Workforce distribution and cataract surgical rates in the eastern mediterranean (EMR) and middle east north Africa (MENA) regions

• Wide disparities exist in ophthalmic workforce availability across EMR and MENA countries. Cataract Surgical Rate (CSR) positively correlates with ophthalmologist density up to 20 ophthalmologists/million. • Iran and Pakistan demonstrate high CSR and productivity with moderate ophthalmologist density. • Productivity, not just workforce size, is key to improving cataract surgical outputs. • Significant gaps in data on optometrists and allied ophthalmic personnel exist. This study analyses the distribution of ophthalmic human resources in countries of the Eastern Mediterranean Region (EMR) and the Middle East North Africa (MENA), and their productivity in relation to cataract surgery. Cross-sectional, secondary data analysis. The analysis compiled secondary data available in the public domain, on the ophthalmic workforce and Cataract Surgical Rate (CSR), defined as the number of cataract surgeries performed annually per million population, using the International Agency for the Prevention of Blindness (IAPB) Vision Atlas and the Rapid Assessment of Avoidable Blindness (RAAB) Repository. We included data from 25 countries (n=25 data points), and performed a segmented linear correlation to account for the correlation between CSR and ophthalmologist density. The density of ophthalmologists per million population ranged from <1 per million population in Somalia and South Sudan to 70 per million in Saudi Arabia. There was a positive correlation between the number of ophthalmologists per million and CSR up to approximately 20 ophthalmologists/million, after which the association was not found. On average, ophthalmologists performed <1 to 22 cataract surgery per week in countries of the region. Iran and Pakistan showed the highest CSR values and CSRs per ophthalmologist/week among the countries analysed. There are wide variations in the availability and productivity of ophthalmic personnel in terms of cataract surgeries/ophthalmologist/week between countries in the region. These findings highlight the need to strengthen efficiency, equitable access, and data quality across eye care systems in the region. Wider adoption of newer indicators, particularly the effective cataract surgical coverage (eCSC), would provide additional information on equity and quality of cataract services.