Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 27  |  Issue : 2  |  Page : 68-75

A Survey of Teachers’ Knowledge, Attitudes, and Practices Related to Pupils’ Eye Health and School-Based Eye-Health Services


1 Department of Ophthalmology, Enugu State University of Science and Technology, Park Lane Hospital, Enugu, Nigeria
2 Department of Ophthalmology, University of Nigeria Teaching Hospital Enugu, Enugu, Nigeria

Date of Submission18-Apr-2018
Date of Decision21-Aug-2018
Date of Acceptance17-Dec-2018
Date of Web Publication07-Feb-2020

Correspondence Address:
Dr. Nkiruka N Okoloagu
Department of Ophthalmology, Enugu State University of Science and Technology, Park Lane Hospital, Enugu
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njo.njo_10_18

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  Abstract 


Objective: This article aims to assess the knowledge, attitudes, and practices of primary school teachers (PSTs) in relation to their pupils’ eye health and school-based eye health services. Materials and Methods: This was a descriptive cross-sectional questionnaire-based survey of PSTs in the Nkanu West Local Government Area, Enugu State, Nigeria. The study’s instrument was a pilot-tested, researcher-administered 16-item questionnaire with subscales measuring participants’ sociodemographics, and knowledge, attitudes, and practices related to their pupils’ eye health and school-based eye health services. Data were analyzed using the Statistical Package for the Social Sciences software for Windows, version 18.0. Descriptive statistics yielded frequencies, percentages, and proportions. Analytical statistics included the Chi-square test, for categorical variables, and Student’s t test for continuous variables. A P-value <0.05 was considered statistically significant. Results: There were 207 participants, including 40 (19.3%) males and 167 (80.7%) females (M:F = 1:4.2) aged 42.2 ± 8.67 SD years. Only 31 (15.0%) participants had good knowledge of their pupils’ eye health and school-based eye health services, and almost half (48.0%) obtained their information from family and friends. Two hundred (96.6%) participants had a positive attitude and 45.4% reported good practices. Conclusion: The majority of the PSTs had poor knowledge and practices related to their pupils’ eye health and school-based eye health services. However, most of the teachers displayed a positive attitude toward their pupils’ eye health and school-based eye health services. A structured health education workshop is advocated to correct the gaps in teachers’ knowledge and practices.

Keywords: Attitudes, children, eye health, knowledge, practices, teachers


How to cite this article:
Okoloagu NN, Okoye O, Onwubiko S, Eze C, Eze B, Chuka-Okosa C. A Survey of Teachers’ Knowledge, Attitudes, and Practices Related to Pupils’ Eye Health and School-Based Eye-Health Services. Niger J Ophthalmol 2019;27:68-75

How to cite this URL:
Okoloagu NN, Okoye O, Onwubiko S, Eze C, Eze B, Chuka-Okosa C. A Survey of Teachers’ Knowledge, Attitudes, and Practices Related to Pupils’ Eye Health and School-Based Eye-Health Services. Niger J Ophthalmol [serial online] 2019 [cited 2020 Jul 6];27:68-75. Available from: http://www.nigerianjournalofophthalmology.com/text.asp?2019/27/2/68/277881




  Introduction Top


The global burden of childhood blindness is 1.4 million,[1],[2] and almost three-quarters of blind children live in developing countries.[1],[2] The prevalence of childhood blindness ranges from 0.3/1000 children in developed countries to 1.5/1000 in developing countries.[1],[2] An estimated 500,000 children become blind every year in developing countries (one every minute) of whom 60% die within 1 to 2 years of becoming blind.[3]

The causes of childhood blindness vary from region to region, but the main causes include corneal scarring due to measles, vitamin A deficiency, harmful traditional eye medications, and ophthalmia neonatorum; other causes are cataracts, glaucoma, retinopathy of prematurity, and uncorrected refractive errors.[3]

The global initiative VISION 2020: The Right to Sight, which was launched in 1999, targets childhood blindness as one of five priority areas for blindness prevention.[4] The inclusion of childhood blindness as one of the objectives of the global initiative VISION 2020 was based on data showing that it leads to decades of lives spent blind and because major interventions to control common causes of childhood blindness are public health in nature. Childhood blindness places an enormous socioeconomic burden on families and communities.[5] Delays in or failures to treat eye diseases in children can lead to conditions, such as amblyopia, that are untreatable in adults.[3] Severe vision loss in children can affect their development, mobility, quality of education, and employment opportunities.[1],[3] Consequently, a blind child has to contend with a lifetime of emotional, social, and economic difficulties, which also affect the family and society.[1],[3] As poor vision and eye diseases have significant adverse effects on the academic learning capacity of children, the integration of eye health programs into comprehensive school-based health systems is of utmost importance.

