Monitoring Primary Eye Care Systems
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Transcript of Monitoring Primary Eye Care Systems
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Assessing Primary Eye Health DeliveryA Systems Approach
Dr. Sandeep ButtanMS (Ophth), MSC CEH (ICEH, UK)
Program Development Advisor E!e Health "HSS (Asia)
Sightsavers
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What does it mean?
What does it mean to my (your) or!?
#$%#&%$#'&OC $#'&, o*!o
Health Systems " a ne Bu##ord
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Health
+a state o -omplete physical$ mental and social .ell/eing
and not merel! an a/sen-e o disease or inirmit!01
It also in-l2des the a/ilit! to lead a socially andeconomically productive li%e0
Preamble to the Constitution of the World Health Organization as adopted by the
International Health Conference, New Yor, !"#$$ %une, !"&'(
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Health& 'omple Prolem
'ommunity
*amily
+ndividual
3Political system , ill toard health
, development
3Social construct (classes , casts)
3Basic civic amenities (Hygiene ,
sanitation)3*amily , social support
3Economic status , livelihood options
3Education
3Aareness (Health , health careservices)
3-eneral health , ell eing
3rgan speci%ic disease or in%irmityDeterminants o% Health
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Actors$ %unctions and outcomes
People
+nput /anagementH4
Medi-ine
Cons2ma/les
Inormation
e-hnolog!
*inancing4even2e generation
4is* pooling
Allo-ation and
p2r-hasing
5overnmentPoliti-ians
Poli-! ma*ers
ProvidersP2/li-%private
Inormal
Service deliveryP2/li- health
O2trea-h
O2tpatient -ons2ltation
Inpatient -areS2rger!
Other a-torsDonors
65Os
Prote-tion rom
impoverishment
Improve Health
stat2s
-overnance4eg2lation
Poli-ies
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Health Systems approach
)*ll organizations, people and actions whose primary intent is to promote,
restore or maintain Health+
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Health Systems
'1 Providing services
$1 5enerating the human and physical resources that ma*e
servi-e deliver! possi/le
0. 1aising and pooling the resources 2sed to pa! or health
-are
2. Steardship 8 setting and enor-ing r2les, strategi-
dire-tion
*unctions3 Processes
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Health Systems
-oals
'1 Improved health (level
and e92it!)
$1 4esponsiveness
:1 So-ial and inan-ial ris*
prote-tion
&1 Improved ei-ien-!
Attriutes
'1 A--ess
$1 Coverage
:1 ;2alit!
&1 Saet!
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Primary eye care
PEC is an integrated, participatory and inclusive approach to the eye
health component of PHC”
“It consists of eye health promotion, prevention, curative and
rehabilitation services.
It is anchored in the community and is delivered by the health
worforce and community members up to and including the front line
health facilities.”
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Primary eye care& a comple
intervention
Health systemHealth inan-ing
Health .or*or-e
treat =%> reer
4e-ord *eeping
Sto-* -ontrol
4 e , e r
r a l s a n d
H M I S
ther health providers
Inormal Health
Pra-titioners Private
se-tor Others e1g1
Opti-ians, pharma-ists
et-1
'ommunity
?elies and attit2des
Health and other prioritiesillingness to pa!
