Purpose: To study patient sources of knowledge about cataract surgical services, and strategies for financing surgery in rural China.
Design: Cross-sectional case series.
Methods: Persons 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 underwent standardized interviews an average of 12 months after surgery.
Results: Among 313 eligible operated persons, 239 (76%) completed the questionnaire. Subjects had a mean 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) prior to surgery. Word of mouth advertising was particularly important: 198 (85.0%) of 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%) favored either TV advertisements or word-of-mouth to publicize the program. 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 (1.01 - 5.0, P = 0.04)).
Discussion: Strategies to increase cataract surgical uptake in rural China may benefit from enhancing word of mouth advertising (such as with pseudophakic motivators), utilizing television where affordable and micro-credit or other programs to enable patients to pay on their own, thus increasing uptake of second-eye surgery.