Understanding demand and provision of eye care services among slum-dwellers in Dhaka, Bangladesh

Studies on access to eye care services in developing countries show that lack of awareness, availability, accessibility and affordability of services constitute major barriers in seeking treatment. This can result in low uptake of eye care services which represents a challenge for the elimination of avoidable blindness. Evidence exists that even when services are available, they are underused by potential beneficiaries. It is therefore important to identify the reasons for the low uptake of services and to implement appropriate strategies to address these issues. Delay in seeking eye care services is an important cause of avoidable blindness, especially in cases where early detection and treatment would have prevented the patient from becoming blind.

The overall aim of this research is to better understand the demand for and provision of eye care services in urban slum-dwelling communities in Dhaka by answering the following questions:
• What types of facility are offering eye care services in the targeted areas? What are their characteristics?
• What is the willingness-to-pay for refractive error services (spectacles)? What are the implications in terms of pricing and sustainability for eye care providers targeting slum-dwellers?
• What is the community attitude and practice around eye care? What are the main reasons for consultations? Where do patients go and why? What is the perceived advantage of each type of facility?
• What are the main barriers to accessing eye care services in poor urban communities? Do eye care facilities targeting slum-dwelling communities deliver effective services to the poor?

Based on the study’s objectives, several different research approaches were adopted to answer the research questions as summarised in the table below:
• Geographic information system (GIS) mapping and facility assessment
• Household surveys
• Qualitative interviews: focus group discussions (FGD) and in-depth interviews (IDI)
• Patient exit interviews (from eye care facilities)
• Patient exit interviews (from optic shop)


Standard Charted Bank’s ‘Seeing is Believing’ programme