Development of a Nigerian Cultural Competency Framework for Optometric Practice in Pluralistic Communities

Nigeria's profound ethnic, linguistic, and religious diversity creates a complex sociocultural context for clinical encounters in optometry. Culturally competent care, which adapts clinical communication and service delivery to the patient's cultural context, has been shown to improve patient trust, adherence, and outcomes globally, yet no Nigerian-specific framework for cultural competency in optometry exists. This study develops and validates a Nigerian Cultural Competency Framework (NCCF) for optometric practice, drawing on grounded theory methodology and extensive fieldwork across five geopolitical zones. Phase one will conduct 60 semi-structured interviews and 10 focus group discussions with optometrists, patients, and community leaders across Kano, Enugu, Lagos, Benin City, and Maiduguri, analyzing data using constructivist grounded theory. Phase two will use the Delphi consensus method with 40 optometry experts to validate and refine the framework. Phase three will pilot-test the NCCF through a structured training program delivered to 50 optometrists and evaluated using standardized patient encounters. This research makes a significant original theoretical contribution by formalizing the sociocultural dimensions of patient-provider interaction in Nigerian optometric practice. The NCCF will be submitted to ODORBN for adoption into continuing professional development programs and integrated into the curricula of Nigerian optometry training institutions. Keywords: cultural competency, Nigerian optometry, grounded theory, pluralistic communities, patient-centred care