Strategies to Operationalise Primary Eye Care

Boateng Wiafe, MD, Regional Director for Africa

Course 11, 9GA IAPB

Hyderabad, 18 Sept, 2012

A step by step method on how to make the concept of Primary Eye Care Operational

In any community . . . . . .

There are 3 categories of people:1. The healthy group

2. The group at risk of eye diseases or problems

3. The group with certain eye diseases or problems

These can only be identified only when community screening takes place

1.Konyama K: Essential Components of Primary Eye Care: J Comm Eye Health1998;11(26):19-21

Primary Eye Care Services

Should not only be clinical, but equal or more attention is needed for people without the disease.

PEC covers the whole range of eye health care for ALL community members.

There should be something in the package of activities for every member in the community

Situational Analysis

A situational analysis should be the first activity that need to be conducted before deciding to implement any Primary Eye Care programs

information Eye Health of individuals in the community Available system of health / eye health care

• State of PHC in the area• State of secondary level eye care in the area• Available human resources • Health financing

This will help to develop a strategic plan which will guide you in the implementation.

2Strategies for the Prevention of Blindness in National Programmes

Participatory planning

TOGETHER WITH STAKEHOLDERS• Problem Identification• Problem analysis• Strategy development• Action plan formulation

This ensures ownership of the plan and likelihood of it being implemented

Results of the analysis

The results of the analysis can be categorized into the following:• Human Resource available• Common eye conditions in the area• Infrastructure and Equipment• State of the health system• Political will• Resources for eye services• Level of awareness about eye health

advocacy

Advocacy is considered to be the lifeline of any sustainable eye care program, therefore advocacy should be• A planned activity at all levels • All key staff should be trained in

advocacy skills

Human resource management

Human Resources are the most important asset in any eye programme, especially in the developing world

The situational and the Gap Analysis will give us some valuable information.

These are 3 essential aspects of HRM• HRD/ Continuous Professional Development • Teambuilding• Motivation

integration Primary eye care is an integral part of Primary

Health Care and should be managed as such. District Health is PHC

Joint planning sessions are very important here. At the district level this is exactly what happens.

Reports are shared with other departments as well

We put systems in place to ensure that they compliment each other.

Joint Monitoring

Partnerships and networking

It is very important to never underestimate any player in eye health in the community

Take stock of what is already happening and see how it can be improved, up-scaled or realigned

NEVER COMPETE, BUT COMPLEMENT EACH OTHER

AVOID DUPLICATION OF EFFORTS

Awareness Creation

Awareness creation should be an on going activity and should be present in all programs• All appropriate methods should be applied

when creating awareness

IEC Materials should be appropriate and relevant

DELEGATE

•Task shifting and Task sharing are happening in so many other disciplines

•Many of us are scared to delegate for fear of failure

•Once you have trained the staff well you can safely delegate.

Motivation

Remember that Motivation does not equal financial incentives.

Following are some suggested forms of motivation:• Recognition of their contribution• Conducive working environment (Infrastructure

and equipment)• Opportunities for career advancement

Managing Infrastructure and Equipment

These account for up to 70% of the budgets in eye care services and so they should be carefully managed

Appropriate Technology does not mean cheap, low quality equipment

Maintenance culture should be cultivated An up to date inventory should be in place

Improving Quality of Care Improving the quality of Care is a change

process and many of us are afraid to change

Once the quality of care (Clinical and Non Clinical) improves, the uptake of services increases

advocacy

Advocacy is considered to be the lifeline of any sustainable eye care program, therefore advocacy should be• A planned activity at all levels • All key staff should be trained in

advocacy skills

Financial Management

It is important to consider all activities in the Primary Eye Care program along business lines.

Activities undertaken should be cost effective

It is important to know and apply the principles of resource mobilization and cost recovery EVEN AT THE COMMUNITY LEVEL

Monitoring and Evaluation

This is a very important aspect of Management we always overlook. At district level, we have always seen joint monitoring to be the best approach

There should be a program of supportive supervision

In Conclusion

In order to build sustainable primary eye care models we would recommend the following CHECK LIST

How do we build sustainable models?

By developing a plan owned by the program Strategic plan Action plan Indicators

Is there an Advocacy plan?Is there a plan to create awarenessIntegrated in other ongoing programsBy maintaining and continually improving standardsPlan for staff development Monitoring and evaluation planIndicators

Thank you