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Sources of patient knowledge and financing of cataract surgery in rural China: the Sanrao Study of Cataract Outcomes and Up-Take of Services (SCOUTS), Report 6

¹ Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
² Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
³ Sanrao Village Hospital, Sanrao, China
⁴ Centre for Epidemiology and Biostatistics, School of Public Health, The Chinese University of Hong Kong, Hong Kong

Correspondence to:
Professor N Congdon, Joint Shantou International Eye Center, Dongxia North Road, Shantou, Guangdong, PRC; ncongdon{at}cuhk.edu.hk

Aim: To study patient sources of knowledge about cataract surgical services, and strategies for financing surgery in rural China.

Design: Cross-sectional case series.

Methods: Patients undergoing cataract surgery by local surgeons in a government, village-level facility in Sanrao, Guangdong between 8 August and 31 December 2005 were examined and had standardised interviews an average of 12 months after surgery.

Results: Of 313 eligible patients, 239 (76%) completed the questionnaire. Subjects had a mean (SD) age of 69.9 (10.2) years, 36.4% (87/239) were male, and 87.0% (208/239) had been blind (presenting visual acuity 6/60) before surgery. Word-of-mouth advertising was particularly important: 198 (85.0%) of the subjects knew a person who had undergone cataract surgery, of whom 191 (96.5%) had had cataract surgery at Sanrao itself. Over 70% of subjects (166/239) watched TV daily, whereas 80.0% (188/239) "never" read the newspaper. Nearly two-thirds of suggestions from participants (n = 211, 59.6%) favoured either TV advertisements or word-of-mouth to publicise the programme. While the son or daughter had paid for surgery in over 70% of cases (164/233), the patient’s having paid without help was the sole predictor of undergoing second-eye surgery (OR 2.27 (95% CI 1.01 to 5.0, p = 0.04)).

Discussion: Strategies to increase uptake of cataract surgery in rural China may benefit from enhancing word-of-mouth advertising (such as with pseudophakic motivators), using television advertising where affordable, and micro-credit or other programmes to enable patients to pay their own fees, thus increasing uptake of second-eye surgery.

Funding: Funding for this study and for Project Vision (the eye care component of the Caring is Hip medical relief programme) was provided by the Li Ka Shing Foundation.

Competing interests: None.