This review from the explores the evidence supporting task-shifting in eye care, specifically the training and use of non-physician cataract surgeons (NPCS) to address cataract-related blindness in Sub-Saharan Africa. Given the shortage and poor distribution of ophthalmologists, NPCS (often clinical officers or ophthalmic nurses with additional training) have been deployed in several countries to increase access to cataract surgery. The report analyzes their effectiveness, quality of surgical outcomes, patient satisfaction, and productivity, with case studies from Kenya, The Gambia, Tanzania, Malawi, and Ghana. While the evidence shows that NPCS can deliver high-quality surgeries, particularly when well-trained, supervised, and supported, issues such as post-training deployment, resource availability, and systemic health barriers remain challenges. The review concludes that while NPCS are not a universal solution, they are a viable strategy in underserved areas and should be integrated thoughtfully into national eye health programs.
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Resources
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Assessing the impact of cataract surgeons trained in eastern Africa for VISION 2020
A regional evaluation of the productivity, challenges, and outcomes of cataract surgeons trained in Eastern Africa to support VISION 2020, with recommendations to enhance service delivery, equipment access, and community outreach.