Globally, an estimated 2.2 billion people are visually impaired (VI) or blind, and a large proportion (90%) of those affected live in low- and middle-income countries (LMICs), where access to eye health services is limited. This study aimed to identify barriers to accessing eye health services and associated factors in suburban communities of Nampula. A cross-sectional community-based study was carried out on adults ≥18 years old. A total of 338 adults were randomly selected from three communities (Muthita, Piloto, and Nthotta). Individual interviews were carried out and socio-demographic data, eye symptoms, date of last eye examination, and barriers to access to eye health services were extracted. Among participants, 49.4% had eye symptoms and 41.7% did not have their eye examinations up to date. The most cited barriers were crowding in hospitals (40.7%), financial difficulties (30.0%), self-medication (20.5%), traditional treatment (17.8%), and buying eyeglasses on the street (11.6%). Barriers limited the service target to 33%. Lower levels of schooling and monthly family income and farmer occupation were statistically associated with the most barriers as risk factors. The use of eye health services was lower due to barriers to accessing eye services. More specific intervention plans and greater cooperation between sectors are needed to improve these indicators.

Background: Computer Vision Syndrome (CVS) is a complex of eye and visual problems that arise while using a computer or other Video Display Terminal (DVT). With the advent of the COVID-19 pandemic, the use of these DVTs has become indispensable in the lives of students and teachers. This study aims to identify the prevalence of CVS and associated factors in students and teachers at Lúrio University, in Nampula, during the pandemic period.Methods: This is a cross-sectional study, carried out between November 2020 and March 2021. The validated CVS questionnaire (CVS-Q) and another semi-structured questionnaire on ergonomic risk factors were applied. Odds ratios (OR) and adjusted odds ratios (aOR) were calculated to measure the association between CVS and computer use conditions.Results: The prevalence of CVS was 76.6%, and the female gender, age ≤ 20 years, levels I, II, III of course, lack of knowledge about ergonomics, use the computer to study, use more than 6 hours daily, absence of anti-reflex treatment, use of other devices and sitting in an inappropriate chair were risk factors for the occurrence of CVS, while being a teacher was a protective factor.Conclusion: The prevalence of CVS found in this study was high, due to several factors, especially not using ergonomic principles when using computers and other DVTs. There is a need to adopt intervention strategies focused on the most vulnerable groups such as women, age group ≤20 years and students, especially at the first year level, right after entering the University.

Visual impairment (VI) can significantly interfere in the child’s daily activities and quality of life, having a negative effect on their development and learning. The aim of the study was to determine the prevalence of VI and associated demographic factors in students examined during the program “Moçambique te vejo melhor”. This study was cross-sectional and retrospective, based on the 2018/19 edition of the program. Eye examinations were performed in secondary school students, aged between 12 and 20 years, of five districts in Nampula province. The examination included visual acuity, non-cycloplegic refraction and assessment of the anterior and posterior segment and ocular adnexa. The prevalence of uncorrected, presenting and best-corrected VI found was 18.3%, 10.8%, and 5.0%, respectively. Refractive error (RE) had a prevalence of 24.7%, and the age groups between 15–17 years and 18–20 years were significantly associated with myopia (with OR: 4.9 and OR: 8.8, respectively), as well as the 11th and 12th grade (OR: 8.1 and OR: 10.7, respectively), and Malema district had association with myopia (ORa: 0.4) and hyperopia (ORa: 0.4 and OR: 0.3) as a protective factor. The prevalence of RE and VI was relatively high, showing the need for greater intervention at the school level.

