Knowledge, attitudes and practices of primary and secondary school administrators on eye health integration in Nansana division, Wakiso district, Uganda.

Abstract

Introduction: Childhood visual impairment remains a significant public health challenge in Uganda and can negatively affect learning, academic performance, and overall child development. Integrating eye health into school health programs offers an effective strategy for early detection, referral, and management of eye conditions. However, successful integration depends largely on the knowledge, attitudes, and practices of school administrators who oversee school health activities. This study assessed the knowledge, attitudes, and practices of primary and secondary school administrators regarding eye health integration in Nansana Division, Wakiso District, Uganda. Methods: A descriptive cross-sectional study employing a quantitative approach was conducted among 154 school administrators selected through stratified random sampling from primary and secondary schools in Nansana Division. Data were collected using semi-structured questionnaires covering socio-demographic characteristics, knowledge, attitudes, and practices related to eye health integration. Data were analyzed using SPSS Version 25. Descriptive statistics were used to summarize findings, while Chi-square tests, Fisher’s exact tests, Spearman’s rank-order correlation, and binary logistic regression were used to examine associations and predictors of practice. Results: The study found that the majority of respondents (72.7%) had poor knowledge of childhood eye health, with a mean knowledge score of 38.2%. Despite this, most administrators (76.6%) demonstrated positive attitudes toward integrating eye health into school health programs, with a mean attitude score of 82.5%. Practices related to eye health integration were generally poor, with only 5.8% of administrators demonstrating good practice and a mean practice score of 55.8%. Although 96.8% supported integrating eye health into routine school health programs, 90% of schools had never organized eye screening activities. Teacher encouragement of parents to seek eye care was common (87.0%), and 71.4% of schools reported providing eye health education. Staff training (62.3%) emerged as the most frequently identified need for improving eye health integration. A statistically significant association was found between sex and attitude towards eye health integration (p = 0.005), while training showed a marginal association with better practice (p = 0.053). Conclusion: School administrators in Nansana Division exhibited positive attitudes towards eye health integration but had inadequate knowledge and poor implementation practices. The findings reveal a substantial gap between administrators’ willingness to support eye health programs and their capacity to effectively implement them. Recommendations: Capacity-building initiatives, regular training of school administrators and teachers, strengthened partnerships between the education and health sectors, and incorporation of routine eye screening into school health programs are recommended to enhance sustainable integration of eye health services in schools and reduce preventable visual impairment among schoolchildren.