Disability-Adjusted Life Years Attributable to Visual Impairment Across Nigeria’s Geopolitical Zones: A Burden of Disease Analysis

Quantifying the disability-adjusted life years (DALYs) attributable to visual impairment across Nigeria's six geopolitical zones is essential for evidence-based resource allocation, priority-setting, and advocacy for eye health investment within Nigeria's health sector resource-constrained environment. This study conducts a burden of disease analysis quantifying DALYs attributable to visual impairment and blindness across all six geopolitical zones of Nigeria. A secondary data analysis and modelling study design will be employed, utilising data from the Nigeria Demographic and Health Surveys, Global Burden of Disease 2019 and 2021 Nigeria datasets, the Nigeria National Blindness and Visual Impairment Survey, and state-level health management information systems. Cause-specific prevalence of blindness and visual impairment by zone will be estimated. Disability weights from the Global Burden of Disease study for relevant visual impairment categories will be applied. Years lived with disability will be computed for each zone stratified by age group and sex. Years of life lost from premature mortality attributable to vision-related conditions will be estimated using standard life tables. Uncertainty analysis using Monte Carlo simulation will quantify confidence around DALY estimates. Zone-level DALY estimates for visual impairment do not exist in published or grey literature for Nigeria, yet such data are essential for health technology assessment, insurance benefit package design, and comparative effectiveness advocacy. This study generates original epidemiological evidence advancing Nigeria's capacity for evidence-based ophthalmology policy and planning. Recommendations will address integration of ophthalmic burden of disease data into the National Health Sector Development Plan and WHO-AFRO regional eye health reports. Keywords: disability-adjusted life years, visual impairment, burden of disease, geopolitical zones, Nigeria