{"title":"Evaluating Eye Care Services in South Africa's Limpopo Province Using Donabedian`s Framework: Insights into Structures, Processes, and Outcomes.","authors":"Hlabje Carel Masemola, Olivia Baloyi, Zamadonda Nokuthula Xulu-Kasaba","doi":"10.2147/OPTO.S509445","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Eye care services play an essential role in public health by addressing the needs of millions impacted by visual impairment and blindness annually. This study aimed to assess eye care services in Limpopo Province through Donabedian's framework, focusing on evaluating the availability and sufficiency of eye care infrastructure (structure), service delivery effectiveness (process), and patient outcomes.</p><p><strong>Methods: </strong>Using an exploratory, descriptive qualitative design, data were gathered in June and July 2024, through in-depth individual interviews. Ten (10) district eye health coordinators were selected as participants using purposive sampling. Data were thematically analyzed with NVivo version 12, revealing three main themes: resources and organizational setup, service delivery and healthcare interactions, and results of care provided.</p><p><strong>Results: </strong>The findings revealed the first theme as resources and organizational setup with sub-themes such as availability of eye care, services, resource allocation and, infrastructure, human resources and staffing. The second theme was service delivery and healthcare interactions with sub-themes such as service delivery and quality, perception, referral systems and inter-hospital coordination, health promotion and community outreach. The third theme was results of care provided with patient outcomes and satisfaction, technological advancements and patient care, challenges in achieving and public health goals as sub-themes. The findings indicate that challenges related to structure and processes significantly influence patient outcomes.</p><p><strong>Conclusion: </strong>The study further highlights resources, service delivery efficiency, and referral timeliness as key factors essential for achieving optimal patient outcomes and contributing to the broader objective of universal eye health coverage.</p>","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"115-126"},"PeriodicalIF":1.8000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955184/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Optometry","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/OPTO.S509445","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
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Abstract
Purpose: Eye care services play an essential role in public health by addressing the needs of millions impacted by visual impairment and blindness annually. This study aimed to assess eye care services in Limpopo Province through Donabedian's framework, focusing on evaluating the availability and sufficiency of eye care infrastructure (structure), service delivery effectiveness (process), and patient outcomes.
Methods: Using an exploratory, descriptive qualitative design, data were gathered in June and July 2024, through in-depth individual interviews. Ten (10) district eye health coordinators were selected as participants using purposive sampling. Data were thematically analyzed with NVivo version 12, revealing three main themes: resources and organizational setup, service delivery and healthcare interactions, and results of care provided.
Results: The findings revealed the first theme as resources and organizational setup with sub-themes such as availability of eye care, services, resource allocation and, infrastructure, human resources and staffing. The second theme was service delivery and healthcare interactions with sub-themes such as service delivery and quality, perception, referral systems and inter-hospital coordination, health promotion and community outreach. The third theme was results of care provided with patient outcomes and satisfaction, technological advancements and patient care, challenges in achieving and public health goals as sub-themes. The findings indicate that challenges related to structure and processes significantly influence patient outcomes.
Conclusion: The study further highlights resources, service delivery efficiency, and referral timeliness as key factors essential for achieving optimal patient outcomes and contributing to the broader objective of universal eye health coverage.
目的：眼保健服务每年解决数百万视力障碍和失明患者的需求，在公共卫生中发挥着至关重要的作用。本研究旨在通过Donabedian的框架评估林波波省的眼科保健服务，重点评估眼科保健基础设施（结构）的可用性和充分性、服务提供效率（过程）和患者结果。方法：采用探索性、描述性定性设计，于2024年6月至7月通过深度个人访谈收集数据。采用有目的抽样方法，选择十（10）个地区眼科保健协调员作为参与者。使用NVivo version 12对数据进行了主题分析，揭示了三个主题：资源和组织设置、服务提供和医疗保健互动以及提供的护理结果。结果：第一主题为资源和组织设置，第二主题为眼科保健的可得性、服务、资源分配、基础设施、人力资源和人员配备。第二个主题是提供服务和保健的相互作用，其分主题包括提供服务和质量、感知、转诊系统和医院间协调、促进健康和社区外展。第三个主题是提供护理的结果：患者的结果和满意度、技术进步和患者护理、实现挑战和公共卫生目标作为次级主题。研究结果表明，与结构和过程相关的挑战显著影响患者的预后。结论：该研究进一步强调了资源、服务提供效率和转诊及时性是实现最佳患者结果和促进全民眼科健康覆盖的更广泛目标的关键因素。
期刊介绍：
Clinical Optometry is an international, peer-reviewed, open access journal focusing on clinical optometry. All aspects of patient care are addressed within the journal as well as the practice of optometry including economic and business analyses. Basic and clinical research papers are published that cover all aspects of optics, refraction and its application to the theory and practice of optometry. Specific topics covered in the journal include: Theoretical and applied optics, Delivery of patient care in optometry practice, Refraction and correction of errors, Screening and preventative aspects of eye disease, Extended clinical roles for optometrists including shared care and provision of medications, Teaching and training optometrists, International aspects of optometry, Business practice, Patient adherence, quality of life, satisfaction, Health economic evaluations.
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