Use of our existing eye care human resources: Assessment of the productivity of cataract surgeons trained in eastern Africa

Objectives: To measure the productivity of cataract surgeons in Africa and assess the factors that predict high productivity. Methods: A questionnaire on productivity and working environments was sent to all cataract surgeons trained in Malawi, Uganda, Tanzania, and Kenya. In addition, 2 meetings and in-depth discussions were held to elicit information on strategies to improve productivity among surgeons in general. Results: More than 77 000 cataract surgeries were performed in the years 2000 through 2004, resulting in an annual productivity rate of 243 surgeries per surgeon. Higher productivity was associated with having 2 or more cataract surgical sets, a well-functioning operating microscope, 3 or more nursing support staff, and a community program that includes transporting patients to the hospital. Conclusion: Strategies for training, supporting, and supervising cataract surgeons in Africa need to be revised to create conditions amenable to greater productivity. ©2007 American Medical Association. All rights reserved.