A report on knowledge, attitude and practice (KAP) survey on eye health service in Nepal: a population based national survey.

Research Report.

SUMMARY: Nepal is multi-lingual, multi-cultural, multi-religious and multi-ethnic country. The total population of Nepal is 28.5 million and over one hundred castes/ethnic and religious groups and ninety-two mother tongues were listed in the census 2011 (National population census, CBS- 2011). Nepal's topography varies from the world's deepest gorge 'Kali-Gandaki' to the highest point on earth 'The Everest'. Hence there is wide and diverse level knowledge, attitude and practice about the eye health behavior. The KAP survey aims at enhancing capacity to assess, communicate and address eye health seeking behavior, especially at community level. In this context, this KAP survey is designed to identify KAP of community members in relation to eye health, to assess understanding of eye health status and their eye health seeking behavior, to plan the awareness raising activities in achieving the goal of VISION 2020: The Right to Sight. This study was based upon cross sectional descriptive study design and quantitative study type, supposed to assess the status of KAP on eye health service in the 15 selected districts of Nepal. Five thousands house hold from entire 100 clusters (50 HH from each clusters) were total sample size and each of the household were sampling unite for this study. Sampled taken was exclusively possessive assuming that 5000 HH can generalize the national wide survey since five development region and three ecological regions were incorporated in this study. A semi-structured questionnaires were developed on the basis of initial qualitative results from the last 15 years of eye health education program in the country in English language first and translated into simple and clear Nepali language. The enumerators visited door to door of 50 household in the selected clusters. The collected questionnaires were brought to Kathmandu and data entry was done in Census and Survey Processing (CS pro) software. The complete data-base were transferred to SPSS version 20 for further cleaning and analysis. This study was based on the involvement of more than three fourth (84 %) of active population between the age of 2059 and involves one third of female (37.4%), thus it represents the real picture of the community and includes all the socio-economic and geographical strata. Despite of three decade of national eye care programme being in practice and two decade of national eye health education programme in the country, only 78% of the people were having basic knowledge about common ocular disease, ranging from 68 to 95 percent. It is found that no single measure seems to be more appropriate than the other to provide eye health education to the people living in all geographical location. For example in Doti 98% people had radio in their homes but in Saptari only 15% had it. Similarly only 5% had television in their home in Doti while in Saptari 20% had it. Therefore radio would be more appropriate to provide health education in Doti and television in the Saptari. Hence different methods and media are to be used at different location to get better outcome. Hence it is necessary that every effort should be considered to choose the most appropriate and effective method and media for health education with clear view that who is the target for that particular education campaign. IEC materials should not be focused only for common disease like cataract and trachoma but also to the emerging causes like diabetes and hypertension from now. It will create awareness about the potentiality of its blinding condition and sensitize the people from now and get prepared for its prevention. Almost 2% of the people are still dependent on drug retailer, 0.6% self-medication and 0.1% traditional healers for the treatment. Hence local drug retailers and traditional healers are also to be continued target for the eye health education.