The impact of effective community engagement in implementing prevention of blindness interventions. The impact of effective community engagement in implementing prevention of blindness interventions. Ahmed Mousa Abdel Rahim, M. Sc., Ph. D. Lecturer, Ocular Epidemiology, Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Study Significance Several Models are available for prevention of low vision and blindness. Several Models are available for prevention of low vision and blindness. The majority of these models are suffering the following defects. The majority of these models are suffering the following defects. – Less effectiveness. – Very costly. – Unsustainable. There is a need for developing and implementing new models that would be of: There is a need for developing and implementing new models that would be of: – Based on the actual community needs, and understand the community characteristics in terms of causes (medical & non medical), cultural issues, and specific barriers. – Of Multi-component nature. – Cost effective. – Self sustainable.

Our model was mainly based on: In depth understanding of the community in terms of: – Behaviors. – Attitudes. – Culture. – Traditions. – Barriers. Effective engagement of the community in: -Planning. -Screening. -Conduct of community health education. -Breaking down barriers. -Maintaining sustainability.

Methods: A sample of four villages with high prevalence of avoidable blindness were selected. The intervention program was conducted in two villages while two other villages were used as control. Qualitative interviews and focus group discussions were held to understand the community characteristics and needs. In the intervention villages, local staff was trained on: screening of avoidable blinding diseases, conduct of community health education, and assist people to seek services. Community leaders and religion men were contacted and involved in addition to local authorities and women groups. Pre and post intervention quantitative assessments were done.

Results: (1) Pre & Post Intervention Prevalence of Low Vision and Blindness.

Pre Intervention Post Intervention Intervention Control Results: (2) Pre & Post Intervention Prevalence of Cataract.

Pre Intervention Post Intervention Intervention Control Results: (3) Pre & Post Intervention Prevalence of TT.

S.Barrier No (%). reported Yes Difference 95% CI p PrePost 1I didn't feel a problem77 (87.5)104 (70.7)16.80%( ) Fear of Surgery78 (90.7)97 (66.4)24.30%( ) Fear of Surgical Outcome78 (90.7)83 (63.8)26.90%( )< I am too Old75 (87.2)59 (51.8)35.40%( )< Fear of Bad treatment at hospital59 (68.6)44 (41.1)27.50%( ) Distance to hospital is too long62 (72.9)52 (48.1)24.80%( ) Expenses of surgery are too much76 (89.4)66 (54.5)34.90%( )< No one to accompany me to hospital47 (56)42 (40)16.00%( ) I couldn't quit work to go36 (42.4)44 (42.3)0.10%( ) No one to take care of family and children32 (37.6)25 (30.1)7.50%(-6.76 to 21.76) Results: (4) Pre & Post Intervention Prevalence of Barriers.

Results: (5) Pre & Post Intervention Prevalence of surgical uptake.

Conclusion Engaging communities should start from the early phases of planning as they are the best advisors to express their needs and barriers. Getting community members involved in conduct of the intervention will facilitate reaching the community and affect its members. Feeling ownership will maintain sustainability of the achieved results after the endpoint of the program.