Page 162 - DISINVESTMENT AND IMPLEMENTATION OF VISION SCREENING TESTS BASED ON THEIR EFFECTIVENESS

CHAPTER 8
The rural family doctors’ nurses said that it was very difficult to get parents to bring children to the doctor’s office for vision screening. Parents often had other priorities, did not understand the benefits of preventive health care, did not think there was anything wrong with their children’s eyes or did not seem interested. There were also several nurses and doctors who mentioned they lacked time to screen and do the paperwork involved. The family doctors’ nurses who screened at the rural kindergartens, said this worked better, but was not without problems either. The number of children attending the rural kindergartens is usually lower than the number enrolled there. According to kindergarten staff, this is because many parents who go abroad to work, take their children with them or leave their children with grandparents who often live in a different commune. Also, many rural children go to kindergartens in cities, because their parents work there. In winter, there are even fewer children, because many stay at home due to road conditions and seasonal illnesses.
Some nurses and doctors seemed unconvinced or not aware of the benefits of vision screening or did not want anything to do with it for reasons that were unclear. Others were very interested in screening. In the interviews, nurses and doctors who were more knowledgeable about amblyopia also expressed more willingness to participate in vision screening
Several interviewees who work in communities with a substantial Hungarian population mentioned a specific problem in reaching this group was language. An issue encountered in communities with a substantial Roma population was a greater lack of awareness of the benefits of preventive health care than among the general population.
Views among nurses and doctors differed as to whether parents would take referred children to an ophthalmologist and, if necessary, buy patches or glasses. Most said this would depend on parents’ affluence, though awareness of its necessity was also mentioned as a relevant factor. There was little experience with follow-up in rural areas in the first year of screening though, because few children were screened (see Additional file 7 for a more detailed report on the on-site interviews).
Questionnaires
Eight questionnaires for screeners were completed, out of 25 distributed. The respondents expressed a positive attitude towards screening and indicated they believe screening is important and should be provided to all children. They felt confident and able to participate in the programme.
After twelve months the questionnaire for screeners was distributed among 40 screeners and this time 23 were returned. The attitude of the screeners was similar to
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