Ophthalmic Health Policy Implementation in Ethiopia: Workforce, Systems, and Global Health Lessons.

Vision impairment remains a persistent public health challenge in Ethiopia. Despite national eye health strategies, implementation is uneven. This study examined how health policy influences ophthalmic care, focusing on barriers and global health implications. A cross-sectional mixed-methods survey was conducted from June to August 2025 across nine Ethiopian regions. Of 270 invited participants, 221 responded (81.9%), including ophthalmic professionals, patients, policymakers, NGO/INGO representatives, and international health experts. Structured questionnaires and semi-structured items assessed service quality, policy alignment, and system challenges. Quantitative data were analysed using descriptive statistics, bivariate tests, and regression models; qualitative responses underwent thematic analysis. Satisfaction with ophthalmic services was high (93.8%, 95% CI: 90.1–96.1). Patients living within 5 km of facilities were significantly more satisfied than those traveling over 20 km (OR = 18.0, 95% CI: 1.4–236.1, p = 0.028). Facility type and waiting time were not significant predictors. Ordinal regression showed adequate model fit (Hosmer–Lemeshow p = 0.080), with no significant demographic predictors (χ² = 8.902, df = 9, p = 0.446). Qualitative themes revealed persistent challenges in financing and workforce distribution. Geographic proximity strongly influences patient satisfaction. While Ethiopia’s eye health policies align with global frameworks, implementation gaps remain. Strengthening access, sustainable financing, workforce capacity, and multisectoral partnerships is essential to advance equitable ophthalmic care.