Evaluating Eye Care Services in South Africa’s Limpopo Province Using Donabedian`s Framework: Insights into Structures, Processes, and Outcomes

Hlabje Carel Masemola,1 Olivia Baloyi,1 Zamadonda Nokuthula Xulu-Kasaba2 1Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; 2Department of Optometry, College of Health Sciences, University of KwaZulu-Natal, Durban, South AfricaCorrespondence: Hlabje Carel Masemola, Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4041, South Africa, Email [email protected]: Eye care services play an essential role in public health by addressing the needs of millions impacted by visual impairment and blindness annually. This study aimed to assess eye care services in Limpopo Province through Donabedian’s framework, focusing on evaluating the availability and sufficiency of eye care infrastructure (structure), service delivery effectiveness (process), and patient outcomes.Methods: Using an exploratory, descriptive qualitative design, data were gathered in June and July 2024, through in-depth individual interviews. Ten (10) district eye health coordinators were selected as participants using purposive sampling. Data were thematically analyzed with NVivo version 12, revealing three main themes: resources and organizational setup, service delivery and healthcare interactions, and results of care provided.Results: The findings revealed the first theme as resources and organizational setup with sub-themes such as availability of eye care, services, resource allocation and, infrastructure, human resources and staffing. The second theme was service delivery and healthcare interactions with sub-themes such as service delivery and quality, perception, referral systems and inter-hospital coordination, health promotion and community outreach. The third theme was results of care provided with patient outcomes and satisfaction, technological advancements and patient care, challenges in achieving and public health goals as sub-themes. The findings indicate that challenges related to structure and processes significantly influence patient outcomes.Conclusion: The study further highlights resources, service delivery efficiency, and referral timeliness as key factors essential for achieving optimal patient outcomes and contributing to the broader objective of universal eye health coverage.Keywords: eye care services, donabedian’s framework, visual impairment, service delivery, patient outcomes, South Africa