Last Updated:  21/09/2022

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Project Pitch By: Operation Eyesight India

 

Proposed Project Title


Integrated Primary Eye Care Program

 

Thematic Area

Eradicating hunger, poverty and malnutrition, promoting health care, sanitation & safe drinking water

Sub Thematic Area

Hospital infrastructure, medical camps, surgeries, healthcare awareness & rehabilitation

Project Synopsis

Poor eye health-seeking behavior usually stems from inadequate knowledge of eye diseases, harmful cultural beliefs and practices, eye problems viewed as low priority, gender discrimination, lack of affordability and poor mobility amongst the elderly. Often hospitals: 1. Provide eye care services but do not empower targeted communities 2. Do not focus on the elimination of avoidable blindness; and3. Make services available free of cost, but poor patients at risk of losing their sight do not access these services. According to the 2019 World Report on Vision, an estimated that 2.6 people globally suffer from myopia and 123.7 million people have moderate to severe distance vision impairment or blindness due to uncorrected refractive error. Operation Eyesight aims to address these challenges by supporting policy development on eye health, establishing effective referral and follow-up mechanisms, strengthening human resources, and establishing facilities to deliver quality eye care services. Under the project
 
 
 

Overview of the Proposed Project

Estimated Budget
INR 0.3 Cr - INR 0.6 Cr
Proposed Location
Arunachal Pradesh, Madhya Pradesh, Uttar Pradesh

Key Project Partners
Government,Gram Panchayat

Project Status
Already Implemented-Replicable
 

Facts

Beneficiary Type (Primary): General
Beneficiary Type (Secondary): Elderly care
Estimated No. of Beneficiaries: above 10000 Individuals
Status of Baseline Survey: Already Done
 
 
 

Proposed Project Description

Goal: Elimination of avoidable blindness on a sustainable basis

Objectives:

  • to deliver comprehensive quality eye care services through competent and empowered health care providers
  • Bringing quality eye care services closer to the communities by operationalizing teleophthalmology and mobile vision center services
  • Designing and implementing an integrated sustainable and scalable eye health model within CPHC service delivery through HWCs using a continuum of care approach.
  • Empowering communities to take care of their eye health needs through health education.

Strategy: Operation Eyesight in association with partner and state/district health departments will support the expansion of the service delivery package for eye care at Health and Wellness Centers. It will adopt a systems approach to operationalize the eye care service delivery components using the prescribed operational guidelines by the Government of India and work closely with state and district officials to ensure all the critical elements necessary for optimal eye health are appropriately addressed. The following strategies are proposed to strengthen the eye care services delivery. 

Strengthening primary eyecare services through;

 

  • Establishing Vision Points and Sub-Center HWCs and Vision Centers at the Primary Health Center
  • Establish linkage of Vision Centers with District Hospital through piloting teleophthalmology
  • Building capacity of existing eye health staff on key components of Primary Eye Care (PEC)
  • Increasing outreach of PEC services through mobile VCs
  • Building capacity of frontline health workers on early diagnosis and timely referral of all suspected cases with eye conditions
  • Establishing functional linkages for the provision of free/affordable spectacles
  • Launching mobile Vision Center
  • Conducting health education sessions to increase community awareness
  • Integrate the learnings in the district PIP

Strengthening secondary eye care services through;

  • Conducting facility audit to identify the gaps in delivery of eye care services and developing an action plan to bridge the gaps
  • Building capacity of existing eye health personnel on eye care services through training needs assessment
  • Establishing functional linkages for the provision of free/affordable spectacles and quality surgical services
  • Piloting teleophthalmology for bringing quality eye care (secondary and tertiary) closer to community and data-driven decision making
  • Establishing functional Intra/interstate referral and feedback linkages with premier/tertiary eye care institutes
  • Meaningful inclusion of private sector by leveraging the available PMJAY impaneled facilities network for the provision of quality assured eye care services
  • Establishing a robust monitoring and reporting framework to support data-driven decision making
  • Promote declaration of Avoidable Blindness Free Villages (ABFVs)
  • Technical support to state and district for scale-up of successful interventions.

Special Features of Project:

COMMUNITY EMPOWERMENT AND DEMAND GENERATION:

One of the key activities of the project is to empower the target communities to take ownership of their eye health. This will be achieved by conducting periodical eye health education sessions by trained frontline workers to raise awareness and promote eye health-seeking behavior among target communities by using appropriate Behavior Change Communication (BCC) materials.

