Ophthalmological care delivery in East Kazakhstan: a qualitative study of ophthalmologists on system barriers and service organization.

BACKGROUND

Access to ophthalmologic care is essential for maintaining eye health and preventing vision loss. However, barriers within health systems may limit timely access to services. Understanding these barriers from the perspective of healthcare providers may help improve the organization and accessibility of ophthalmological care.

METHODS

A qualitative study was conducted in the East Kazakhstan region using semi-structured interviews with 22 ophthalmologists working in primary healthcare and hospital settings. Interviews explored public awareness, workforce capacity, service provision, equipment availability, and system-level barriers. Data were analyzed using thematic analysis supported by Dedoose software.

RESULTS

Five major themes were identified: limited public awareness of eye diseases, workforce shortages and uneven distribution of ophthalmologists, gaps in equipment and resource availability in primary healthcare, systemic barriers such as long waiting times and referral delays, and proposed strategies for improving ophthalmological services. Participants emphasized that shortages of specialists and diagnostic equipment at the primary healthcare level contribute to delayed diagnosis and increased reliance on hospital-based care.

CONCLUSION

Improving ophthalmological care in East Kazakhstan requires strengthening primary healthcare capacity, increasing workforce availability, expanding preventive programs, and improving infrastructure and referral pathways. Addressing these challenges may improve early detection of eye diseases and enhance access to ophthalmic services.