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MUFARRIQ SHAH, Rahul Chakrabarti, Ayesha Noor, Gail Ormsby, Jing Xie, Alex Harper, Jill Keeffe; Task Sharing in the Eye Care Workforce for Detection and Management of Diabetic Retinopathy in Low Resource Countries. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1373.
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Team work approach and a co-management strategy to screen, detect and manage diabetic retinopathy (DR) could improve coverage of people with diabetes mellitus (DM) to prevent vision loss. This study aimed to investigate the potential roles of ophthalmologists and mid-level eye care workers in detection and management of DR in low resource countries through Task Sharing.<br />
Due to the explorative nature of the investigation, a multi-phase mixed-methods approach was used. Data were collected from stakeholders (policy level personnel, ophthalmologists and other eye care workers). In phase one a situation analysis of DR to identify strengths and weaknesses of the eye care service delivery models for detection and management was performed in Cambodia through semi-structured interviews (n=24). In phase two in Pakistan a survey to assess stakeholders’ (n=101) attitudes, perceptions and the feasibility for co-managed eye care for people with DM through task sharing was conducted. That was followed by 22 key informant interviews which focused on 7 themes including understanding the situation and perspectives about eye care services for DR, task shifting, policy and guidelines for task sharing.
The Pakistan survey showed that 97% (n=56) of ophthalmologists and all (n=43) eye care workers suggested introducing task sharing for primary eye care (p=0.219). Most ophthalmologists (97%) and eye care workers (98%, n=42) stated that task sharing could potentially be effective in preventing vision loss from DR (p=0.674). 98% (n=57) of ophthalmologists and all (n=43) eye care workers reported that task sharing could strengthen linkages amongst the health care workforce and community for more efficient care for people with DM (p=0.387). About half of them (57% vs 58%, p=0.022) believed that changes were required in laws and policies for task sharing. The case study revealed that the positive effects of task sharing included increased awareness of DR; potential for development of a team work approach with better comprehensive management and greater coverage without negative effects on each eye care workers’ primary responsibilities.
Task sharing among all cadres of eye care workers could help to achieve greater coverage to prevent visual loss from DR. There is need of policy and guidelines to reinforce task sharing in low resource countries.<br />
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