A--ess to servi-es
So-ioe-onomi- development
Health see*ing /ehavio2r
S 2 p e r v
i s i o n,
s 2 p p l i e s
a n d C
P D
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4niversal access to eye health& a gloal
action plan$ 567285679
/ay 5670$ -eneva
:+S+;
A .orld in .hi-h no one is needlessl! vis2all! impaired, .here
those .ith 2navoida/le vision loss -an a-hieve their 2ll
potential and there is 2niversal a--ess to -omprehensive
e!e -are servi-es1
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4niversal 'overage8 main elements
'1 Comprehensive e!e -are servi-es (o-2s on Primar! e!e
-are)
$1 E!e health integrated into health s!stems
:1 Ens2re a--ess or v2lnera/le gro2ps (poor, minorities,
PD, .omen)
&1 Point>o>-are Pa!ment sho2ld not prevent a--ess1
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4niversal coverage8 components
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7 Sightsavers
Assessing Health Systems
3 Monitoring o programme inp2ts, pro-esses and res2lts, re92ired or the
management o health s!stem investments@
3 Health s!stems perorman-e assessment, as the *e! or de-ision>
ma*ing pro-esses@ and
3 Eval2ating the res2lts o health reorm investments and identi!ing .hi-h
approa-hes .or* /est1
+n%ormation is needed to trac! ho health systems respond to
increased inputs and improved processes$ and the impact they have
on improved health indicators
Purpose
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7 Sightsavers
Assessment /atri
Inp2ts "Pro-ess O2tp2ts O2t-omes Impa-t
+mproved Health8
Supply
chain
+n%ormation
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7 Sightsavers
4>++@A>+;
A**1DAB++>
SE1:+'E DE+:E1
A''ESS+B++>
+/P1:ED EE HEA>HSA>+S*A'>+;
AWA1E;ESS
DE/A;D
PE'8 +denti%y ey attriutes
EE 'A1E ;EED
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7 Sightsavers
/apping o% components
'//4;+>
>E1>+A1
evel
SE';DA1
evel
Primary 'are
EADE1SH+P3 -:E1;A;'E
1ES41'ES(+;*1AS14'>41E)
+;*1/A>+;
SS>E/
SE1:+'E DE+:E1
HEA>H
W1*1'E
*+;A;'+;-
Access
'overage
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7 Sightsavers
Data collection , Analysis
3 M2ltiple so2r-es
3 ?oth 92antitative " 92alitative data (Primar! data)
3 A--essing availa/le data so2r-es (Se-ondar! data)
3 Setting I s!stems or ro2tine -olle-tion o relevant
inormation
/ied methodology
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Data 'ollection
/anagement3
Policy /a!ers
ocal'oordinators
PA>+E;>S
'//4;+>
SE1:+'E
P1:+DE1S
+;>E1:+EW
*-D
*-D
EC+>
+;>E1:+EW
S41:E
P+'
D'4/E;>S
*A'++>
:+S+>
*A'++>1EP1>S
('+;+'A 3
*+;A;'+A /+S)
1-A;+@A>+;
SE1:+'E
4;+>
BE;+*+'+A1+ES
P1+/A1 DA>ASE';DA1
DA>A
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7.-:E1;A;'E
'1 ision " poli-ies
$1 Strategi- planning
:1 Operational planning
5. H4/A;1ES41'E
'1 4e-r2itment -riteria
$1 raining
:1 In-entive " motivation
2. *+;A;'E
'1 So2r-e o 2nds
$1 Cost -ons-io2sness
. SE1:+'EDE+:E1
'1 Servi-e -omponents
$1 Coverage
:1 Comm2nit!engagement
&1 Integration .ith healths!stems
0. HEA>H+;*1/A>+;
'1 Data -olle-tion
$1 4evie. " anal!sis:1 e-hnolog!
E**E'>+:E;ESS
'1 A--ess ordisadvantaged gro2ps
$1 Aorda/ilit!
E
'1 A--essi/ilit!
$1 Availa/ilit! " -ontin2it!
:1 Health see*ing
&1 Satisa-tion
E**+'+E;'
'1 Cost re-over! "s2staina/ilit!
HEA>H SS>E/S *4;'>+;S
4>P4>S
Systems +ndicators , Analysis
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7 Sightsavers
Assessment /aps
-overnance
Health Wor!%orce
/edicines and >echnology
Health *inancing
+n%ormation
Service delivery
6
6
766
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'hallenges in measuring systems
strengthening
3 6ot pres-riptive
3 O/Be-tive, eviden-e>/ased and
tailored to the -ontet
3 Indire-t lin* /et.een HSS and health
o2t-omes Attri/2tion dii-2lt
3 Donor -oordination
3 term pro-ess
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All PEC initiatives are -ontet spe-ii-
3 Dierent approa-hes in dierent settings
3 Dierent priorities
3 Dierent roles pla!ed /! 5overnments, 65Os and Private
se-tor
3 Dierent so-io>politi-al environment
3 Dierent levels o interventions (Individ2al, Instit2tion,
so-iet!, poli-!)
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Systems thin!ing
Every intervention$ %rom the simplest to the most comple$
has an e%%ect on the overall system$ and the overall
systemhas an e%%ect on every intervention
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If you can!t plan it, "ou can!t do it
If you can!t measure it, you can!t
manage it
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