School children comprise the most important target group that needs screening for early detection of eye diseases and prevention of childhood blindness.[6] Screening for conditions that lead to blindness and visual impairment among children can be effectively performed by teachers.[3],[6],[7],[8] What children learn in school from their teachers about their eyes and eye health, including how to protect their eyes and what to do to prevent eye diseases, has a significant impact on their lives as adults. A comprehensive approach to the implementation of primary school eye health programs should include eye health education for teachers and pupils in addition to screening pupils for eye diseases.[6]

Primary school teachers (PSTs) play a critical role in the primary prevention of blindness in children through the promotion of primary health care (PHC) and school-based screening programs.[3] As children do not usually complain of visual difficulties, early detection and prompt treatment of eye diseases are important to prevent vision problems and eye morbidities, which could affect their learning ability, personality, and adjustment to school.[9],[10] PSTs should have good knowledge, attitude, and practices (KAP) related to their pupils’ eye health and school-based eye health services for the successful implementation of early detection and treatment programs. In accordance with the VISION 2020: The Right to Sight initiative, teachers are among the target groups to implement PHC strategies for health promotion information, education, and communication[3] to improve vision and prevent childhood blindness. PSTs see and communicate with their pupils for hours daily, when they are visually active during school periods, and therefore are able to detect abnormalities in their vision.[11] Primary school children are very sensitive, and their knowledge, attitude, and behaviors may be substantially influenced by their teachers.

The Nigerian operational plan for the implementation of the VISION 2020: The Right to Sight document[12] included the establishment of a school-based eye health screening program in each local government area (LGA) to identify all cases of visual impairment. At present, there is no school-based health-services program in the Nkanu West LGA. Consequently, there are no data on the KAP of PSTs in the Nkanu West LGA of Enugu State in Southeast Nigeria, or data on their pupils’ eye health and school-based eye health services. This could strongly influence the PSTs’ assigned roles within the recommended school-based eye health services. This study aimed to assess the PSTs’ KAP related to their pupils’ eye health and school-based eye health services, identify deficiencies in the PSTs’ KAP, and develop evidence-based recommendations. The generated data will assist stakeholders in primary school education and planners and implementers of school-based eye health programs in the promotion of good eye health and prevention of visual impairment among primary school students in this and similar settings elsewhere in Nigeria.


  Materials and Methods Top


Study design and participants

The study was a descriptive cross-sectional survey of PSTs in the Nkanu West LGA of Enugu State, Nigeria, conducted between October 25 and December 13, 2012.

The Nkanu West LGA, one of the 17 LGAs of Enugu State, is located approximately 15 km south of Enugu town, the capital of Enugu State. The administrative headquarter of the LGA is in Agbani. There are 55 public primary schools and 414 PSTs (87 males and 327 females). These schools are under the direct supervision of the Enugu State Universal Basic Education Board.

Eligible PSTs and their headmasters/headmistresses in the public primary schools in the Nkanu West LGA, Enugu State, were included in the study.

The minimum sample size was estimated using the formula for cross-sectional population surveys.[13] A power analysis with a 95% confidence level showed that 199 participants were required; 5% of the minimal sample size was added to obtain a modified sample size of 209, to make up for potential shortfall resulting from refusal to participate. However, 207 had complete data and were studied.

Sampling technique

Systematic random sampling was used to select participants for the study. A list of the names of all public PSTs in the Nkanu West LGA was obtained from the secretary of the LGA’s Education Department. All the teachers were assigned numbers, beginning with the first primary school on the list. Beginning with the first name on the list, alternate numbers were selected for recruitment until the modified sample size of 207 was obtained.

The researcher used the World Health Organization guidelines to construct a 16-item interviewer-administered close-ended questionnaire. The pilot-tested questionnaire contained four sections on participants’ (A) sociodemographics, (B) knowledge of their pupils’ eye diseases and school-based eye health services, (C) attitudes toward their pupils’ eye health and school-based eye health services, and (D) practices related to their pupil’s eye health and school-based eye health services. To ascertain its internal consistency, reliability, and construct validity, the questionnaire was pretested on PSTs teaching in public primary schools, under a similar setting, elsewhere outside the study area. Feedback obtained from the pretest was used to modify the questionnaire to achieve the study objectives. Age and educational qualifications were modified under sociodemographic characteristic. Their age groups were recategorized to represent the working age group. Educational qualifications were modified to reflect the minimal requirement in teaching for PSTs.

