Community perspectives on awareness, care-seeking, and implementation of a corneal ulcer prevention program in Nepal: a mixed-methods study.

Authors

Kelly C Nguyen, Puspa Giri, Sadhan Bhandari, Gopal Bhandari, Raghunadan Byanju, Ram Prasad Kandel, Binita Sharma, Bimal Poudyal, Pramod Bhatta, John P Whitcher, Muthiah Srinivasan, Madan Upadhyay, Thomas M Lietman, Carolyn Brandt, Jeremy D Keenan, Kieran S O'Brien

Published in

Global health action. Volume 19. Issue 1. Pages 2695741. Epub Jul 03, 2026.

Abstract

A corneal ulcer prevention program trained Female Community Health Volunteers (FCHVs) to diagnose and treat corneal abrasions in Nepal.
To understand community eyecare-seeking behavior, program awareness, and program perceptions.
This mixed-methods study was conducted in program communities. Surveys assessed awareness in a random sample of 10-20 households per community at 6 and 18 months after program initiation. Focus group discussions (FGDs) with community members and FCHVs examined care-seeking behavior and perceptions at 9 months. Six communities were randomly selected for FGDs, and within each, a random sample of 10 males and 10 females were invited to participate. FCHVs from these communities participated separately. The intervention was modified based on the FGDs before the final survey.
The pre-FGD survey found 3.1% (SD 7.2%) of participants were aware of the program. All 13 FGDs (92 participants) indicated eye trauma and delayed care-seeking were common. Participants from only four FGDs reported awareness of the FCHV program though participants from all FGDs indicated a willingness to seek eye care from the FCHVs. As FGDs identified word-of-mouth and door-to-door outreach as effective publicity approaches, two door-to-door campaigns were subsequently implemented. Household surveys 9 months after the FGDs found that program awareness increased to 32.9% (SD 26%, p-value <0.001).
FGDs revealed that eye trauma and delayed care-seeking were common, underscoring the need to address barriers to timely care. Community engagement strategies identified during FGDs were successfully implemented. Program awareness was much higher post-FGDs, although causality cannot be established in this observational study.

PMID:
42394569
Bibliographic data and abstract were imported from PubMed on 03 Jul 2026.

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