Abstract
Aims: To support policymakers in enhancing access to eye care for the population aged 45 years and
older in Pakistan, this study aims to identify and quantify the barriers that hinder effective eye care
delivery to this group. Additionally, it seeks to explore patients' experiences with the Sehat Sahulat
(health insurance) program in the context of eye care services.
Background: Accessible eye care services can reduce avoidable blindness by delivering timely, highquality interventions. In Pakistan, the lack of primary eye care burdens overcrowded hospitals and
combined with economic challenges, limits access for underprivileged populations. To address this, a
nationwide health insurance scheme (SSP) was introduced to reduce out-of-pocket expenses and
improve healthcare access for economically disadvantaged groups.
Methods: Using an exploratory sequential mixed methods design, an initial qualitative phase
explored participant experiences and identified specific barriers. The qualitative study provided the
basis for the development of a customised survey tool. The survey tool was then used in a second
phase to obtain quantitative data to capture the magnitude of barriers and costs associated with
accessing eye care in Pakistan.
Findings: Numerous considerable barriers were identified including illiteracy, long travel times,
female gender, old age, mobility issues, and costs, all of which limited access to eye care in Pakistan.
Awareness surrounding use of the SSP was poor, with the programme seldom used towards eye care
costs. This study highlights patient experiences with eye care in urban and rural Pakistan, including
enablers and barriers to accessing eye care. Improvements should focus on educating the public on
eye health, increasing availability of eye care services in rural areas, improving accessibility within
eye care facilities, addressing gender disparities, and reducing costs associated with eye care
treatments, potentially through advancement of the SSP.
older in Pakistan, this study aims to identify and quantify the barriers that hinder effective eye care
delivery to this group. Additionally, it seeks to explore patients' experiences with the Sehat Sahulat
(health insurance) program in the context of eye care services.
Background: Accessible eye care services can reduce avoidable blindness by delivering timely, highquality interventions. In Pakistan, the lack of primary eye care burdens overcrowded hospitals and
combined with economic challenges, limits access for underprivileged populations. To address this, a
nationwide health insurance scheme (SSP) was introduced to reduce out-of-pocket expenses and
improve healthcare access for economically disadvantaged groups.
Methods: Using an exploratory sequential mixed methods design, an initial qualitative phase
explored participant experiences and identified specific barriers. The qualitative study provided the
basis for the development of a customised survey tool. The survey tool was then used in a second
phase to obtain quantitative data to capture the magnitude of barriers and costs associated with
accessing eye care in Pakistan.
Findings: Numerous considerable barriers were identified including illiteracy, long travel times,
female gender, old age, mobility issues, and costs, all of which limited access to eye care in Pakistan.
Awareness surrounding use of the SSP was poor, with the programme seldom used towards eye care
costs. This study highlights patient experiences with eye care in urban and rural Pakistan, including
enablers and barriers to accessing eye care. Improvements should focus on educating the public on
eye health, increasing availability of eye care services in rural areas, improving accessibility within
eye care facilities, addressing gender disparities, and reducing costs associated with eye care
treatments, potentially through advancement of the SSP.
| Original language | English |
|---|---|
| Journal | Primary Health Care Research and Development |
| Publication status | Accepted/In press - 25 Mar 2025 |
