Evaluation of Training Programme on Vision Screening and Primary Eyecare for the Frontline Healthcare Workers in Kathua District, India: A Mixed-method Study Design

Introduction: Frontline healthcare workers are the first link between the community and health facilities. By acquiring proper training and providing them with basic logistics, frontline health workers can identify patients with vision impairment and refer them to primary eye care centres. Aim: To assess the training outcomes of frontline healthcare workers in primary eye care and vision screening. Materials and Methods: A prospective cohort study (mixedmethod) was conducted in the Kathua district from February 2022 to February 2024, involving 96 frontline healthcare workers from five blocks of the district. A one-day training session was conducted for each block using charts, diagrams, role-plays and small group discussions. The training of frontline healthcare workers was evaluated on four aspects of the Kirkpatrick model. Data analysis was performed using Open Epi version 3.01. Quantitative data analysis was conducted using paired t-test and Chi-square test, with a p-value <0.05 considered significant. For qualitative data analysis, all audio responses were transcribed, and themes were generated for each component. Results: Out of 96 frontline healthcare workers, 56 were included in the study. The mean age of the frontline healthcare workers was 36.14 years, ranging from 20 years to 58 years. Pre- and post-training scores were 7.08±2.29 and 10.75±2.58, respectively, with p-value <0.01 (paired t-test). Focus Group Discussions (FGD) revealed that healthcare workers were now confident in performing vision screenings and could guide people regarding eye diseases. They also mentioned issues related to transportation and incentives. There was no significant difference in Outpatient Department (OPD) patient turnout three months before and after training when considering the five blocks of Kathua district. Conclusion: Training of frontline healthcare workers has notably increased their knowledge about primary eye care and their skills in vision screening. This observation reinforces the potential of frequent training for healthcare workers to ensure sustained outreach, follow-up and compliance with treatment regimens, which are often challenging in remote and underserved areas. The study also highlights the experiences, practical problems and challenges faced by healthcare workers, as well as their knowledge application in the community, which needs to be addressed by healthcare policymakers.