Estimated number of cataract surgeries performed in government hospitals in Nigeria and factors affecting cataract surgical activity

Abstract

Aim: To estimate the number of cataract surgeries performed from 1 January 2017 to 31 December 2019 in government hospitals in Nigeria and explore factors affecting their cataract surgical activity.

Methods: This was a retrospective study conducted between 1 August 2020 and 4 October 2020 through online survey emailed to respondents working in 55 government-owned hospitals in the 36 Nigerian states and federal capital territory. Information obtained included a number of cataract surgeries performed yearly and correlation analysed between variables obtained using IBM Statistical Package for Social Sciences software for Windows version 22 (SPSS Inc., Chicago, Illinois, USA).

Results: A total of 40 institutions were included in the study, 26 (65%) federal government and 16 (35%) state government institutions. About 70,792 cataract surgeries were performed during the study period with the North-West geopolitical zone performing 47.7% of the surgeries. The average price for cataract surgical service in government hospital was USD($)77.45(±7.08) (surgical fee) and USD ($) 128.23(±11.96) (total treatment cost) with a wide variation from zone-to-zone. Lower fees were associated with increased surgical volumes, and GNI per capita of each state did not influence the price set for surgery or the number of surgeries performed. Provision of outreach services, free surgeries, and having an eye manager correlated to increased cataract surgical numbers (P < 0.05).

Conclusion: There is need to improve existing strategies to increase cataract surgical numbers in government institutions such as increased advocacy for funding for eye care services, conducting frequent outreaches, establishing and redistribution of satellite centres to underserved communities and fostering surgical relationships between institutions to improve surgeon’s competency and cataract surgical outcome.