Epidemiology Research International / 2014 / Article / Tab 4

Research Article

Blindness Registers as Epidemiological Tools for Public Health Planning: A Case Study in Belize

Table 4

Potential areas of improvement for the Belize Council for the Visually Impaired (BCVI) register.

GapDescriptionRecommendation(s)

Organization/staffingResponsibilities for the register are split between multiple staff positions, and personnel have many other demands that take precedence over the register (i) Include register maintenance and updating in descriptions of staff positions and contracts
(ii) Develop a formal and explicit system for how the responsibilities for the register will be divided and put accountability checks in place
(iii) Train personnel to carry out regular data cleaning checks

Register maintenanceErrors and inconsistencies in data entry and lack of follow-up on patient status (i.e., if referred to treatment or surgery)(i) Develop a formal follow-up process for updating the register with set timelines
(ii) Consider linking the register with other sources of information (i.e., clinics, the patient records database, the Belize Health Information System, mortality records, etc.)

Incomplete coverage of the population The register may potentially miss many individuals suffering from low vision and blindness, including those who use private doctors and those in remote areas of the country(i) Promote awareness of BCVI and registration in the community (clinics, grocery stores, churches, and schools) to boost referrals
(ii) Build more relationships with private ophthalmologists to boost their referrals
(iii) Conduct more outreach clinics to reach remote/marginalized communities
(iv) Provide professional training for ophthalmologists on how to complete the register using clear definitions and criteria

Collecting relevant variablesSome key variables regarding the social determinants of health are missing(i) Collect information on ethnicity, socioeconomic status, and residence within an urban or rural setting for all new registrants

CodingCoding of some variables is not aligned with categories that are widely in use elsewhere (i) Code the level of visual impairment and the cause of registration according to criteria set by the World Health Organization (WHO) in order to allow for easier cross-comparison and contextual analysis in the future

Registration processIndividuals with avoidable blindness are listed on the register for rehabilitation and support services when they should be referred to treatment instead (i) Evaluate patients on the current register and refer them to treatment if applicable (i.e., for cataract); if all treatment fails, then keep them on the register for rehabilitation

Publicizing resultsReports from BCVI data go to funders but are not included in the public domain, and results are not widely disseminated(i) Advocate for the inclusion of data from the register in Belize’s compilation of national health statistics
(ii) Send results from analyses of register data to the WHO and the Pan American Health Organization (PAHO) so that data from Belize will be included in their reports

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