interview and the category of eye care worker (ECW) and the serial number of the interviewed participant.

Results: The results of the study showed that the eye care workers (n=271) working in 28 public health care Institutions included 45(16.6%) males and 226(83.4%) females with age range of 20-65years, and modal age range of 30-39years, with a mean age of 42.23±11.0 S.D. years. A large proportion 216(79.7%) of ECWs were married and most 206(76.0%) of the workers had tertiary education. A large proportion 170(62.7%) of the ECWs live in Owerri and the same number(62.7%) also work in Owerri, and 102(37.6%)were integrated eye care workers(IECWs). The qualitative survey also showed that some of the workers were not appropriately posted to their areas of specialization, not trained in eye care and were not sponsored to updates, workshops/ refresher courses and seminars.

Conclusion: The results of the study showed a skewed distribution of ophthalmic nurses, optometrists and ophthalmologists in favour of the urban, Owerri . However, the eye care personnel to population ratio could not be fully ascertained in this study due to non-contribution from privately-owned clinics which were not  included in this study. The obvious health care manpower mal-distribution gap could be urgently addressed through adequate provision of social amenities like safe water/electricity, recreational facilities, establishment of industrial estates in Orlu and other rural areas Imo State to generate employment opportunities to minimize the prevailing rural-urban drift of health care manpower. Training of eye health personnel (human resource development), one of the key goals of Vision 2020 was not met, but can be improved through re-training and in-service training with motivations and inducements in form of sponsorships to updates, workshops and refresher courses.  Additionally, the integration of primary eye care into the health care system of the state will go a long way in closing the existing health care gaps and by extension, the socio-economic gaps that exist between the more economically endowed Owerri and the rural population in Orlu, as it is popularly said that “health is wealth”.

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Keywords :

Availability, Clinical Audit, Distribution, Eye care workers., human resources., Qualitative, Quantitative, Vision 2020

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