Towards Universal Eye Health: Hospital-based disability-disaggregated data collection in Takeo province, Cambodia

Background: Universal access and equity are salient principles of the World Health Organization global action plan 'Towards Universal Eye Health'. However, collection of disability-disaggregated data to measure access to eye hospitals in low-and middle income countries, including referral to rehabilitative services, are not routinely integrated into Health Management Information Systems. Objective: This report presents secondary-data analysis of disability-disaggregated data collection that was introduced at a tertiary eye hospital in a rural province in Cambodia. Methods: A modified version of the Washington Group Short Set of Questions was used to count the number of eye patients with self-reported difficulties. The number of referrals of patients with unavoidable visual impairment to low vision services as well as referral to rehabilitative services was also counted. Results: From 2011 to 2016, out of 182,327 patients overall 4981 (2.7%; 95% CI 2.66-2.81) reported difficulties with hearing, moving or communicating in addition to visual or other eye-related problems. Most of the difficulties were reported in the age group of patients aged 50 years and older (89.8% [95% CI 88.9-90.6]). All together 901 (0.5%; 95% CI 0.46-0.53) patients were treated at the low vision unit and 652 (0.36%; 95% CI 0.33-0.39) patients were referred to rehabilitation services. The number of referrals to rehabilitation declined annually from the year 2013-2016. Conclusions: Patients with self-reported impairments constitute a significant proportion of the eye hospital's population. A modified version of the Washington Group Short Set of Questions enabled routine disability-disaggregated data collection but resulted also in possible under-reporting of difficulties. (C) 2018 Elsevier Inc. All rights reserved.