Scoring system for the questionnaire

Section (B) assessed participants’ knowledge of pupils’ eye diseases and school-based eye health services. Each of the subquestions of question 5 had four correct options, two incorrect options, and an ‘I don’t know’ response. Each correct option was assigned a score of 25 points, such that the highest possible score for the correct answers was 100 points. Each incorrect answer or ‘I don’t know’ response was assigned 0 point. Each of the subquestions for questions 6 to 9 had two correct options, two incorrect options, and an ‘I don’t know’ option. Each correct option was assigned a score of 50 points. The highest possible score for the correct answers was 100 points. Each incorrect answer or ‘I don’t know’ response was assigned 0 point.

In this study, the sum of the scores for correct answers was 100 points. On average, respondents who scored 50 points or above for each question were considered to have a good knowledge base of the subject area, whereas respondents who scored below 50 points were judged to have poor knowledge.

Section (C) consisted of two questions on participants’ attitudes toward pupils’ eye health and school-based eye health services. On questions 11 and 12, respondents’ who ranked blindness first (before other diseases) were considered to have a positive attitude toward blindness, whereas those who ranked other diseases first (before blindness) were considered to have a negative attitude. Respondents to question 13, who rated the prevention and treatment of blindness as very important or as important, were regarded as having a positive attitude, whereas those who rated prevention and treatment of blindness as less important or not as important were considered to have a negative attitude. Respondents, who indicated that school-based eye health services were important on question 14, were considered to have a positive attitude, whereas those who indicated that they were not important were considered to have a negative attitude.

Section (D) consisted of two questions about practices related to pupils’ eye health and school-based eye health services. Question 15 had five options: two correct options, two incorrect options, and an ‘I don’t know’ option. Each correct response was assigned 50 points. The highest possible score for the correct answers was 100 points. Each incorrect and ‘I don’t know’ response was assigned 0 point. Respondents who scored 50 points or above were judged as having good practices, whereas those who scored below 50 points were judged as having poor practices. Question 16 required a ‘Yes’ or ‘No’ response, with ‘Yes’ indicating good practices and ‘No’ indicating poor practices regarding their pupils’ eye health.

Ethics

The Health and Medical Research Ethics Committee of the University of Nigeria Teaching Hospital, Enugu (UNTH), approved this study, which was compliant with the 1964 Helsinki Declaration (last revised in 2008). Written informed consent was obtained from all participants prior to the commencement of the study.

Postsurvey interventions

Free health education on the causes, clinical features, and treatment of common eye diseases among pupils (corneal scarring, refractive errors, cataracts, and glaucoma) was organized by the researcher at the end of the study for all the PSTs in the local government’s conference hall. Participants with treatable eye conditions, such as bacterial conjunctivitis and allergic conjunctivitis, were treated with antibiotic eye drops (chloramphenicol and gentamicin) and anti-allergic eye drops (lodoxamide and sodium cromoglycate) free of charge. Treatment for refractive errors was provided by optometrists for those needing spectacles, and appropriate presbyopic corrections were dispensed to them at no cost. Individuals who had other forms of ocular pathology were referred to Ituku Ozalla, at the UNTH for appropriate management of their eye conditions.

Data management

Data on all participants were cleaned, coded, and double entered into a Microsoft Office database. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) for Windows, version 18.0 (SPSS Inc., Chicago, Illinois, USA). Descriptive statistics were calculated to yield frequencies, percentages, and proportions. Interclass comparisons of observed differences were analyzed for their significance using the Chi-square or Fisher’s exact test for categorical variables and Student’s t test for continuous variables. A P-value <0.05 (95% confidence interval) was considered statistically significant for all comparisons.


