Perceptions of cataracts and cataract services of elderly persons in Mathangwane, Botswana

Master Thesis


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University of Cape Town

Background: Cataract is the leading cause of blindness globally. In Botswana about 60% of blindness is due to cataract. Health services in Botswana are free, as are cataract services. Despite the free health services offered, the Batswana do not fully utilize the available eye care services especially the cataract services. Many Batswana access health care in public hospitals, where patients may have to wait for long periods for clinic appointments and surgery. Research question: What are the perceptions that elderly persons in Mathangwane village in Botswana, have of cataracts and cataracts services? Aim: To explore and describe the perceptions of elderly persons in Mathangwane about cataracts and cataract services. Objectives: 1. Explore and describe elderly persons' perceptions of cataracts; 2. Explore and describe elderly persons' perceptions of cataract services; 3. Explore reasons for use and non-use of current cataract services. Methods: Qualitative exploratory descriptive methods were used. A qualitative study design with purposeful sampling was used to identify participants for interviews and focus group discussion. Semi-structured interviews with seven participants aged sixty-five years and older with diagnosed cataract as well as a focus group with six of the seven participants were conducted. Data was analysed using a content analysis approach. Results: Five themes emerged from the interviews and a focus group discussion: i. Cataract as the 'spider web'; ii. Curing cataract with traditional herbs; iii. Cataract a problem of the elderly caused by modem food; iv. The burden of cataract blindness: 'mealie on the fire'; v. The ambivalent voice of elderly persons about cataract services. Conclusion: Findings from this study show that the participants had a general understanding of what cataract is and they had a particular description for this. Both positive and negative feelings were expressed in relation to the services available. Although cataract surgery was perceived to restore vision a major concern of the elderly persons was in relation to delays they experienced while waiting for the cataract to fully mature. Despite the free services offered at community level there is a great need for affordable and accessible transportation services for elderly persons utilising the cataract services.