Level of eye healthcare utilisation and associated factors in Gamo and Gofa Zones, Southern Ethiopia: a community-based, cross-sectional study.

Objective: About 90% of eye health problems are preventable or curable with existing cost-effective interventions. There is limited evidence on eye healthcare utilisation (ECU) and the factors influencing it in the study area. This study aimed to determine the level of ECU and the associated factors in Southern Ethiopia.

Design: A community-based, cross-sectional study was conducted in Southern Ethiopia from 1 June to 15 July 2023. Data were analysed using SPSS V.27.

Setting: Two selected districts (Dita and Uba Debretsehay) in Southern Ethiopia.

Participants: Permanent residents living in randomly selected kebeles.

Outcome Measure: The level of ECU was the outcome measure. A binary logistic regression model was used to check the association between explanatory variables and the dependent variable. To avoid many variables and unstable estimates and to control for possible confounders in the subsequent model, only variables that reached a p value of less than 0.25 on binary analysis were used in the multivariate logistic regression analysis to identify factors independently associated with ECU.

Results: 992 respondents participated in this study, with a response rate of 95.4%. The prevalence of ECU within the past 2 years was 21.6% (95% CI 19.0, 24.3). The reported barriers to ECU were lack of awareness (123, 40.6%) and lack of money (58, 19.2%). Age <30 years (adjusted OR (AOR)=2.7; 95% CI 1.5, 4.6), being male (AOR=2.2; 95% CI 1.4, 3.6), shorter travel time (AOR=2.0; 95% CI 1.3, 3.1), undergoing regular vision check-ups (AOR=5.4; 95% CI 3.47, 8.37), history of eye diseases (AOR=4.8; 95% CI 2.5, 9.1) and having trichiasis (AOR=1.5; 95% CI 1.1, 2.3) were positively associated with eye care service utilisation. Low wealth quantile (AOR=0.62; 95% CI 0.39, 0.98) and poor knowledge (AOR=0.26; 95% CI 0.16, 0.44) were negatively associated with eye care service utilisation.

Conclusions: The ECU within the past 2 years was a quarter. Socioeconomic factors, disease-related factors and respondent knowledge are independently associated with ECU. Designing strategies that can improve the capacity of healthcare facilities and patient awareness is important in order to reduce barriers and improve service utilisation. Researchers interested in working in the area should focus on community-specific approaches that can improve community health literacy by using stronger study designs.