Implementing a school vision screening programme using smartphone technology in southern Botswana




Poster session 3 Friday: Evidence Tools / Evidence synthesis - creation, publication and updating in the digital age


Friday 15 September 2017 - 12:30 to 14:00


All authors in correct order:

Tuelo M1, Sawers N2, Sparrow K3, Littman-Quinn R1, Ndlovu K1, Bastawrous A3, Panicker T4, Lehasa A5, Maunge F6, Mahlaka M4
1 Botswana-UPenn Partnership, Botswana
2 St George’s University, London, United Kingdom
3 Peek Vision, United Kingdom
4 Botswana Optometrist Association, Botswana
5 Ministry of Health and Wellness, Botswana
6 Ministry of Basic Education, Botswana
Presenting author and contact person

Presenting author:

Maipelo Tuelo

Contact person:

Abstract text
Background: The Ministry of Health (MoH) in Botswana has developed the National Plan for Eye Care 2015-2019 to improve eye health. Peek Botswana, MoH, Ministry of Education and Botswana Optometrists Association implemented smartphone-based Peek Vision School Screening in one subdistrict to provide evidence for the development of a national school screening programme.

Objective :To evaluate the challenges and opportunities of implementing a school vision screening programme utilising Peek Vision smartphone technology to inform planning and implementation of a national school vision screening programme.

Method: 49 schools in the Goodhope Sub-district of Botswana underwent school vision screening using smartphone vision screening, SMS notification and tracking level of take up of services: refraction, spectacles, referral. Triage (including refraction where indicated) was delivered in two comparative arms: directly after screening (26 schools), and at a hub school (23 schools). Selected teachers and nurses were trained to use the system.

Results: 12 876 children were screened (6-22 years). 16% screened positive. There was a 96% triage attendance rate (95.2% attendance for same day triage, 97.4% for ‘hub’ site triage. Relative to total cohort: 1985 refractions (15.4%), 796 spectacles (6.2%), 94 treated with medications (0.7%), 63 referred for investigation (0.5% of screenings). True positive rate of screening 43%. Where elite screeners were identified and used the true positive rate rose to 64%.

Conclusion: The true positive screening rate, although acceptable (>40%), varied greatly between schools but paired screeners had better true positive rates which can be incorporated into future programmes. Cost savings and efficiencies of running triage in hub schools did not result in a lower attendance. Combining the learnings from this pilot will increase the effectiveness of school vision screening programmes in Botswana resulting in efficiencies, cost savings and contribute to planning for a national scale up.