Article Text

other Versions

PDF
Improving services for glaucoma care in Nigeria: implications for policy and programmes to achieve universal health coverage
  1. Fatima Kyari1,2,
  2. Clare Gilbert1,
  3. Karl Blanchet3,
  4. Richard Wormald1,4
  1. 1Department of Clinical Research, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Baze University, Abuja, Nigeria
  3. 3Department of Global Health and Development, Health in Humanitarian Crisis Centre, London School of Hygiene and Tropical Medicine, London, UK
  4. 4Department of Ophthalmology, Moorfields Eye Hospital, London, UK
  1. Correspondence to Dr Fatima Kyari, Department of Clinical Research, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Fatima.Kyari{at}lshtm.ac.uk, fatimaygk{at}gmail.com

Abstract

Glaucoma in Africa is sometimes referred to as the silent thief of sight. In Nigeria, glaucoma is common, it is serious, ophthalmologists face many constraints in managing it, people do not even know they have it until it is advanced, patients do not understand or comply with treatment after they are diagnosed and the poor are more likely to be glaucoma blind. Available evidence indicates that the health system in Nigeria is failing to meet the needs of patients with glaucoma. Based on evidence, we propose future directions for improving services for glaucoma care in Nigeria, and the implications for policy and programmes to control glaucoma blindness, using a health system-oriented approach. Three complementary strategies are required: (i) strengthening clinical services for glaucoma—by developing models of glaucoma care, improving clinical treatment options, making medicines and equipment available, financing glaucoma care and training eye care workers; (ii) introducing initiatives for earlier detection of glaucoma in the clinic and approaches in the community and (iii) strengthening health system governance. Glaucoma is a complex disease to manage and addressing it as a public health problem is challenging. However, we need to change the paradigm to recognise that glaucoma is a potentially avoidable cause of blindness in Africa.

  • Glaucoma
  • Public health
  • Treatment other

Statistics from Altmetric.com

Footnotes

  • Contributors FK led the conception and design of the study and drafted the manuscript and edited it with consideration of input from coauthors. CG supervised the conception and design of the study and revised the article for important intellectual content. KB and RW contributed to the design of the study and revised the article for important intellectual content.

  • Funding The writing of this article was supported by the Fred Hollows Foundation (grant code ITCRVW04) as part of research degree study for FK. RW is funded in the UK by financial support from the Department of Health through the award made by the National Institute for Health Research to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Specialist Biomedical Research Centre for Ophthalmology.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.