  Results Top


Data from the 207 enrolled participants consisting of 40 (19.3%) males and 167 (80.7%) females (M:F = 1:4.1) who were 25 to 60 years old (mean = 42.2 ± 8.67 SD years) were analyzed. Their modal age group was 41 to 50 years (84%), and their age and sex distributions are shown in [Table 1]. A total of 143 (69.1%) participants were married and 153 (73.9%) had a Nigerian Certificate in Education.
Table 1 Age and sex distributions of the participants (N = 207)

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Age >40 years, being a female, being married, and having a degree were associated with good knowledge, although the associations were not statistically significant [Table 2]. Age <40 years, being a female, being married, and having a degree were associated with a positive attitude, although the associations were not statistically significant [Table 3]. Age <40 years, being a male, being married, and having a degree were associated with good practices, although the associations were not statistically significant.
Table 2 Associations between knowledge of pupils’ eye health and school-based eye health services and participants’ socioeconomic characteristics (N = 207)

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Table 3 Associations between attitudes toward pupils’ eye health and school-based eye health services and participants’ sociodemographic characteristics (N = 207)

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A total of 149 (72.0%) participants had poor knowledge of their pupils’ eye health and 147 (71.0%) had poor knowledge of school-based eye health services. Almost half of the participants, that is, 126 (48.0%) obtained their information from family and friends, followed by 100 (38%) participants who used the radio.

A total of 178 (86.0%) participants had a positive attitude toward their pupils’ eye health and 198 (95.7%) had a positive attitude about the school-based eye health services. However, 116 (56.0%) had poor practices in relation to their pupils’ eye health, and none of the participants used the school-based eye health services [Table 4].
Table 4 Associations between practices related to pupils’ eye health and school-based eye health services and participants’ sociodemographic characteristics (N = 207)

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  Discussion Top


The study’s sample consisted of more females than males who were predominantly aged 40 years or older. The observed age and sex distributions were similar to the results of studies conducted in Ilorin, Nigeria,[14] and India.[15] However, the observed preponderance of female participants differed from a Pakistani[11] study, which had equal numbers of male and female participants. The reason for the preponderance of females in this study is most likely due to the higher number of female teachers in the school settings, which were similar to the settings in the Ilorin study.[14] The Indian[15] study reported a preference for female teachers who taught science subjects and wore spectacles, although it was not an inclusion criterion for the survey. While reason for this preference was not indicated by the investigators, it may be due to the understanding that teachers already wearing spectacles will bear their experience on the optimal outcome of the survey.

The majority of respondents in this study were married and possessed the minimum certification for teaching in Nigeria, that is, the National Certificate in Education (NCE). This finding is consistent with those of previous surveys in Pakistan,[16] Nigeria,[14] India,[15] and Nepal.[17] A literature search of previous studies did not show any contradictory findings with the present study. The NCE is one of the minimum requirements for PSTs in Nigerian public schools. Therefore, educational background might have also influenced the actions of PSTs when any abnormal eye problem was identified.

The participants’ knowledge of pupils’ eye health and school-based eye health services was grossly deficient. This finding is similar to that of an Indian study,[18] which reported a low level of knowledge among PSTs in a preintervention survey, but both of these studies differ from the results of other studies conducted in India,[6] Pakistan,[11],[16] and Nigeria.[14] The poor knowledge found in this study may be attributed to the fact that there were no preexisting eye-health programs in the LGA, and that this study was conducted in a rural setting where the majority of teachers may not have been exposed to eye-health issues, although they were relatively educated. In contrast, the Ilorin, Nigerian study recruited PSTs from within the Ilorin metropolis, the capital of Kwara State, which may have influenced their findings of a higher level of knowledge. Although the Nigerian study[14] reported adequate knowledge of eye diseases among teachers in that study, they did not investigate their knowledge of the causes, features, or treatments for their pupils’ eye diseases, which were examined in the present study.

Being female, older than 40 years, married, and having a university degree were associated with good knowledge of pupils’ eye health and school-based eye health services. However, none of the associations was statistically significant. This finding is similar to those of studies conducted in Pakistan,[16] Nigeria,[14] and India.[15] It might be due to the present study’s high proportion of female participants, of which some were mothers who were closer to the pupils and were more likely to identify eye diseases/problems in their pupils’ eyes. Having a relatively good educational background predisposes PSTs to be aware of health issues in general, which may include pupils’ eye health and school-based eye health services. It may, therefore, be easier for eye specialists to train these educated teachers to detect simple eye abnormalities.

The majority of participants had family members and friends as their main source of information about their pupils’ eye health and school-based eye health services. Other sources of information were radio, television, and newspaper. However, previous studies on hypertension and diabetes, which were conducted in urban settings, had media organizations as their major sources of information for patient-related knowledge.[19] The findings in this study may be due to poor access to news media in this rural area or to the rural setting’s communal living where information is shared easily. The lack of interest in reading newspapers may also be attributed to their cost.

