Mixed methods evaluation of a primary eye care training programme for primary health workers in Morogoro, Tanzania

There are 285 million people with visual impairment (VI) worldwide, including 39 million who are blind; 15 % of those with VI live in Africa, and around 80 % of VI is preventable or treatable with the right equipment, information and skills. The scarcity of human resources for eye health, particularly in Sub-Saharan Africa, is a key challenge towards achieving this goal. Therefore training primary health workers (PHW) in providing eye care services has been seen by some authors as a way to improve access to eye care services in remote communities. However, the package of interventions which could be effectively delivered for eye care at the primary-care level, or the set of skills and competencies that PHWs need has not yet been delineated.

The aim of the study was to evaluate the effectiveness of a four-day training programme of PHWs in primary eye care conducted in Morogoro, Tanzania in 2010/2011. Pre-and immediate post-training assessments indicated improvement in health worker knowledge about eye care in the short term. Qualitative investigations two to three years after the training showed that although staff could make the correct management decisions when presented with eye health problems, they often could not make a correct diagnosis. Theoretical teaching was appreciated by most participants, but almost all suggested increasing the time spent on acquiring skills.