Completed Research Report Assessment of eye care needs and eye care coverage among refugee populations

ประเมินความต้องการและความครอบคลุมของการให้บริการดูแลรักษาโรคตาในกลุ่มผู้อพยพในค่ายต่างๆขององค์การ อนามัยโลก

Name: Vincent, Jerry E.

MeSH: Vision Disorders -- Case Reports

MeSH: Eye -- Care and hygiene

MeSH: Eye -- Diseases -- Treatment

Abstract: Intro By the end of 2021, wars and conflicts have caused over 89 million people to flee their homes, becoming displaced. Among these, 27.1 million have fled across an internationally recognized border to become refugees. The context of eye care needs among refugee and displaced populations is not well understood. Eye epidemiological data, information on coverage with eye services, and evidencebased guidance on providing eye services are lacking. Aim of study 1. Define scale and scope of current knowledge base of eye care in refugee populations. 2. Extrapolating from regional data to estimate the rates and numbers of refugees with BVI. 3. Identify gaps in eye services for refugee populations. Methods Using mixed methodologies, we used a scoping review to encapsulate what we know to date for the provision of refugee eye services; we used existing data to make regional estimates for rates of blindness and vision impairment in refugee populations; and we assessed the current state of eye service coverage in refugees living in protracted camp situations. iii Scoping Review This scoping review was conducted using a wide swath to collect as much of the available information as possible, by using published peer-reviewed literature, gray literature and unpublished data. Surveyed rates of blindness and vision impairment (BVI) in refugee populations are found to be high and rates of BVI in self-selected presenting refugee patients are very high. The causes of blindness and vision impairment are typically cataract and uncorrected refractive error in adults and cornea opacities in children. Trachoma may be an important cause of blindness where endemic. Vitamin A deficiency in children is of significant concern and has frequently been identified in refugee populations, even with Vitamin A supplementation. Published guidance relevant to eye care in refugee populations is limited to Vitamin A deficiency. Estimates We apply Global Burden of Disease Study (GBDS) regional rates of blindness and vision impairment to UN regional refugee populations to determine the numbers of refugees and displaced that are affected by BVI. The Eastern Mediterranean has the largest number of refugees (over 30 million) and the highest percent of the population that is made up of refugees (4.07%) and the largest number of refugees with BVI (1,264,063). Africa has the second largest number of refugees (23,2115,458) and the third largest number of refugees/displaced with BVI (566,457). The Americas, Southeast Asia, Europe and the Western Pacific regions all have noticeably fewer refugees and displaced with BVI. Globally, over 430,000 refugees and displaced can be expected to be blind, and over 3,400,000 will have some level of vision impairment. Coverage The assessment of coverage for eye care was limited to the largest, protracted refugee camp populations. Published papers, web site information of relevant NGOs and UN organizations and personal contacts within UNHCR, UNRWA and relevant NGOs that provide refugee health care or that provide eye care were used to establish where eye care services are or recently have been available. Among the world’s 28 million refugees, about 8.5 million having been living long term in camps. Among these, about 3.1 million are in camps where they might iv occasionally benefit from outreach trips by eye teams or might benefit from in camp basic services of cataract surgery and spectacle provision when funding is available. Another 1.6 million likely have routine access to primary health care centers that can provide antibiotic ointment as needed and may be able to refer, in some cases, for ocular emergencies. No refugee camp population anywhere has access to comprehensive eye care services. Eye services tend to come and go depending upon the availability of funding. Recommendations 1. Develop guidance for providing refugee eye care based upon evidence and experience to date. 2. Monitor progress by ongoing monitoring of BVI estimates and rates and ongoing monitoring of eye care coverage in refugee populations. 3. Encourage publication of refugee eye care programming, research and lessons learned. 4. Ongoing advocacy of donors and policy makers for better funding, technical support and integration of eye care into refugee health systems. 5. Better preparedness of the eye sector for much larger numbers of refugees as climate change begins to become an increasing reason for populations to flee. Conclusion Universal Eye Care in Refugees and other Marginalized Populations will never be reached until all people can access and use eye services where and when needed

Rangsit University. Rangsit University Library

Email: library@rsu.ac.th

Name: Research Institute of Rangsit University

Role: Funding By

Created: 2022

Modified: 2567-09-04

Issued: 2024-09-04

งานวิจัย/Research report

application/pdf

eng

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