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Kilimanjaro Centre for Community Ophthalmology (KCCO)

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Presentation on theme: "Kilimanjaro Centre for Community Ophthalmology (KCCO)"— Presentation transcript:

1 Kilimanjaro Centre for Community Ophthalmology (KCCO)
Tumaini University/KCMC PO Box 2254 Moshi, Tanzania

2 Kilimanjaro Centre for Community Ophthalmology (KCCO)
…dedicated to the elimination of avoidable blindness through the integration of programmes, training, and practical research focusing on the delivery of sustainable and replicable community ophthalmology services

3 Community Ophthalmology
Manpower Infrastructure Community Ophthalmology Patients

4 Karibuni Macho Creating capacity for high-volume cataract surgery while improving financial & organizational sustainability Computerized record & management information system Accounting system Financial planning for sustainability Training to build human resource management capacity Capacity building for nurses

5 Kilimanjaro Region, Tanzania
Indicator 2001 2004 # cataracts ( # total surgeries) (1,420) 1,968 (2,934) Regional CSR 402 1124 Cataracts/staff surgeon 188 492 Collaboration between partners Non-existent; duplication & lack of trust MoH, KCMC Hospital, CBR, Lions working together Outreach to community Campaign mode Integrated; reaching all communities

6 Childhood Cataract Training of district health staff in promotion and recognition of children with congenital or developmental cataract Promotion throughout northern Tanzania to improve early recognition and referral Free surgery and free spectacles post operation (subsidized transport, if necessary) Integration within regional Vision 2020 plans Also: assessment for development of regional low vision programme

7 Congenital/developmental cataract surgeries at KCMC
Girls Boys Boys Girls 2004 (Oct) = 121 2001 (n=60) 2003 (n=99)

8 Kilimanjaro Regional Vision 2020 Programme
Overall strategy for addressing cataract (also trichiasis & childhood cataract) needs in the region Creation of a partnership to implement regional programme (MoH, CBR, KCMC, Lions, others) KCCO coordinates activities District health authorities decide on places for direct referral sites (DRS) DRS are held on a regular basis to ensure trust in the service Every village linked to a DRS (Arumeru district of Arusha region added June 04)

9 Critical components Partnership Sustainability High quality of service
All partners with the same target/goal and complementary strategies Engages religious centres, schools and village leaders in programme Sustainability Moving from externally supported activities to locally supported (Lions Clubs, local businesses, others) Using community optometry to help support programme High quality of service Examiner has enough skills to provide final diagnosis (avoid bringing patients unnecessarily)

10 Critical components Reliability/trust Meeting needs of patient
Builds trust among community members by returning to same site Never cancel date Always provide a full range of services (eye medicines, spectacles, etc.) Patients brought back for surgery that day, surgery the following, taken back the following day Counseling of patients and family members done in the field (increasing utilisation among women). Meeting needs of patient No specific visual cut off for deciding on surgery Village helps decide patients “too poor to pay”

11 Kilimanjaro Region Population 1.4 million DRS

12 Cataract surgery at KCMC by 6 months
Start of Kilimanjaro Regional Vision 2020 plan

13 Kilimanjaro Region (1.4 million) CSR by district for 2004 1,008 884
1,426 1,263 1,115 1,168 CSR = 1,165 Hospital

14 Male:Female CSR by district for 2004
1.28:1 1.19:1 Kilimanjaro Region (1.4 million) Male:Female CSR by district for 2004 1.10:1 1.59:1 0.90:1 Male:Female ratio = 1.12:1 0.91:1 Hospital

15 Tanzania                                                                                                                      Regions without ophthalmologist or cataract surgeon

16 Tanzania                                                                                                                      15 Ophthalmologist 6 Cataract surgeon in training

17 Cataract Surgical Rate (2002)
143 Tanzania 257 428                                                                                                                      317 736 340 198 37 240 234 201 216 Cataract Surgical Rate (2002) Tanzania = 323 724 700 88 421 180 182 34 1st priority 227 118 2nd priority

18 Community Ophthalmology
Manpower Infrastructure Community Ophthalmology “Bridging strategy”

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