Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach program

Abstract Background Effective Cataract Surgical Coverage (eCSC) is one of the Universal Health Coverage (UHC) indicators recommended by the World Health Organization (WHO). It is calculated from a population survey and measures access and quality of eye care services in the community. We conducted s...

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Main Authors: Mohamad Aziz Salowi, Nyi Nyi Naing, Norasyikin Mustafa, Wan Radziah Wan Nawang, Siti Nurhuda Sharudin, Mohd Aziz Husni
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21602-0
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author Mohamad Aziz Salowi
Nyi Nyi Naing
Norasyikin Mustafa
Wan Radziah Wan Nawang
Siti Nurhuda Sharudin
Mohd Aziz Husni
author_facet Mohamad Aziz Salowi
Nyi Nyi Naing
Norasyikin Mustafa
Wan Radziah Wan Nawang
Siti Nurhuda Sharudin
Mohd Aziz Husni
author_sort Mohamad Aziz Salowi
collection DOAJ
description Abstract Background Effective Cataract Surgical Coverage (eCSC) is one of the Universal Health Coverage (UHC) indicators recommended by the World Health Organization (WHO). It is calculated from a population survey and measures access and quality of eye care services in the community. We conducted simultaneous population-based eye surveys in two regions in Malaysia in 2023 to estimate eCSC and compare the results with the survey in 2014 following the implementation of a mobile cataract program. Methods The surveys were simultaneously done in Eastern and Sarawak administrative regions using the Rapid Assessment of Avoidable Blindness (RAAB) technique. It involved a multistage cluster sampling method, each cluster comprising 50 residents aged 50 years and older. Presenting visual acuity (PVA) was checked, and subjects with cataracts were identified. The corrected VA (Pinhole) of those who had undergone cataract surgery was measured. eCSC was calculated at all levels of cataract surgical thresholds according to the protocol. The findings were compared with the previous survey. Results A total of 10,184 subjects were enumerated, with 9,709 examined and 475 non-respondents. Females had a significantly lower Cataract Surgical Coverage (CSC) than males for cataract surgical threshold of < 3/60 for both regions in National Eye Survey (NES) II in 2014, [Eastern female 82.0%, 95% Confidence Interval (CI) (72.5, 91.5) vs. male 97.8%, 95% CI (92.8, 100.0), Sarawak female 76.9%, 95% CI (66.4, 87.3) vs. male 96.4%, 95% CI (91.6, 100.0)]. However, there was no significant gender difference in eCSC. Comparing NES II (2014) and NES III (2023) at various levels of cataract surgical threshold, eCSC improved within the range of 13.8-19.2% and 18.6-23.8% for Eastern and Sarawak, respectively. Conclusion The improvement in eCSC could likely be attributed to both quality outcome enhancement and increased coverage, possibly due to the impact of the mobile cataract services in both regions. However, a coordinated approach is necessary to further strengthen and expand the coverage of the program to enable the country to achieve the 30% increase in eCSC as targeted by WHO.
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spelling doaj-art-26098d47e74745bbbf2c62e667bc23002025-02-09T12:57:31ZengBMCBMC Public Health1471-24582025-02-0125111210.1186/s12889-025-21602-0Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach programMohamad Aziz Salowi0Nyi Nyi Naing1Norasyikin Mustafa2Wan Radziah Wan Nawang3Siti Nurhuda Sharudin4Mohd Aziz Husni5Clinical Research Centre, National Institute of Health, Ministry of HealthFaculty of Medicine, Universiti Sultan Zainal AbidinFaculty of Medicine, Universiti Teknologi MARADepartment of Ophthalmology, Selayang Hospital, Ministry of HealthDepartment of Ophthalmology, Selayang Hospital, Ministry of HealthDepartment of Ophthalmology, Tengku Ampuan Afzan Hospital, Ministry of HealthAbstract Background Effective Cataract Surgical Coverage (eCSC) is one of the Universal Health Coverage (UHC) indicators recommended by the World Health Organization (WHO). It is calculated from a population survey and measures access and quality of eye care services in the community. We conducted simultaneous population-based eye surveys in two regions in Malaysia in 2023 to estimate eCSC and compare the results with the survey in 2014 following the implementation of a mobile cataract program. Methods The surveys were simultaneously done in Eastern and Sarawak administrative regions using the Rapid Assessment of Avoidable Blindness (RAAB) technique. It involved a multistage cluster sampling method, each cluster comprising 50 residents aged 50 years and older. Presenting visual acuity (PVA) was checked, and subjects with cataracts were identified. The corrected VA (Pinhole) of those who had undergone cataract surgery was measured. eCSC was calculated at all levels of cataract surgical thresholds according to the protocol. The findings were compared with the previous survey. Results A total of 10,184 subjects were enumerated, with 9,709 examined and 475 non-respondents. Females had a significantly lower Cataract Surgical Coverage (CSC) than males for cataract surgical threshold of < 3/60 for both regions in National Eye Survey (NES) II in 2014, [Eastern female 82.0%, 95% Confidence Interval (CI) (72.5, 91.5) vs. male 97.8%, 95% CI (92.8, 100.0), Sarawak female 76.9%, 95% CI (66.4, 87.3) vs. male 96.4%, 95% CI (91.6, 100.0)]. However, there was no significant gender difference in eCSC. Comparing NES II (2014) and NES III (2023) at various levels of cataract surgical threshold, eCSC improved within the range of 13.8-19.2% and 18.6-23.8% for Eastern and Sarawak, respectively. Conclusion The improvement in eCSC could likely be attributed to both quality outcome enhancement and increased coverage, possibly due to the impact of the mobile cataract services in both regions. However, a coordinated approach is necessary to further strengthen and expand the coverage of the program to enable the country to achieve the 30% increase in eCSC as targeted by WHO.https://doi.org/10.1186/s12889-025-21602-0CataracteCSCRAAB
spellingShingle Mohamad Aziz Salowi
Nyi Nyi Naing
Norasyikin Mustafa
Wan Radziah Wan Nawang
Siti Nurhuda Sharudin
Mohd Aziz Husni
Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach program
BMC Public Health
Cataract
eCSC
RAAB
title Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach program
title_full Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach program
title_fullStr Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach program
title_full_unstemmed Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach program
title_short Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach program
title_sort improvement in the effective cataract surgical coverage in malaysia evidence of impact from a mobile cataract outreach program
topic Cataract
eCSC
RAAB
url https://doi.org/10.1186/s12889-025-21602-0
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