Abstract
Purpose :
Indonesia is a rapidly growing county with over 262 million inhabitants, but among highly populated countries it has one of the lowest concentrations of eye care providers. This study evaluates the cost-effectiveness of a program implemented in South Sulawesi, Indonesia that trained schoolteachers to conduct vision screenings, organized in-school evaluations by opticians, and provided free eyeglasses to schoolchildren with refractive error (RE).
Methods :
Schoolteachers across 6 districts in South Sulawesi were trained to screen children with possible RE for subsequent evaluation by opticians. All costs associated with designing and implementing the program (administration, training personnel, labor, service delivery, etc.) were assessed. Expenditures and outcomes data were utilized to calculate the cost per disability-adjusted-life-year (DALY) for this intervention using 2010 and 2016 Global Burden of Disease (GBD) weights.
Results :
521 teachers screened 41,212 students across 172 schools in South Sulawesi. 4,506 (10.9%) students failed screening, 2,652 were seen by optometrists, and 2,038 received glasses. 1,854 (41.1%) students that failed screenings did not follow-up. The total program cost was $97,380, which included glasses (39.6%) and labor (23.3%). In districts with school-based refraction services, the costs per student screened, refracted, and receiving glasses were $2.57, $31.33, and $41.40, respectively; costs were $2.04, $59.80, and $73.22 when district services were instead provided centrally. Assuming an 18.4% prevalence of uncorrected refractive error in South Sulawesi, the estimated cost per DALY averted was $89.04 by GBD 2010 weights.
Conclusions :
Treating children with correctable RE in limited resource settings can be done cost-effectively through school-based models.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.