Social determinants of cataract surgery utilization in south India. The Operations Research Group
G. E. Brilliant, J. M. Lepkowski, B. Zurita and R. D. Thulasiraj
Institute for Social Research, University of Michigan, Ann Arbor.
A field trial was conducted to compare the effects of eight health
education and economic incentive interventions on the awareness and
acceptance of cataract surgery. Cataract screening and follow-up surgery
were offered to more than 19,000 residents age 40 years and older in a
probability sample of 90 villages in south India. Eight months after
intervention, an evaluation was conducted to identify those in need of
surgery who had been operated on. Two principal measures of program
effectiveness are examined: awareness of cataract surgery and acceptance of
the surgery. The type of intervention had a negligible effect on awareness
of cataract surgery. A multiple logistic regression analysis revealed that
individuals who were aware of surgery tended to be male, literate, and more
affluent than those who were unaware of that option. Interventions that
covered the complete costs of surgery had higher surgery acceptance rates.
One health education strategy, house-to-house visits by a subject with
aphakia, increased acceptance of the procedure more than others. In a
multiple logistic regression analysis of acceptance rates, persons
accepting surgery tended to be male; other factors were not important in
explaining variation in acceptance rates.
