Mobile Eye Clinic Operations and Cost-Effectiveness in Reaching Underserved Communities in Zamfara State

Mobile eye clinics represent an increasingly adopted model for delivering ophthalmic services to geographically remote and underserved populations in Nigeria. This study evaluates the operational model and cost-effectiveness of mobile eye clinic services deployed to underserved communities in Zamfara State, North West Nigeria. A retrospective programme analysis and cost-effectiveness study will be conducted using operational data from a three-year mobile eye clinic initiative implemented from 2021 to 2023 by the Zamfara State Eye Care Programme with support from an international non-governmental organisation. Data collected will include the number of communities reached, persons screened, conditions diagnosed, procedures performed (including extractions, minor lid surgeries, and refractions), spectacles dispensed, and referrals completed. Cost data per output indicator will be derived from programme expenditure records. A cost per disability-adjusted life year (DALY) averted analysis will be performed where data permits. Mobile eye clinic programmes in comparable Nigerian states demonstrate high productivity in reaching communities where fixed facility utilisation is low due to distance and transport costs. However, operational sustainability is often challenged by fuel costs, vehicle maintenance, and dependence on external funding. This study provides Zamfara State-specific evidence on the efficiency and scalability of the mobile clinic model. Recommendations will address government co-financing, preventive vehicle maintenance schedules, community pre-mobilisation, and integration with the state's primary health care system. Keywords: mobile eye clinic, underserved communities, cost-effectiveness, Zamfara State, outreach