School-based vision screening in Quetta, Pakistan: a qualitative study of experiences of teachers and eye care providers

In this paper, we describe the experiences and perspectives of teachers and eye care providers with a school-based vision screening programme in Pakistan.

Our findings suggest that a multiplicity of operational issues and systems-level factors including poor planning, organization, and delivery of the programme undermined this task shifting initiative. Teachers over referred children to ophthalmic services, overwhelming their capacity and undermining the efficiency of the approach.

To maximise the effectiveness and efficiency of school-based vision screening, future initiatives should give sufficient attention to the duration of teacher training, experience of trainers, support supervision, refresher trainings, regular use of the screening guidelines, and the workload and motivation of the teachers trained.