Exploring challenges and community support for hard-to-reach persons with visual impairment in the Free State province, South Africa: A qualitative study

Abstract

Background: Visual impairment is the third most prevalent impairment worldwide. Persons with visual impairment may have to navigate complex societal barriers and marginalisation daily. Thus, making them hard to reach. Objectives: To explore mobilisation strategies for hard-to-reach persons with visual impairment among community health workers and low-vision clinicians in the Free State province, South Africa. Method: An exploratory qualitative approach was used to explore mobilisation strategies for hard-to-reach persons with visual impairment in the Free State province. Results: Two main themes were identified: (1) challenges of accessing eye care services and (2) social and community support. Affordability and accessibility of spectacles and low-vision devices remain significant challenges, serving as barriers to accessing eye care services, particularly in rural areas. Poor social and community support by local government structures of resources, such as funding of eye care and transport costs, may be available to support persons with visual impairment, but are not utilised effectively by the local government. Lack of physical infrastructure that is accessible to persons with visual impairment and the poor inclusion of persons with visual impairment in community programmes and decision-making processes to improve social interaction and foster independence are prevalent. Conclusion: The challenges limit the capacity to deliver appropriate interventions to persons with visual impairment, further exacerbating the gap in care for the hard-to-reach. This emphasises a need for a more equitable distribution of resources, increased funding for eye care services, and the employment of more specialised professionals in underserved areas. Contribution: Findings informed a set of recommendations for the benefit of hard-to-reach persons with visual impairment in the development of inclusive eye care policies and empowered both the hard-to-reach and community health care workers.