Community-Based Participatory Research to Reduce Avoidable Blindness Among Ageing Populations in Rural Benue State

Avoidable blindness among ageing rural populations in Benue State, North Central Nigeria, results from an intersection of age-related disease burden, limited health facility access, and community-level knowledge gaps that demand a participatory rather than top-down research and intervention approach. This study employs community-based participatory research (CBPR) methodology to develop, implement, and evaluate a community-driven intervention to reduce avoidable blindness among adults aged 50 and above in rural Benue State. A four-year CBPR study will be conducted in partnership with community advisory boards in eight rural communities in Gwer-East, Logo, and Katsina-Ala local government areas. Phase one establishes community partnerships through sustained engagement with traditional leaders, women's groups, and CHEWs. Phase two conducts participatory needs assessment combining focus group discussions, photo-voice, and community mapping of eye care access barriers. Phase three co-designs a community-led intervention incorporating trained volunteer vision screeners, community-administered visual acuity testing, referral linkages to Federal Medical Centre Makurdi, and cataract awareness campaigns using local Tiv language. Phase four implements and evaluates the intervention over 18 months, using a difference-in-differences design comparing intervention and control communities on key indicators including cataract surgical coverage, proportion screened, and proportion of persons with treatable blindness receiving treatment. CBPR has been extensively applied in chronic disease and maternal health research in Africa but remains novel in ophthalmic research, particularly in Nigeria. This study advances the evidence base for community-owned blindness prevention and challenges researcher-driven models dominant in the field. Keywords: community-based participatory research, avoidable blindness, rural Benue State, cataract, ageing population