Process evaluation of a national primary eye care programme in Rwanda

Background: Visual impairment is a global public health problem, with an estimated 285 million affected globally, of which 43% are due to refractive error. A lack of specialist eye care in low and middle-income countries indicates a new model of care would support a task-shifting model and address this urgent need. We describe the features and results of the process evaluation of a national primary eye care (PEC) programme in Rwanda.

Methods: We used the Medical Research Council process evaluation framework to examine the implementation of the PEC programme, and to determine enablers and challenges to implementation. The process evaluation uses a mixed methods approach, drawing on results from several sources including a survey of 574 attendees at 50 PEC clinics, structured clinical observations of 30 PEC nurses, in-depth interviews with 19 key stakeholders, documentary review and a participatory process evaluation workshop with key stakeholders to review collated evidence and contex...

背景：视力障碍是全球性公共卫生问题，全球约有2.85亿人受其影响，其中43%由屈光不正（refractive error）导致。中低收入国家缺乏专业眼科护理服务，这表明需要一种新型护理模式来支持任务转移（task-shifting）模式，以应对这一迫切需求。本文描述了卢旺达全国初级眼保健（PEC）项目过程评估的特征与结果。

方法：我们采用医学研究理事会（Medical Research Council）过程评估框架，考察PEC项目的实施情况，并确定实施的推动因素与挑战。该过程评估采用混合方法，整合了多种来源的结果，包括对50个PEC诊所574名就诊者的调查、对30名PEC护士的结构化临床观察、对19名关键利益相关者的深度访谈、文献回顾，以及与关键利益相关者共同举办的参与式过程评估研讨会（旨在审查整理的证据及背景...）