Knowledge, attitudes and eye care seeking practices associated with utilization of trachoma eye care services in central division, Kajiado County

Abstract

Background Information - Trachoma is considered the second leading cause of avoidable blindness in Kenya, accounting for 19% of the blind. Kajiado County has been documented as an area with a high prevalence of the eye disease. The focus of most researchers has been on risk factors for trachoma and the interventions put in place towards prevention and treatment of this eye disease but not much has been done concerning utilization of the available trachoma eye care services by the communities and on the factors affecting utilization of these services. Specific Objectives- To determine the level of knowledge, attitudes and eye care seeking practices of the community towards the available trachoma eye care services and assess utilization of these in Central division of Kajiado County. Methodology- A cross-sectional study design was conducted. A sample of 321 respondents who met the inclusion criteria were randomly selected from the community while eleven health workers were purposively sampled from facilities providing the eye care services. Questionnaires, structured interview schedules and observational checklists were used for data collection. Data analysis was performed using STATA version 12. Categorical variables were summarized as frequencies and corresponding percentages while the continuous variables were summarized as the median and the corresponding lower and upper quartiles. The association between categorical variables was assessed using the Pearson’s Chi Square test at 95% confidence level. Data was presented in prose, tabular and graphical forms. Results- Of the 321 respondents included in the study, the response rate was 98.7%. The mean age of the respondents was 37 years, with female participants (65%) being the majority and most respondents (62%) having attained at most a primary level of education. The level of awareness of trachoma disease in the study area was significantly high (95%). Close to three quarters (71%) of the respondents were knowledgeable of the available trachoma eye care services provided by health facilities and NGOs in the area. The community had a positive attitude towards the available services with most of the respondents expressing need for the eye care services. Majority (59%) felt the health facilities and NGOs in the area adequately met their eye care needs. Public health facilities were preferred by most respondents. Age and educational level of the respondents were found to be associated with communities’ eye care seeking practices. Most respondents subscribing to cultural practices believed in the efficacy of traditional medicine. Utilization of the available trachoma eye care services in the region was low (36%). The statistically significant factors found to influence utilization of these services were knowledge of the available eye care services and gender of respondents. The main barriers to utilization of trachoma eye care services were accessibility and affordability of the services. Conclusion– The community was knowledgeable of the available trachoma eye care services and had a positive attitude towards these services. Despite this, utilization of the trachoma eye care services was quite low in the region. Accessibility and affordability of the eye care services were the main barriers to utilization of these services. Recommendations- Reinforcement of positive attitudes towards the services through community based educational programs and overcoming local barriers to uptake of the services through community participation in education and provision of outreach services through mass treatment programmes