Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review
Purpose Globally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care se...
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doaj-f408e1b34d224e8986c80280ed2b059e2021-04-03T19:30:29ZengBMJ Publishing GroupBMJ Global Health2059-79082021-03-016310.1136/bmjgh-2020-004484Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping reviewMatire Harwood0Anthea Burnett1Matthew J Burton2Jacqueline Ramke3Helen Burn4Joanna Black5Jennifer R Evans6Lisa Hamm7General Practice and Primary Healthcare, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New ZealandSchool of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, AustraliaInternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UKInternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UKInternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UKSchool of Optometry and Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New ZealandInternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UKSchool of Optometry and Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New ZealandPurpose Globally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care services. We conducted a scoping review to identify and summarise service delivery models designed to improve access to eye care for Indigenous peoples in high-income countries.Methods Searches were conducted on MEDLINE, Embase and Global Health in January 2019 and updated in July 2020. All study designs were eligible if they described a model of eye care service delivery aimed at populations with over 50% Indigenous peoples. Two reviewers independently screened titles, abstracts and full-text articles and completed data charting. We extracted data on publication details, study context, service delivery interventions, outcomes and evaluations, engagement with Indigenous peoples and access dimensions targeted. We summarised findings descriptively following thematic analysis.Results We screened 2604 abstracts and 67 studies fulfilled our eligibility criteria. Studies were focused on Indigenous peoples in Australia (n=45), USA (n=11), Canada (n=7), New Zealand (n=2), Taiwan (n=1) and Greenland (n=1). The main disease focus was diabetic retinopathy (n=30, 45%), followed by ‘all eye care’ (n=16, 24%). Most studies focused on targeted interventions to increase availability of services. Fewer than one-third of studies reported involving Indigenous communities when designing the service. 41 studies reflected on whether the model improved access, but none undertook rigorous evaluation or quantitative assessment.Conclusions The geographical and clinical scope of service delivery models to improve access to eye care for Indigenous peoples in high-income countries is narrow, with most studies focused on Australia and services for diabetic retinopathy. More and better engagement with Indigenous communities is required to design and implement accessible eye care services.https://gh.bmj.com/content/6/3/e004484.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Matire Harwood Anthea Burnett Matthew J Burton Jacqueline Ramke Helen Burn Joanna Black Jennifer R Evans Lisa Hamm |
spellingShingle |
Matire Harwood Anthea Burnett Matthew J Burton Jacqueline Ramke Helen Burn Joanna Black Jennifer R Evans Lisa Hamm Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review BMJ Global Health |
author_facet |
Matire Harwood Anthea Burnett Matthew J Burton Jacqueline Ramke Helen Burn Joanna Black Jennifer R Evans Lisa Hamm |
author_sort |
Matire Harwood |
title |
Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review |
title_short |
Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review |
title_full |
Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review |
title_fullStr |
Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review |
title_full_unstemmed |
Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review |
title_sort |
eye care delivery models to improve access to eye care for indigenous peoples in high-income countries: a scoping review |
publisher |
BMJ Publishing Group |
series |
BMJ Global Health |
issn |
2059-7908 |
publishDate |
2021-03-01 |
description |
Purpose Globally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care services. We conducted a scoping review to identify and summarise service delivery models designed to improve access to eye care for Indigenous peoples in high-income countries.Methods Searches were conducted on MEDLINE, Embase and Global Health in January 2019 and updated in July 2020. All study designs were eligible if they described a model of eye care service delivery aimed at populations with over 50% Indigenous peoples. Two reviewers independently screened titles, abstracts and full-text articles and completed data charting. We extracted data on publication details, study context, service delivery interventions, outcomes and evaluations, engagement with Indigenous peoples and access dimensions targeted. We summarised findings descriptively following thematic analysis.Results We screened 2604 abstracts and 67 studies fulfilled our eligibility criteria. Studies were focused on Indigenous peoples in Australia (n=45), USA (n=11), Canada (n=7), New Zealand (n=2), Taiwan (n=1) and Greenland (n=1). The main disease focus was diabetic retinopathy (n=30, 45%), followed by ‘all eye care’ (n=16, 24%). Most studies focused on targeted interventions to increase availability of services. Fewer than one-third of studies reported involving Indigenous communities when designing the service. 41 studies reflected on whether the model improved access, but none undertook rigorous evaluation or quantitative assessment.Conclusions The geographical and clinical scope of service delivery models to improve access to eye care for Indigenous peoples in high-income countries is narrow, with most studies focused on Australia and services for diabetic retinopathy. More and better engagement with Indigenous communities is required to design and implement accessible eye care services. |
url |
https://gh.bmj.com/content/6/3/e004484.full |
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