COMMUNITY SCREENING OF EYE CONDITIONS:

The project will develop a mechanism for community screening for eye conditions. The project will explore the possibilities of incorporating relevant elements into the existing Community Based Assessment Checklist (CBAC). The project will also explore the possibility of incentivizing the frontline workers for undertaking door to door surveys.

CAPACITY BUILDING:

The project will undertake capacity-building activities for the various cadre of staff on key elements of comprehensive primary eye care in line with the GoI prescribed operational and CPCH guidelines.

ESTABLISHMENT OF VISION POINTS, VISION CENTERS, AND MOBILE VISION CENTERS:  The project proposes to establish.

  • Vision Points at HWCs-SC to provide screening services such as visual acuity measurement, provide primary eye care services for eye conditions like dispensing of prescribed medicines and ointments for conjunctivitis, dry eye. Identification of common eye diseases and referral linkages with Vision Center.
  • Vision Centers at HWCs-PHCs and CHC to provide comprehensive eye examination services, diagnosis and treatment of refractive errors, identification of cataract and other eye diseases, consultation with a specialist using teleophthalmology, referral and follow-up of operated cases.
  • Mobile Vision Center in difficult geographies to provide primary eye examination at the community level, identification of refractive errors, linkage for spectacles, Identification of common eye diseases, dispense medicines for common eye infections, health education, and referral to the appropriate center.

STRENGTHENING SURGICAL EYE CARE SERVICES THROUGH UPGRADED COMMUNITY HEALTH CENTER AND DISTRICT HOSPITAL:

The project will leverage the already upgraded OPD and Operation Theater  to deliver quality eye care services. The project will also support the district and state to conduct a gap analysis and action plan to streamline and strengthen eye care service delivery. It will facilitate the training needs assessment for the various cadre of staff across the spectrum and work closely with the state and partners for putting in place the mechanisms for continued capacity building.

STRENGTHENING REFERRAL AND FOLLOW-UP MECHANISM TO ENSURE CONTINUUM OF CARE:

One of the key activities will be to develop and establish robust referral feedback linkages to provide free/affordable quality eye services throughout the continuum care. We work closely with the state and partners to strengthen the referral feedback mechanism through;

  • Defining and strengthening patient flow, care provision, and follow-up processes and mechanisms
  • Establishing functional referral linkages for complicated case management
  • Exploring possibilities for leveraging the available network of PMJAY impaneled private sector facilities within the state
  • Exploring possibilities of establishing functional interstate referral linkages with premier eye care institutes.
  • Promoting the use of Tele-ophthalmology to provide specialist care near the community
  • Establishing mechanisms for tracking back referrals and follow up at the community level

DECLARATION OF AVOIDABLE BLINDNESS FREE VILLAGES (ABFV):

One of the success indicators of the project will be to declare villages as avoidable blindness free. The project will work with the state and partners to promote the declaration of ABFV in the villages where no patient has visual acuity less than 6/60 in the better eye due to avoidable or treatable conditions. The definition of the ABFV has been validated by L V Prasad Eye Institute. The declaration would be celebrated and leveraged to ensure sustainability and provide motivation to the health workers and the communities.

 
 

Salient Features

  1. Strengthening surgical eyecare services through upgraded community health center and district hospital
  2. Training and Capacity Building of frontline workers
  3. Empowering communities to take care of their eye health needs
 

About Operation Eyesight India

Operation Eyesight India(OEI) is a NGO based in Hyderabad. It is part of Operation Eyesight Universal- a Canadian organization working with a mission “To prevent blindness and restore sight”. Founded in 1963 to address the backlog of cataract surgeries in India, we now have comprehensive eye health programs in eight countries- India, Bangladesh, Nepal, Ghana, Zambia, Kenya, Ethiopia and Liberia. 

When people suffer from poor eye health, their quality of life is diminished, and the cycle of poverty is perpetuated. Some of the common eye issues includes cataracts, diabetic retinopathy, glaucoma and uncorrected refractive error. As per the WHO –India contributes 21% of world’s blind population and 22% of world’s visually impaired population.  But sadly, upto 90% of these people are suffering from avoidable blindness, which means their condition can be treated or could have been prevented. OEI is addressing in eliminating the unaddressed disability, “blindness”. We partner with local governments and hospitals to ensure quality eye health care services are made available, accessible and affordable to those in need along with quality. In India, we are working with 35 partner hospitals, across 90 districts within 17 states, established 200 Vision Centers/Points and declared over 1,072 villages as avoidable blindness-free.

 
 

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