From The Perspective Of Human Capital, The Status Quo And Improvement Model And Mechanism Of Rural Students' Poor Eyesight

Poor vision is the most common impairment affecting school aged children in the developing world,comprising half of all disabilities among children.Common,but untreated,vision problems can lead to a variety of broader issues.The WHO estimates the potential global lost productivity due to uncorrected vision to be hundreds of billions of US dollars annually.Studies have also shown that for school-aged children,visual impairment has negative effects on quality of life.Several observational studies show that among school-aged children,uncorrected vision problems are also correlated with lower performance on a variety of tests.Fortunately,these problems can be easily addressed through the wearing of eyeglasses.In most cases,children's vision problems can be easily detected by simple vision tests,such as visual acuity screening.Typically almost all vision problems among children are caused by refractive error(largely myopia,but also hyperopia and astigmatism),which is easily addressed through corrective lenses.Research has shown that providing eyeglasses to students and ensuring that students wear them can erase any academic performance gap caused by poor vision.However,research also has found that in developing settings—including rural China—less than one third of children with poor vision own or wear eyeglasses.Why are the rates of student ownership and wearing of eyeglasses so low,and what can be done about this problem?An absence of knowledge and/or misinformation about vision problems,consequences and solutions may lead to low rates of ownership and use of eyeglasses.Around the world,affordable and accessible Vision Centers are one of the most popular strategies used by both non-governmental organizations(NGOs)and governments to overcome barriers to access of high-quality glasses.However,to date,no studies have rigorously evaluated the impact of Vision Centers on access to eyeglasses.In order to answer the above questions,I use data from ten large-scale studies conducted in rural China to:(1)explore the extent of vision impairment among schoolchildren,and how this is linked to academic performance;and(2)evaluate two distinct strategies for improving access to high quality vision care for rural children.Specifically,I utilize a massive dataset comprising observations on 76,774 school students from six cohorts spanning five provinces in rural China.I assess the prevalence of visual impairment,ownership of glasses,and the severity of impairment across the six cohorts.Second,I use data from a large-scale randomized controlled trial(RCT)in rural China that implemented a health information campaign to improve eyeglasses ownership and wearing behavior among students.Third,I use data from a second RCT to measure the impact of a county-based Vision Center on eyeglasses uptake and academic performance among rural Chinese schoolchildren.I have three main findings.First,visual impairment is the most common disability affecting school-aged children;however,only a small fraction of affected children own or wear eyeglasses.Second,I find that the health information campaign was able to successfully increase student ownership and wearing of eyeglasses,relative to a control group.Finally,I find that the county-based vision center can significantly improve students' school performance,glasses ownership,and glassing wearing behaviors.I draw several policy recommendations based on these findings.First of all,we suggest that more effort should go into improving the regularity and coverage of in-school eye examinations and to addressing non-income barriers to ownership of eyeglasses.Second,our results show that health information campaigns are an effective way to improve eyeglasses ownership and eyeglasses wearing behavior among poor vision students in rural China.Third,a hospital-based model of refractive service delivery is effective at improving access to services,and may be able to play an important role for China and other countries with a high prevalence of refractive error.