Given the teachers’ poor knowledge and their use of family/friends as their main source of information, media organizations should be considered a mechanism through which health information can be disseminated to communities, because some of the information obtained from family and friends may be incorrect and have a negative influence on teachers’ knowledge.

The majority of respondents had a positive attitude about their pupils’ eye health and school-based eye health services. A positive attitude was associated with being a female, being married, and having a university degree, although the associations were not statistically significant. This finding is similar to other studies that were conducted in the Abbottabad District in northern Pakistan,[11] Ilorin, Nigeria,[14] and the Satna District of Madhya Pradesh, India.[23] However, the Pakistani study[11] also uncovered some participants’ misconceptions about their pupils’ eye health in relation to the use of kohl eyeliner, which contains lead that is hazardous.[20],[21] The similarities of this study with the Ilorin[14] and Indian[15] studies may be due to their selection of appropriate methods, target groups, and settings. In accordance with the VISION 2020: The Right to Sight initiative, teachers are among the target groups to implement PHC strategies for health-promotion information, education, and communication[3] to improve vision and prevent childhood blindness. Therefore, schools are important settings with enormous potential for blindness prevention programs.[11],[22] However, there were concerns about whether the program substantially added to the existing educational workload of the teachers, thereby hindering their primary responsibility for teaching. A follow-up survey to evaluate this among teachers is suggested. In view of the potential benefits of utilizing teachers in eye care programs, planners should incorporate strategies to initiate and sustain PSTs’ interest in school and community-based health programs.

The proportion of participants with good practices in this study was low. Good practices was associated with being a male, age >40 years, being single, and having a degree, although the associations were not statistically significant. The poor practices found in this study are similar to studies[11],[23] that found poor practices of PSTs in relation to their pupils’ eye health and school-based eye health services. Contrary to this finding, some studies[14],[17],[24] observed good practices in the majority of PSTs in relation to their pupils’ eye health and school-based eye health services. Good knowledge brings about positive self-care practices most times. The present study observed poor knowledge and poor practices, contrary to studies[14],[17],[24] that have reported good knowledge with positive self-care practices. This difference implies that improvements in teachers’ knowledge and awareness of pupils’ eye health and school-based eye health services might also improve their practices. Consequently, periodic health education workshops on childhood eye diseases are recommended for all the PSTs in the LGA.

None of the participants in this study used school-based eye health services. This is expected, as none of the schools had eye-health services. Opubiri and Pedro-Egbe[23] reported lack of utilization of materials (e.g., visual acuity charts and vision recording books) given to trained school teachers for use with their pupils, which was attributed to lack of incentives. This behavior shows that the provision of school-based eye health services is not enough. Additional follow-ups are needed to ensure the proper utilization of the school-based eye health services that are provided.

One of the limitations of this survey was the exclusion of PSTs from privately owned primary schools. The proprietors/proprietresses of the privately owned primary schools in the LGA declined to participate in the study. Therefore, the results obtained might not be generalizable to other PSTs in the region. Another limitation is the bias inherent in self-reports of knowledge and efficacy in surveys. There is a tendency for respondents to these surveys to overestimate their knowledge and competencies. This behavior can be overcome through advocacy.


  Conclusion Top


The majority of the PTSs’ in the Nkanu West LGA, Enugu State, Nigeria, has poor knowledge and practices in relation to their pupils’ eye health and school-based eye health services. However, most of the teachers have positive attitudes about their pupils’ eye health and school-based eye health services. There was no statistically significant association among age, gender, marital status, and having a degree amongst the participants and their KAP regarding their pupils’ eye health and school-based eye health services.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


  Appendix Top


Questionnaire

Teachers’ knowledge, attitude, and practice on pupils’ eye health and school eye health services

Instructions: 1. Tick good (√) against the correct response/s in the spaces provided.

2. Provide additional information as appropriate in the spaces provided.

Section A: Sociodemographic characteristics

Sex: (a) Male (), (b) Female ()

Age: (a) 20–30 (), (b) 31–40 (), (c) 41–50 (), (d) 51–60

Marital status: (a) Single (), (b) Married (), (c) Divorced (), (d) Separated (), (e) Widowed ()

Qualification: tick highest qualification. (a) Grade 11 Teachers Certificate ()

(b) National Certificate in Education ()

(c) University Degree Certificate ()

Section B: Knowledge of childhood eye diseases and school eye-health services

5. (a) Have you ever heard of corneal scarring (white scar on the black eye)? Yes () No ().

