Ophthalmic nursing services in Botswana

Ophthalmic nurses make up 90% of all eye workers in Botswana’s public sector, and they are the only eye professionals being trained inside the country. In 2010, there were 88 ophthalmic nurses working in the public sector. The majority (74) were in primary and secondary care settings where they functioned independently under the supervision of general (non-ophthalmic) facility and department managers. Some received remote supervision and support from ophthalmologists based at tertiary hospitals, but this was minimal. Fourteen nurses worked in tertiary hospitals under the direct supervision of an ophthalmologist; they also scrubbed for minor and major ophthalmic surgical procedures. Overall, most ophthalmic nurses (81%) worked in the urban or semi-urban areas inhabited by 61% of Botswana’s approximately 2 million people. The 39% of people who live in the remote and isolated rural parts of the country were served by only 16 ophthalmic nurses (18%). Eye services remain a challenge in rural areas due to difficult terrain and limited financial and material resources. However, in many cases, ophthalmic nurses have built strong teams and share resources, such as transport, to extend services to all catchment areas within the district.