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New research · Ophthalmology
Frontiers in health services · 4d
Cohort studyFrontiers in health services · 2026

The effect of eye health system strengthening on the productivity of services: a before-and-after evaluation conducted in seven counties in Kenya.

Joyce Koech, Jefitha Karimurio, Mary B Adam … Faith Kasoly
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OphthalmologyCohort study

Eye care facilities in Kenya increased sharply after multi-component health system investment.

The effect of eye health system strengthening on the productivity of services: a before-and-after evaluation conducted in seven counties in Kenya.

Joyce Koech … Faith Kasoly
Frontiers in health services · 2026
Background

Health system strengthening is essential for achieving universal eye health coverage, yet evidence on the combined effect of simultaneous investments in infrastructure, human resource, equipment, and governance remains limited in low- and middle-income countries.

Purpose

This study evaluated the effect of a multi-component health system intervention on productivity of eye service in seven Kenyan counties.

Methods

A before-and-after study was conducted using longitudinal program data from the Vision Impact Project (2021-2024), a partnership between Christian Blind Mission (Christian Blind Mission), Kenya's Ministry of Health, county governments, and implementing partners.

Results

eye clinics available across seven counties rose sharply, expanding access

5
Before
27
After
More results

The training of 72 core eye health workers addressed 48% of the total workforce deficit at baseline across counties.

Of 53 purposively selected high-value equipment, 50 (94.0%) were fully operational, 49 (92.0%) were routinely used, and 33 (62.0%) were first acquisitions.

More results

7 out of 8 secondary level facilities reported reduced patient referrals to higher-level facilities.

Five counties showed increased Cataract Surgical Rates (Cataract Surgical Rates).

“
Conclusion

Variability in outcomes underscores that health system strengthening efforts should be intensified to broader health system constraints to achieve universal eye health coverage in Kenya.

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