Aim: To provide comprehensive information on existing human resources for the provision of comprehensive eye care services in the North West Province of Cameroon.
Methods: Quantitative data were collected using a pre-tested questionnaire administered to all consenting eye care workers in the North West Province. Data on service outputs were obtained using a checklist and other available documents. Qualitative data were collected by means of semi-structured interviews administered to staff of eye units, primary level eye care workers, and visual rehabilitation workers.
Results: The North West Province, which has a population of 2.1 million, had 9 eye units, 3 ophthalmologists, 21 ophthalmic paramedics, 47 community-based rehabilitation workers trained in primary eye care, and 8 ophthalmic paramedic students. There were also 19 special education teachers in two schools for the blind. In addition, the province had 3,131 community-directed distributors of ivermectin. The duration and type of ophthalmic training of ophthalmic paramedics, as well as their educational backgrounds, were very diverse. Close to 90% of the staff in the eye units were employed by mission hospitals and the distribution of human resources in the province was grossly unequal. The cataract surgical rate had increased by 35% between 2002 and 2005, to a total of 414 per year. The coverage of refractive services and the number of patients consulted per outreach had remained constant during the same period, at less than 1% and at 30 patients, respectively. The main barriers to the provision and uptake of eye care services were lack of human resources, poor collaboration among stakeholders, cost of services, and patient beliefs.
Conclusion: The number, distribution, mix of skills, and output of eye care workers in the North West Province are inadequate. At provincial level, it would be desirable to have a committee for the prevention of blindness. It would be worthwhile to research consumer perceptions and barriers to the uptake of eye care services. At national level, an action plan, advocacy, and funding for in-country training of different levels of eye care personnel should be considered.
A signpost advertising the services of a traditional healer in Bamenda, capital of the North West Province of Cameroon. Many interviewees in Henry Nkumbe's study made reference to the services of this healer. CAMEROON