Access to eye health care services for older people with disabilities in two districts in Karamoja

The aim of this study is to explore how older people with disabilities access and are provided with eye health care in Karamoja, Uganda, and to identify opportunities for improvement.

The specific objectives are:

• To understand the experiences of older men and women with disabilities who have successfully sought eye health care in Karamoja and to identify the resources (financial and otherwise) they used on their pathways to access care
• To examine how eye health care workers are trained, resourced and supported to provide services to older men and women with different types of disabilities, within different health care facilities in Karamoja
• To elicit and synthesise recommendations for how different aspects of the eye health system can be made more inclusive for older men and women with different types of disabilities

Despite high levels of health care needs, the little data that exists suggests that older people with disabilities have disproportionately low access to health services, face greater difficulties in the process of accessing health services, and are more likely to experience poor outcomes when they do access services.

People who have accessed health services successfully possess useful insight into the factors that supported their health-seeking journeys, and eliciting and synthesising those factors is an important step in identifying strategies to improve health outcomes among this population.

Eye health problems disproportionately affect older people, and eye health services provide a useful case study around which to situate this investigation. This is a cross-sectional study using qualitative methods, notably in-depth interviews, to generate data with participants. Thematic analysis will be guided by the Conceptual Framework of Access to Healthcare. Strategies for improvement will be validated in a one-day workshop involving representatives of the Ministry of Health and from organisations of people with disabilities.

The most important outcome of the study will be the recommendations for making the eye health care services more accessible to older people with disabilities. These will be validated and refined by Ministry of Health and organisations of people with disabilities stakeholders during the workshop and documented as part of the main report. The recommendations may take the form of changes to practice, standalone interventions or policy change, and once documented they will be available for testing and scaling up.