Strengthening Community- to- Hospital Eye Care Pathways From Boko Eye Care Center in Rural Assam

NCT07333248 | Not Yet Recruiting DMC

• 1 other identifier: SSDN/IARC/46/2025-NOV/7
• Study Type: interventional
• Target: 2,000
• Locations: 1 country
• Sites: 1

Brief Summary

This operational research project aims to strengthen continuity of eye care delivery between community screening and hospital-based treatment in rural Assam by redesigning referral pathways from the Boko Eye Care Center (ECC) to Sri Sankaradeva Nethralaya (SSDN) base hospital. Despite active outreach in the Boko region from the Boko ECC through conducting regular outreach screenings, less than 30 percent of patients referred to the base hospital actually arrive for evaluation and less than 25 percent of those advised for surgery proceed to treatment. The proposed study addresses these gaps by examining behavioural, structural and logistical barriers to referral completion and surgical uptake, and by implementing a coordinated patient-centered referral and engagement strategy. The proposed intervention comprises of five sequential components: (1) root cause analysis to identify bottlenecks and facilitators in the current referral pathway, (2) community engagement activities to improve awareness and proactive health-seeking behaviour, (3) implementation of an integrated referral and engagement model supported by trained community team and structured referral tracking, (4) strengthening referral completion through patient navigation, scheduled transport and follow-up reminders, and (5) enhancement of surgical acceptance through standardized counseling, affordability support and social reinforcement. The outcomes will be measured prospectively, focusing on increase in hospital footfall from the Boko catchment area, proportion of referred patients who complete hospital visits, and proportion of patients who were advised for surgery and had undergone the procedure. The proposed project aims to achieve a minimum of 70 percent referral completion and 45 percent surgical conversion by the end of the 36-month study period.

Conditions

Cataract; Refractive Errors

Keywords

Referral completion; Cataract surgery uptake; Patient navigation; Community engagement; Rural eye care; Surgical acceptance; Assam; LMIC

Outcome Measures

Primary Outcomes (1)

• Referral completion rate to base hospital

  Referral completion rate to base hospital

  36 months

Secondary Outcomes (1)

• Surgical conversion rate among patients advised for surgery

  36 months

Other Outcomes (1)

• Increase in overall hospital footfall originating from Boko catchment area

  36 months

Study Arms (1)

Referral and Engagement

EXPERIMENTAL

Referral tracking, patient navigation, community awareness tools, standardized counseling, transport and financial facilitation mechanisms

Other: Experimental: Integrated Referral and Engagement Model

Interventions

Experimental: Integrated Referral and Engagement Model OTHER

Referral tracking, patient navigation, community awareness tools, standardized counseling, transport and financial facilitation mechanisms

Referral and Engagement

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults diagnosed with eye conditions requiring referral or surgical treatment.

You may not qualify if:

• Patients requiring emergency treatment, patients medically unfit for surgery, or patients unwilling to participate.
• Eligibility: Enrolment criteria: Participants will be enrolled consecutively at the time of screening in community outreach camps and at the Boko Eye Care Center if they meet the following operational criteria:
• i. Adult (≥18 years) with a diagnosed eye condition requiring referral to Sri Sankaradeva Nethralaya for tertiary evaluation or surgical treatment, as determined by the examining optometrist/ophthalmologist.
• ii. Resident of the Boko Eye Care Center catchment area (villages linked to the Eye Care Center under Sri Sankaradeva Nethralaya outreach).
• iii. Patients willing to provide informed consent to participate in the study and to allow follow-up for referral completion and surgical acceptance outcomes.

Sponsors & Collaborators

• Pragyaan Sustainable Health Outcomes Foundation: collaborator
• Seva Canada Society: lead
• Sri Sankaradeva Nethralaya: collaborator

Study Sites (1)

Sri Sankaradeva Nethralaya

Guwahati, Assam, 781028, India

Location

MeSH Terms

Conditions

Cataract; Refractive Errors

Condition Hierarchy (Ancestors)

Lens Diseases; Eye Diseases

Study Officials

• Priya Adisesha Reddy

  Seva Canada Society

  STUDY DIRECTOR

Central Study Contacts

Dr Harsha Bhattacharjee

CONTACT

0361-2233444; ssnghy1@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 30, 2025
• First Posted: January 12, 2026
• Study Start: February 1, 2026
• Primary Completion (Estimated): January 31, 2027
• Study Completion (Estimated): January 31, 2028
• Last Updated: January 12, 2026

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

IN (1)