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Page 1: Integrating Primary Eye Care and Primary Health Care 17 th Sept 2012

Integrating Primary Eye Care and

Primary Health Care17th Sept 2012

Dr Padmaja Kumari Rani,M.S,FNB (Retina)Head, Village Vision ComplexInternational Centre for Advancement of Rural Eye Care (ICARE)L V Prasad Eye InstituteHyderabad

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Acknowledgement:Puwat Charukamnoetkanok, MD, Thailand

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IntegratingPrimary Eye Care

and Primary Health Care

• Why • What• How • Global Scenario – Thailand Case Study• Indian Scenario (OEU & LVPEI Case studies)• Challenges• Way forward

Page 4: Integrating Primary Eye Care and Primary Health Care 17 th Sept 2012

Why?

• Holistic care

• Treating causes of causes

• Wide reach

• Sustainability

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What?

WHO

Page 6: Integrating Primary Eye Care and Primary Health Care 17 th Sept 2012

What?

• Horizontal approach

• Team work

• Networking

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What?

WHO

Page 8: Integrating Primary Eye Care and Primary Health Care 17 th Sept 2012

How?

• Location

• Areas of Integration

• Stake holders

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How?

Khan et al

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Global scenario-Thailand

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Global scenario-Thailand

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Global scenario-Thailand

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• Launched in 1963

• 15 Projects

• 11 Partners

• 9 States & UT

• 3.4 million - people

covered

• 0.75 million – persons

directly benefited

HBCEHP –

USEHP –

OE India -

Indian scenario – OEU Operation Eye Sight Universal – India

•Immunization coverage •ANC/ PNC coverage has reached 100%•Increased Awareness levels

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Indian scenario – LVPEI

To eliminate avoidable blindness through

integration of Primary eye care with Primary health

care by community Development Initiatives.

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Who is a Vision health guardian

•Local village person

•Literate

•Healing touch

•Health worker background

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LVPEI (2010-2012)

• One tiny Village (5 months) – n-746

• Mandal ( District Subunit) – 54 villages with (2011-14) n-39,000

• Present Coverage – 70 villages -n-100,000

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Methodology

i. Identification and Training of Village Vision Health Guardians

i. Awareness creation

ii. Service delivery

iii. Community Development Initiatives

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Methodology I . Identification and Training of Village Vision Health

Guardians and village vision committee formation

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Methodology

II. Awareness creation

Teacher conducting Eye screeningTeachers Training Program

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Methodology

III. Service delivery

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MethodologyIV: Community Development Initiatives

JSS trade training program inauguration JSS trade training program in house wiring and electrical maintenance for village youth

Vision Garden Inauguration

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Coverage of One Mandal -54 Villages

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Situational Analysis of Study area

Illiteracy in Jainad Mandal 39.45 % - very low in females

% of population below poverty line >26%

Pattern of agricultureDry crops / irrigated dry crops cultivation due to lack of perennial source of irrigation

InfrastructurePoor Drainage / Sanitation / Power supply, roads etc.,

Employment opportunitiesMeager, due to lack of industries or arable lands and low scope for self employment

Type of houses 50% Semi pucca

Gas connection 30%

Individual toilets attached to houses 26%

Average percapita annual income 

Rs 29,187/-

GDP : 8,786 crores [2007-2008]

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Project Survey Data

Slums/Villages surveyed 54Houses surveyed 9,538

Population covered through door to door survey 38,829

Diabetes high risk [score>60] 56Known diabetics identified (2.5%) 1,006Known Hypertension (3.4%) 1106Identified with High BP > 140/90 by VHG 221Identified with disability [All category] 103People identified with eye ailments and referred for eye examination

2,740

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Project Survey Interim Data

• Blindness (<6/60)-0.4%• Visual Impairment (<6/18)-7.1%• Spectacles prescribed- 664• Spectacles Purchased-354 (53%) children-35• Cataract Identified – 771• Patients visited SC-491• Cataract surgeries done-122

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Project Survey Interim Data

• Eye health and Primary health education events conducted -363

• n-2,877 • Number of pregnant women in the covered

villages - 408• Antenatal care-408 , Postnatal care-140

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Qualitative Impact

Master SaiKumar

Three VHGs – enrolled as Vision technicians

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Challenges

• Slow Process• Linkage with health care providers• Understanding Motivators/Barriers for

performance of VHGs • Measuring the Impact

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Way forward

• Cost effective Technology Innovations

• Care of the Community, by the Community and for the Community

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“Thousands of candles can be lit from a single candle, and the life of the candle will not be shorter. Happiness never decreases by being shared.”

The Buddha

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L V Prasad Eye Institutewww.lvpei.org

Thank you!

Excellence

Equity

Efficiency


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