Challenges faced by key informants practicing case finding for vision loss in children: the experience in Cross River State, Nigeria

Background To identify challenges faced by key informants (KIs) in a childhood blindness and severe visual impairment survey in Cross River State (CRS), Nigeria. Methods Based on eligibility 742 KIs were selected by their village/clan heads in the 18 local government areas (LGAs) of Cross River State. After training in each LGA, KIs were to identify children with visual problems. KIs used a number of methods to identify children with vision loss. After the case detection period, KIs were requested to bring children suspected of vision problems to a central site for examination. Following this, an interviewer-administered semi-structured interview was used to obtain information from the KIs. Thematic content analysis was used to identify these challenges. Results Among the 742 KIs, 642 did not provide any comment on challenges during interview; 100 KIs reported challenges. Major challenge themes identified were issues related to the family of the child and issues related to operational conditions, principally transportation, communication, and incentives. Conclusions It is likely that challenges were under-reported. Research is needed to understand why some parents feel stigmatized by having children with vision problems. Community based programmes need to strengthen community awareness, address trust issues, and ensure transportation and communication are improved in order to enhance programme success.