Table 3

Strategies for improving access to eye care for Indigenous peoples proposed in reports of non-implemented models (n=17)

Service delivery modelProposed strategies to improve access
Teleophthalmology screening
  • Ensure culturally appropriate ‘patient-provider’ communication regarding diabetic retinopathy to reduce non-adherence to screening programmes.86

Eye care integrated within primary care and Indigenous healthcare
  • Train primary care staff to enable primary care to support eye care delivery.62 81 87–90

  • Design tertiary ophthalmic services to incorporate needs of Indigenous peoples to improve uptake.72 88

  • Ensure primary healthcare staff have knowledge of a well-defined patient pathway from community identification of eye care need to referral, treatment and monitoring.91

Outreach ophthalmology and optometry
  • Improve coordination between Indigenous healthcare system and eye care services.62 87–90 92–94

Education, training and health promotion
  • Provide culturally appropriate eye health knowledge training for healthcare workers and their communities.70 90 95

Trachoma control measures
  • Optimise the intensity and strategy of comprehensive interventions in Australian Aboriginal communities with endemic trachoma.70 92 96–98

Broader service delivery components
  • Use a health systems approach when designing eye care services.90

  • Calculate estimates of cost, cost-effectiveness and models of funding eye care.88 90 99 100

  • Deliver culturally appropriate eye care services to reduce barriers to patient access.11 88 89 101

  • Distribute eye care professionals and funding equitably.13 62 89

  • Plan sustainable eye care services.101

  • Ensure monitoring and evaluation to collect, analyse and report local, regional and national data on eye care services, quality and satisfaction.89 90