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THE NEED FOR ADVOCACY &
PROMOTING EYE HEALTH IN INDIA
Thulasiraj RavillaLAICO – Aravind Eye Care System
Why Advocacy
Plan ≠ Performance
Money ≠ Resources
Resources ≠ Results
Ideas ≠ Action
Any program to succeed needs .. Resources – Finance Resources – Program input Right policies Enabling environment Right Structure & Governance Partners in implementation These don’t fall in place automatically Advocacy is all about making these
happen
Advocacy Model
Target Group
Purpose
Advocacy & SensitizationStrategies
Desired Outcomes
Target Groups
Policy Makers Funding agency Providers (eye care professionals) Enabling agencies (Education
departments) Community Patient
Advocacy Focus - Policy MakersPurpose:
Ensuring that blindness control stays on the agenda of MOH – GOI & State Health Ministries
Financial commitment Supportive policies Legislations Approvals
Strategies: Workshops Evidence based intervention strategies Impact assessment Evidence of money well spent
Advocacy Focus - Funding AgenciesPurpose:
To mobilize required resources Budget/expense approvals
Strategies: Workshop on National/State plans Workshops on project details Evidence of regular monitoring Impact assessment
Advocacy Focus – Eye Care Providers
Purpose: Alignment Involvement Increasing quality/efficiency/coverage
Strategies: Inclusion of Community Ophthalmology
(Vision 2020) in the PG curriculum Sessions in State, National association
meetings
Advocacy Focus - Enabling Agencies
Purpose: Cooperation Taking on additional responsibilities
Strategies: Activity Focused Workshops Legislation/Directives from Policy makers
Advocacy Focus - CommunityPurpose:
Influencing health seeking behaviour Support of outreach, case finding
Strategies: Health education Social marketing Awareness campaigns Including eye health in school curriculum State launches of Vision 2020 Write-up/programmes in popular media
Advocacy Focus - Patient
Purpose: Compliance – treatment, follow-up, care
Strategies: Counselling Disease or treatment specific information
Case Study – Examples from India
Advocacy for right “Program Structure” Eye Care coordination committee to be
constituted at National level District Blindness Control Societies (idea piloted
and developed by DANPCB-DANIDA) VISION 2020 – The Right to Sight India: a
consortium of non-governmental organizations working in eye care
State Eye Health Societies
Request for increased financial allocation
from about $ 100 to $ 400 Million(request made in Sep 2006)
XI Five Year Plan (2007-12)
CATARACT SURGERIES: 1985-2005CATARACT SURGERIES: 1985-200512.19
12.09
11.96
11.85
10.96
11.97
15.12
16.05
19.14
21.67
24.71
27.23
30.35
31.71
33.56
36.44
37.00
38.57
41.98
44.91
48.21
0.00
10.00
20.00
30.00
40.00
50.00
60.00
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
World Bank Project
World Bank Project
Quality: 5% with IOL in 1993 increased to 90% in 2005
Evidence: Funding enhances performance
Tenth Plan (2002-07): Target Vs. AchievementsTenth Plan (2002-07): Target Vs. Achievements
ActivityActivityTarget Target
(2002 - 2007)(2002 - 2007)AchievementAchievement
(till 2002-2006)(till 2002-2006)
Cataract operationsCataract operations 16,753,00016,753,000 17,366,89617,366,896
Spectacles to school Spectacles to school childrenchildren
313,500313,500 915,120915,120
Eye donationsEye donations 175,000175,000 92,43692,436
Training of ophthalmic Training of ophthalmic SurgeonsSurgeons
1,2001,200 1,0301,030
Grants-in-aid to NGOsGrants-in-aid to NGOs 8989 4545
Evidence : Have capacity to deliver
Tenth Plan Performance:Tenth Plan Performance:Budget Allocation & ExpenditureBudget Allocation & Expenditure
YearYear Allocation ($ Millions)Allocation ($ Millions) Expenditure ($ Millions)Expenditure ($ Millions)
2002-032002-03 21.2521.25 21.1621.16
2003-042003-04 21.5021.50 21.4121.41
2004-052004-05 22.0022.00 21.8321.83
2005-062005-06 23.3323.33 23.2123.21
2006-072006-07 22.5022.50 7.327.32
(Total allocation for 10th Plan was $ 110 Millions)(Total allocation for 10th Plan was $ 110 Millions)
Evidence: Have capacity to absorb funding
Major challenges to be addressedMajor challenges to be addressed Reaching the underserved populationReaching the underserved population
Providing Comprehensive Eye CareProviding Comprehensive Eye Care
Enhancing the quality of Services & monitoring outcomesEnhancing the quality of Services & monitoring outcomes
Human Resource Development - training all cadresHuman Resource Development - training all cadres
Developing Sustainable Infrastructure through a public-private Developing Sustainable Infrastructure through a public-private partnership for service deliverypartnership for service delivery
Remaining Technologically current in Eye CareRemaining Technologically current in Eye Care
Monitoring the impact - epidemiology of BlindnessMonitoring the impact - epidemiology of Blindness
Rationale: What needs to be done?
BUDGET 2007 – 2012 BUDGET 2007 – 2012 ($ Millions)($ Millions)
ActivityActivity Total outlayTotal outlay
InfrastructureInfrastructure 3838HRDHRD 2121Disease ControlDisease Control 338338Programme ManagementProgramme Management 2424
TOTALTOTAL 421421(Total allocation for 10th Plan was $ 110 Millions)(Total allocation for 10th Plan was $ 110 Millions)
The Pitch: $ 110 M to $ 421 M
Ultimate purpose of Advocacy Improved Eye Care Services More persons served (prevention, cure
and rehabilitation) Universal coverage Goals of Vision 2020 met
Course Schedule
Speakers Title1. Mr R D Thulasiraj
The need for Advocacy and its Importance in Promoting Eye Health in India
2. Mr Peter Ackland
IAPB’s Advocacy Goals for VISION 2020 and the IAPB Advocacy Training Programme
3. Dr Abdulaziz Al Rajhi
Advocacy Strategies and Lessons Learned from EMR’s success in Securing Support for Recent WHA Resolutions
4. Ms Jennifer Gersbeck
Advocacy Strategies and Lessons Learnt from Securing Australian Government Support for the Australian Blindness Initiative
5. Mr William Felch
The ICO Advocacy Network
6. Plenary Q&A session + Secrets of Successful Advocacy based on the Experiences of Audience
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