Routine monitoring of cataract surgery outcomes needed to improve coverage in Kenya and Nepal
A comparative qualitative case study by Arazi et al. examined how Kenya and Nepal are implementing the WHO target to increase effective cataract surgical coverage drawing on interviews with 20 senior stakeholders — 10 in each country.
Key Findings:
- Kenya delivers cataract services through 47 devolved county governments, while non-governmental institutions perform more than 85% of cataract surgeries in Nepal.
- The WHO target did not prompt either country to restructure; each absorbed it into the system it already had, adapting delivery to local realities through community engagement, outreach services and partnerships to reach underserved populations.
- Limited public financing, donor dependence and high out of pockets costs remain major barriers to sustainable and equitable cataract services.
- Weak routine monitoring of surgical outcomes is a major challenge in both countries, limiting learning, accountability, and quality improvement.
Reference: Arazi M, Puri L, Kiaraho M, et al. Implementing effective cataract surgical coverage: a comparative qualitative study in Kenya and Nepal. BMJ Glob Health 2026;11:e023025. doi:10.1136/ bmjgh-2025-023025.
