Study on the provision and demand for eye care services in urban slums of Lahore, Pakistan

• To identify the magnitude and causes of avoidable blindness and visual impairment among people living in urban slums
• To identify spectacle and cataract surgical coverage among slum-dwellers and quality of services delivered (outcome)
• To explore health-seeking behaviour and identify barriers to slum-dwellers effective engagement with available eye care services and its relation with socioeconomic status and disability
• To identify slum-dwellers willingness to pay (WTP) and demand for cataract surgery and spectacles
• To describe eye health services available to slum communities – in particular noting type of facility, ownership, operating time, services provided and prices, main income sources and provision made to facilitate access to poor patients

In South Asia, approximately 71.6 million people live with moderate or severe visual impairment and around 10.6 million are blind (Stevens et al, 2014). As for the situation in Pakistan, a national prevalence survey from 2004 showed a blindness prevalence rate of 2.7% for adults above 30 years old where cataract represented the leading cause (51.5%) (Jadoon, Dineen et al, 2006). The same study reported that refractive error is the first cause of visual impairment (43%) followed by cataract (42%). Despite existing interventions and public health programs, cataracts and refractive errors continue to be significant public health concerns.

Urban health is a growing area of interest given the high urbanisation rates globally. Even though availability of eye care services is less of an issue in urban areas compared to rural areas, these services are not always accessible, particularly for marginalised population such as urban slum dwellers and/or the urban poor.

Population projections show that population in urban slums will increase at a faster rate than the general population and health access disparities are expected to further increase as a result. This makes it important to investigate and address these health disparities in urban areas. Following two successful research projects carried out in Bangladesh and India, this study will contribute to the evidence base for programming and a better understanding on the demand and provision of eye care services to people living in slums in urban settings.

Read the 2018 report (pdf)
Provision and demand for eye care services