Factors Influencing Disability Inclusion in General Eye Health Services in Bandung, Indonesia: A Qualitative Study

Abstract

The Inclusive System for Effective Eye-care (I-SEE) is a pilot project for disability inclusion in eye health in Bandung district of Indonesia. The aim of this research was to investigate factors influencing the introduction, i.e., adoption, implementation and continuation of I-SEE. A qualitative exploratory study was conducted by interviewing relevant stakeholders (n = 27) and users with disabilities (n = 12). A theoretical framework on the introduction of innovations in health care was used to guide data collection and thematic analysis. Factors related to the characteristics of the innovation (I-SEE) (e.g., infrastructure, equipment, engagement of people with disabilities, inclusive communication), service provider characteristics (e.g., motivation, attitudes, training), organizational characteristics (e.g., supervision, indicators, data), and the socio-political context of I-SEE (policy, motivation of users, family support, costs, transport) were essential for supporting the introduction process. Additionally, stakeholders proposed strategies for enhancing the introduction of I-SEE (e.g., awareness, collaborations). While there are specific disability related factors, most factors influencing the introduction of disability inclusive eye health were similar to introducing any innovation in general health care. Strategies for disability inclusion should be included from the planning phase of an eye health program and are reasonably simple to adapt.