Coverage and Challenges of Retinopathy of Prematurity Screening and Treatment in Nigeria: Perspectives of Ophthalmologists and Paediatricians

Context: Retinopathy of prematurity (ROP) is an important cause of blindness in children worldwide. It affects premature children especially when there is sub-optimal neonatal care and no screening and treatment program in place. Nigeria has the third highest number of premature births in the world, but no national program for ROP screening. Aim: To explore the coverage and challenges affecting ROP screening including the perspectives of ophthalmologists and paediatricians. Methods and Material: Mixed methods were used to obtain information in two phases. In the first phase, a Google form was designed and sent to paediatricians and ophthalmologists in Nigeria to find out the coverage of ROP screening and treatment. The second phase involved visiting some large centres to administer a semi-structured questionnaire with some qualitative questions. Statistical Analysis Used: The quantitative responses from the structured questionnaire were also inputted into the excel sheet and presented with charts and maps. Themes in the transcripts were analyzed manually by thematic analysis using deductive reasoning. Results: A total of fifty-nine multispecialty tertiary hospitals were identified. Responses were received from 40 (68%) of them. Forty percent of the centres that responded were doing ROP screening. The challenges include inadequate human and material resources, difficulties with coordination of program and follow up of patients, high work-load in the paediatric eye units for few available specialists, financial constraints on hospital managements and on patients and poor collaboration between ophthalmic and neonatal units. Conclusions: ROP screening/treatment coverage is poor in Nigeria, and is bedeviled by inadequate human and financial resources. More data from screening centres is needed for advocacy to governmental and non-governmental agencies in order to expand ROP screening coverage, and design a program for sustainable and efficient ROP screening in Nigeria.