Background: Despite advances in surgical techniques, cataract remains the leading cause of preventable blindness, and massive surgeries have been adopted as a strategy to change this situation. Monitoring the results of cataract surgeries has become imperative to ensure their quality. Therefore, this study aims to assess the cataract surgery outcomes performed at the Central Hospital of Nampula Mozambique. Methods: This is a prospective and longitudinal study in which translation, cultural adaptation and validation of the visual function (VF) and quality of life (QoL) questionnaire were performed. The appearance, content, construct, criterion, internal consistency and responsiveness were validated using the most common methods and indicators. Visual acuity (VA), VF and QoL were evaluated on 447 patients before and after surgery by t-test and effect sizes. Results: VF and QoL questionnaires showed one-dimension, good values of TLI (0.973, 0.951) and SRMR (0.057, 0.054), and for each item, weights > 0.7, H2 > 0.5, ranges > 5.8 and the RMSEA < 0.08. Correlations for criterion validity were high and for responsiveness were high for QoL and moderate for VF one and the ordinal Cronbach’s alpha coefficients were greater than 0.97. Difference between VA, VF and QoL before and after surgery was statistically significant (p < 0.001). After surgery, 74.3% of patients had good, 23.5% had borderline and 2.2% had poor VA. Conclusions: The cataract surgery outcomes are outside the WHO recommendations regarding VA, but they have had a great impact on improving VF and QoL. The questionnaires showed excellent psychometric properties and should be used in daily clinical practice to evaluate the results of cataract surgeries.

Background: The unavailability of human and material resources can affect access to eye health services, constituting an obstacle in the fight against avoidable visual impairment. This study aimed to assess the availability and distribution of human and material resources for eye health in the public sector in Nampula province. Methods: A mixed method approach was used, which included document reviews (to extract information regarding the number of professionals and inhabitants in each district) and application of a questionnaire to heads of the ophthalmology department in each health facility (to obtain the list of available equipment). The ratios of eye health professionals per population in Nampula province and each of its districts were calculated and evaluated taking into account the recommendations of the World Health Organization (WHO). Based on the level of care of each health facility, the availability of equipment was evaluated. Results: Nampula Province has not reached the recommended ratio of eye health professionals per population in the different categories (ophthalmic technicians with 0.8 per 100 thousand inhabitants; optometrists and ophthalmologists with 0.4 and 0.2 per 250 thousand inhabitants, respectively). Most districts of Nampula did not reach the recommended ratio in the three categories of professionals, except Nampula City (provincial capital). However, there was a greater concentration of professionals and facilities with eye health services in the provincial capital. Primary and secondary level health facilities lacked some equipment to provide eye health services within their scope. Conclusions: There is an unequal distribution of the workforce in Nampula and the centralization of surgical services at the Central Hospital of Nampula level. Therefore, there is a need to review resource distribution strategies and decentralization policy of eye health services in Nampula.

Scientific evidence on the burden of visual impairment, its causes, and associated factors are essential to monitor progress in eye health, identify priorities and develop strategies and policies that meet the needs of the population, towards the eradication of preventable blindness. The aim of this study was to determine the prevalence of visual impairment, its causes and associated factors in adults living in suburban communities in Nampula. This is a cross-sectional study conducted from November 2019 to February 2020. Eye examinations were performed on adults aged ≥18 years covered by the Lúrio University program, 'one student, one family'. The odds ratio (OR) and adjusted odds ratio (aOR) were calculated to study the association between the dependent variable (presenting visual impairment) and independent variables (gender, age, school level, residence, family income and systemic diseases), with a 95% confidence interval. Distance and near presenting visual impairment had a prevalence of 16.3% and 21.1%, respectively, and were statistically associated with the age groups between 45-65 (OR:4.9) and >65 years (OR: 29.1), illiterate (OR:13.8), primary (OR:4.8) and secondary (aOR:37.5) school level, farmer (OR:32.8) and retired (OR:14.3) occupation, and presence of systemic diseases (OR :3.3). The main causes of presenting visual impairment were uncorrected refractive error and cataract. The prevalence of presenting visual impairment is relatively high, given the enormous effort undertaken within the framework of VISION 2020: The Right to Sight global initiative. There is a need to develop intervention plans targeted at the highest risk groups, with a view to achieving the 'one student, one family' program goals with respect to eye health.