Is the Child-to-child Approach Useful in Improving Uptake of Eye Care Services in Difficult-to-reach Rural Communities? Experience from Southwest Nigeria

BACKGROUND To determine if primary school pupils aged 9-14 years can be satisfactorily trained, using the child-to- parent approach, to assess vision, refer and motivate people to attend screening eye camps. METHOD Ninety pupils aged 9-14 years attending two purposively-selected primary schools were selected by simple random sampling. Using the child-to-parent approach and Snellens 6/60 illiterate E-chart, participants had a three-day knowledge and skill-based training followed by 2 days of community-based vision assessment and referral of those assessed. The adequacy and success of the training were assessed by comparing preand post-test scores. RESULTS Three hundred and thirty-six persons were referred and examined; of these, 142 (42.3%) persons were reviewed. Overall, there was significant improvement in knowledge. The accuracy of assessments was 82.1% for Right Eyes (RE), 83.3% for Left Eyes (LE) and 72.1% for presbyopia. The sensitivities for the RE, LE and presbyopia were 84.8%, 86.1% and 76.3% respectively. Similarly, the specificities were 44.4% for RE, 50.0% for LE and 68.6% for presbyopia. The performances were not significantly influenced by age, sex and locality. CONCLUSION Children aged 9-14 years in primary schools can be empowered, using the child-to-child approach, to assess vision and motivate members of their communities to utilize available eye care services.