Table 4 Summary of study findings

Eye health policy and governance

• Responsibility for human resources, equipment and infrastructure necessary to deliver eye care services lies at regional level.

• Eye health not perceived as a priority leading to reduced funding.

Health financing

• Health care generally underfunded;

• Primary health care financing initiatives such as fee exemptions and community health insurance poorly understood and implemented.

Equipment and supplies

• Inadequate equipment available to provide primary eye care;

• Stock-outs of eye medications commonplace at primary health facilities.

Patient records and health service data

• Inadequate data on eye diseases captured within HMIS;

Patient referrals

• No formal referral system in place;

• Successful referrals undermined by local poverty levels and low prioritisation of eye health among community.

Post-training supervision of staff

• No regular supervision of primary health workers by eye health specialists;

• Supervision to remote facilities undermined by lack of financial resources, however pragmatic solutions could be explored.