(b) Causes: i. Vitamin A deficiency (), ii. Traditional eye medication (), iii. Measles (),

iv. Trauma (), v. Dust (), vi. Sunlight (), vii. I don’t know ().

(c) Features of causes: i. Redness (), ii. Discharge (), iii. Itching (), iv. Foamy deposit on the white outer part of the eye (), v. Growth on the eye lid (), vi. Black patch on the white eye (), vii. I don’t know ().

(d) Treatment of causes of cornea scaring: i. Surgery (), ii. Immunization (), iii. Vitamin A (),

iv. Eye drop (), v. Holy water (), vi. Breast milk (), vii. I don’t know ().

(e) Treatment of cornea scarring: i. Surgery (), ii. Immunization (), iii. Vitamin A (), iv. Eye

drop (), v. Holy water (), vi. Breast milk (), vii. I don’t know ().

6. (a) Have you ever heard of the eye condition, refractive error (inability to see far or near

objects clearly)? Yes () No ()

(b) Features are: i. Difficulty seeing the board (),

Holds book close to face (), i Redness (), iv. Discharge (), v. I don’t know ().

(c) Causes: i. Heredity (), ii. Age (), iii. Dust (), iv. Sunlight (), v. I don’t know ().

(d) Treatment options: i. Eye glasses (), ii. Eye drops (), iii. Surgery (),

iv. Traditional eye medications (), v. I don’t know ().

7. (a) Have you ever heard of eye condition called cataract? Yes () No ().

(b) Features are: i. White reflex (), ii. Tearing (), iii. Reduced vision (),

iv. Discharge (), v. I don’t know ().

(c) Causes: i. Hereditary (), ii. Trauma (), iii. Divine cause (), iv. Discharge (), v. I don’t know ().

(d) Treatment options: i. Eye drop (), ii. Surgery (), iii. Eye glasses (),

iv. Traditional eye medication (), v. I don’t know ().

8. (a) Have you ever heard of eye condition called glaucoma? Yes () No ().

(b) Features are: i. Reduced peripheral (side) Vision (),

ii. No symptom (), iii. Itching (), iv. Discharge (), v. I don’t know ().

(c) Causes: i. Unknown (), ii. Vitamin A deficiency (), iii. Heredity (), iv. Infection (),

v. I don’t know ().

(d) Treatment options: i. Eye glasses (), ii. Surgery (), iii. Eye drop (), iv. Traditional eye

medication (), v. I don’t know ().

9. (a) Have you heard of school eye-health services? Yes () No ()

(b) What does it mean?—Strategies, activities or services, providing care and identifying eye

diseases before it becomes a serious medical issue. Yes () No ().

(c) Components of school eye-health programs are: i. Symptom identification of eye

diseases (), ii. Timely referral (), iii. Treatment of any health problem (), iv. Treatment of

complicated eye diseases (), v. I don’t know ().

(d) Do you have school eye-health services in your school: Yes () No ().

10. What is your sources of information? i. Family and friends (), ii. Television (),

iii. Radio (), iv. Newspaper ().

Section C: Attitudes toward childhood eye diseases and school eye-health services

11. If it were possible to rate the prevention of one of the following diseases: which one will you prevent first? second? third? and fourth? Enter figure in the space provided.

i. Blindness (), ii. Dumbness (), iii. Deafness (), iv. Paralysis/loss of a limb(s) ().

12. If it were possible to provide treatment and support for one of the following disabilities, which of these disability would you first provide treatment for first? second? third? and fourth?

i. Blindness (), ii. Dumbness (), iii. Deafness (), iv. Paralysis/loss of a limb(s) ().

13. How would you rate the prevention and treatment of blindness? i. Very important () ii. Important (), iii. Less important (), iv. Unimportant ().

14. Do you think school eye services are important? Yes () No ()

Section D: Practices to pupils’ eye health and school eye-health services

15. What would you do when you notice features of poor eye health in your pupils’ eyes?

i. Alert the parents to seek eye care (), ii. Directly refer to eye specialist (), iii. Self medication (), iv. Ignore the sign/symptom, believing it may resolve later (), v. I don’t know ().

16. Do you use school eye-health services? Yes () No ()

Thank you so much for sparing your valuable time



 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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