Challenges and supports for children with low vision in accessing education in Nigeria: A six-state mixed-methods study

Background: Low vision reduces functional vision and cannot be fully corrected with standard spectacles, medication, or surgery, thereby limiting children’s ability to participate effectively in key school tasks such as reading the board, reading print, copying notes, and completing assessments. In Nigeria, inclusive education policies and disability-rights frameworks emphasize equal educational access and reasonable accommodation for learners with disabilities; however, implementation gaps persist in teacher preparedness, accessible learning materials, assistive devices, and school–eye health referral pathways. This study assessed the challenges and supports affecting educational access for children with low vision across Nigeria’s six geopolitical zones.Materials and Methods: A convergent mixed-methods cross-sectional study was conducted across six states representing the six geopolitical zones of Nigeria: Lagos (South-West), Enugu (South-East), Rivers (South-South), FCT–Abuja (North-Central), Kano (North-West), and Bauchi (North-East). Eight schools were selected per state (48 schools), and 2,760 learners were screened for eligibility. A total of 384 learners met the study definition for low vision; 360 provided assent and caregiver consent and were included in the quantitative analysis. Data were collected using learner and teacher questionnaires, a school administrator questionnaire, and an observation checklist assessing classroom accessibility and supports. Qualitative data were obtained through semi-structured interviews with learners, caregivers, teachers, administrators, and eye-care providers. Quantitative data were analyzed using descriptive statistics and multivariable logistic regression, while qualitative data were analyzed thematically, and findings were integrated during interpretation.Results: Most learners reported difficulty seeing the board (78.1%) and reading standard print (72.5%). Difficulties copying notes (66.4%) and eye strain/headache during reading (59.2%) were common. Assessment barriers were substantial: 62.0% reported difficulty reading examination scripts, 55.3% reported running out of time during tests, 78.9% did not receive extra time, and 91.4% reported that large-print examination scripts were not provided. Supports were inconsistent: 58.6% owned spectacles but only 34.2% had updated correction within 12 months; 10.8% had ever used a handheld magnifier and 1.4% had accessed electronic magnification. In regression analysis, better educational access and participation were associated with regular spectacle use (AOR 2.10), consistent front-row seating (AOR 1.86), availability of large-print materials (AOR 3.41), and teacher training exposure (AOR 2.69), while rural/peri-urban location (AOR 0.62) and bullying/stigma (AOR 0.58) were associated with poorer access.Conclusion: Children with low vision across Nigeria experience substantial instructional, assessment, and psychosocial barriers to education, driven largely by limited accommodations and low availability of accessible materials and assistive devices. Strengthening routine classroom and examination accommodations, improving teacher capacity, expanding access to updated correction and basic low-vision devices, and reinforcing school eye health linkages are critical to improving equitable educational participation for learners with low vision.