Participatory Rural Appraisal to Detect Childhood Blindness in Community

Introduction: To evaluate the role of participatory rural appraisal (PRA) in community based rehabilitation (CBR) to detect and manage childhood blindness from rural community. Methods: Fifteen rural project areas with pre-existing CBR project were shortlisted. Main criteria of this selection were pre-existing CBR project with significant number of children with visual impairment. We have adopted PRA methodology to reach the rural community whilst aiming to detect childhood blindness. PRA approaches were also utilized to achieve immunization, spacing between child birth, proper maternal and child health and overall improvement of lifestyle. Information about the villages was collected from villagers by social mapping performed by the villagers themselves. Student’s t test was used to analyze the result. Results: 128 children (CBR program) with visual disability were identified out of which 77.14% were blind and 22.86% had SVI. After adopting PRA approach 84 new cases (p<0.05%) were detected of which 71.43% were blind and 28.57% had SVI. Main causes of blindness were cornea related (31.28%), lens related (21.72%) and buphthalmos (17%). Immunization of child improved from 11% to 81% (p=0.011) over a period of one year. Common practices including food habit, spacing between child births improved. 41% children are mobilized to blind school for rehabilitation. Conclusions: PRA methodology is a new approach in community ophthalmology and is very promising to detect and rehabilitate visually impaired children. PRA is very useful to improve knowledge, to plan rehabilitation as well to treat underlining causes of childhood blindness.