The African Journal of Primary Health & Family Medicine welcomes submissions that encourage scholarly exchange between family medicine and primary health care researchers and practitioners across Africa and the developing world, whilst providing a contextual and holistic view of family medicine as practiced across the continent.

Compared to other African countries, Swaziland performs the worst in terms of providing eye health care services. A priority goal of the World Health Organization (WHO) is to alleviate childhood blindness, particularly in low-income countries such as Swaziland, where many people live in poverty, which is a contributor to poor health outcomes. A mixed method approach that entailed a document review, key informant interviews and clinical facility assessment questionnaires was used. Hospitals and mission clinics offering ophthalmic services were identified through the website of the Ministry of Health and verified during key informant interviews. A saturated sampling procedure was applied due to the few facilities that offer eye care services. Six framework components from the WHO for analysing health systems were utilised in an eye health care service context: leadership and governance, eye health services, eye health workforce, eye health financing systems, eye health medical supplies and technologies, and eye health information systems. Poor management, lack of accountability, poor monitoring and evaluation mechanisms, weak coordination and ineffective private-public sector regulations were identified as factors that lead to poor eye care in the country. The optometrists indicated that refractive services are the most rendered ophthalmic services. The exodus of healthcare practitioners has contributed to the downfall of the public health sector in the country. Five government eye care facilities, 3 government hospitals, 1 non-governmental organization (NGO) and a church mission clinic were included in this analysis. The eye services distribution favors the more affluent areas, particularly the more urban Hhohho Region, which is also where most of the eye health professionals are located. No campaigns have been conducted to prevent childhood blinding diseases or create awareness about getting children’s eyes tested for refractive correction. The burden of eye diseases among children in Swaziland remains unknown. More eye health care personnel and equipped facilities are needed throughout the country, and the eye health care program needs to be adopted.

Background: Vision-related problems have a negative impact on the learning abilities and school performance of a child. Adequate knowledge and practices of teachers enable the early identification and intervention of school children with visual deficits.Aim: This study aimed to investigate the knowledge and practices of teachers about child eye healthcare in the public education system in Swaziland.Setting: The setting for this study was Swaziland.Methods: This was a cross-sectional quantitative study using a survey instrument containing closed-ended questions to investigate the knowledge and practices of teachers about child eye health in the public sector.Results: Two hundred and forty-three (N = 243) teachers responded to the questionnaire. The majority (90.1%) of teachers indicated that they were able to detect signs and symptoms of eye diseases. Most teachers without a family member wearing spectacles were more likely to be informed about eye health (p = 0.001) than those who had family wearing spectacles. A significant proportion (44%) of teachers indicated that refractive errors were not serious among school children. Above one-third (38.7%) of the teachers indicated that they referred children with vision problems to public hospitals. One hundred and fifty-five (63.8%) reported that health officials have never visited their schools. One hundred and forty-nine (61.3%) teachers agreed that they did not monitor children wearing spectacles and 94 (38.7%) monitored them. Monitoring children wearing spectacles was significantly associated with teachers who indicated being well informed about eye health (p 0.001) and teachers who were more likely to advise parents to take their children for eye testing (p = 0.003).Conclusion: The lack of adequate knowledge by some teachers may contribute to the already existing barriers for children to access eye health. Addressing the broader issues of child eye health requires the participation of well-trained and knowledgeable teachers.

Background: International and African rights instruments stipulate that children have the right to access quality general and eye health care. Lack of access to quality eye care can have a significant negative impact on the child, family and society in general.Aim: To determine the knowledge and practices of eye care professionals about the availability and accessibility of child eye care services in the public sector in Swaziland.Setting: The study was conducted in Swaziland.Methods: This was a quantitative study design, and 15 public eye health professionals completed and returned the Questionnaire for Eye Health Professionals (QEHP).Results: Thirteen (86.7%) eye health practitioners reported that both standard practice guidelines and paediatric national guidelines for ophthalmic services were unavailable. The majority (66.7%) identified cost and unawareness of available services by parents as the most common barrier to accessing eye care services. Nine (60%) felt that they were less informed about eye health problems and 6 (40%) reported being well informed. Eight (53.3%) respondents indicated that there were no outreach programmes and 7 (46.7%) reported that their clinics offered these services. Thirteen (86.7%) eye health practitioners indicated that they were not part of teachers’ training for supporting visually impaired children, while 2 (13%) reported that they were.Conclusion: Formulation of guidelines to support eye health care service delivery in Swaziland is essential in order to improve availability, accessibility, affordability and effectiveness in the public health system.

Visual impairment is a serious public health challenge that impacts on the social, economic, and educational opportunities of affected children, particularly those in Sub-Saharan Africa (SSA). Most countries in SSA fail to address education barriers emanating from poorly formulated education policies and implementation that directly or indirectly discriminate against children living with visual disabilities, particularly those from rural backgrounds. Therefore reviewing education policies and legislative laws about their pertinence and execution appears paramount. An extensive literature search was conducted using PubMed, Cochrane, Medline, and EBSCOhost databases as well as official websites including technical reports, policy documents and/or frameworks. The literature search used the following keywords in various combinations ‘access to basic education’, ‘challenges to accessing basic education’, and ‘visual impairment among children in Sub-Saharan Africa’. The literature reviewed geographically covers a SSA perspective on the following aspects: (1) visual impairment among children in SSA, (2) the lack of access to basic education for visually impaired children, (3) shortage of specialised skills in basic education for visually impaired children, (4) violations of good practice and discrimination in accessing basic education, and (5) possible solutions to the challenges experienced by children with visual impairments in SSA. Visually impaired children need to be recognised as part of their communities and should have the same rights to education as other citizens. All necessary measures should be made available for them to have fulfilling lives, including appropriate educational facilities.

Background: Patient satisfaction plays a vital role in the healthcare sector, holding significance for both medical providers and patients. Aim: The study investigated patient satisfaction levels regarding the quality of care delivered by private optometry services in South Africa. Setting: The study was conducted across all nine provinces in South Africa, with a specific focus on individuals utilising private optometry services. Methods: This study employed a quantitative, cross-sectional design to evaluate patient satisfaction levels regarding service quality in private optometry practices within South Africa, utilising questionnaires disseminated through social media platforms for data collection. Results: Our study included 283 participants, with a mean age of 36.3 ± 10.41 years, predominantly female (69.8%) and Black African (96%), and found high satisfaction scores with optometrists. The primary reasons for visiting optometrists in our cohort were spectacle or contact lens renewal (34.9%), routine check-ups (24.5%) and addressing reduced vision (24.5%). Among those who switched optometrists, 40.8% cited relocation and 17.9% reported service dissatisfaction. The mean overall satisfaction score was 4.38 ± 0.66, with high ratings for cleanliness, physical facilities and staff conduct. Conversely, waiting time and cost received relatively lower scores. Conclusion: Participants were highly satisfied with private optometry services in South Africa, although cost and waiting time had comparatively lower ratings. Contribution: The study provides evidence on patient satisfaction in private optometry and highlights areas for service improvement.