*Article* **Knowledge, Attitudes and Practices of Eye Health among Public Sector Eye Health Workers in South Africa**

**Zamadonda Xulu-Kasaba 1,\*, Khathutshelo Mashige <sup>1</sup> and Kovin Naidoo 1,2**


**Abstract:** In South Africa, primary eye care is largely challenged in its organisational structure, availability of human and other resources, and clinical competency. These do meet the standard required by the National Department of Health. This study seeks to assess the levels of knowledge, attitudes, and practices on eye health amongst Human Resources for eye health (HReH) and their managers, as no study has assessed this previously. A cross-sectional study was conducted in 11 districts of a South African province. A total of 101 participants completed self-administered, closeended, Likert-scaled questionnaires anonymously. Binary logistic regression analysis was conducted, and values of *p* < 0.05 were considered statistically significant. Most participants had adequate knowledge (81.6%), positive attitudes (69%), and satisfactory practices (73%) in eye health. HReH showed better knowledge than their managers (*p* < 0.01). Participants with a university degree, those aged 30–44 years, and those employed for <5 years showed a good attitude (*p* < 0.05) towards their work. Managers, who supervise and plan for eye health, were 99% less likely to practice adequately in eye health when compared with HReH (aOR = 0.012; *p* < 0.01). Practices in eye health were best amongst participants with an undergraduate degree, those aged 30–44 years (aOR = 2.603; *p* < 0.05), and participants with <5 years of employment (aOR = 26.600; *p* < 0.01). Knowledge, attitudes, and practices were found to be significantly moderately correlated with each other (*p* < 0.05). Eye health managers have poorer knowledge and practices of eye health than the HReH. A lack of direction is presented by the lack of adequately trained directorates for eye health. It is therefore recommended that policymakers review appointment requirements to ensure that adequately trained and qualified directorates be appointed to manage eye health in each district.

**Keywords:** visual impairment; human resources for eye health; avoidable blindness; eye health; public health; eye health directorate
