Strategies to improve uptake of cataract surgery: a systematic review

• To synthesize all available literature to identify factors influencing patient uptake of cataract surgery as well as strategies for improving it in LMICs
• To assess how factors influencing patient’s decision and strategies vary in specific population sub-groups, more specifically, women, people in lower socio-economic groups and people with disabilities

Despite significant evidence around barriers hindering timely access to cataract surgery in low and middle income countries (LMICs), little is known about the strategies necessary to overcome them and the factors associated with improved access. Despite significant evidence that certain groups, women for example, are disproportionately affected by low access, even less is known about how to improve the situation for them. Little empirical evidence exists and to date, apart from a review by Ramke et al., 2017 which looked at interventions to improve access of cataract surgical services and only focused on RCT studies, no other review of that evidence has been conducted.

The aim of this systematic review was to collate, analyse and synthesise evidence from both published and unpublished studies on factors influencing uptake of cataract surgery and strategies to improve the uptake in LMICs. We performed a literature search of five databases, and a detailed reference review to identify studies with evidence on factors that influence uptake of cataract surgery and strategies that can be applied to improve the uptake in LMICs. Our findings provide a basis for the development of targeted combination of strategies to improve access to cataract surgical services by integrating these enabling factors.

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The uptake of cataract surgery in low and middle income countries -a systematic review