THE NEED FOR ADVOCACY & PROMOTING EYE HEALTH IN INDIA Thulasiraj Ravilla LAICO – 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 & Sensitization Strategies Desired Outcomes

Target Groups  Policy Makers  Funding agency  Providers (eye care professionals)  Enabling agencies (Education departments)  Community  Patient

Advocacy Focus - Policy Makers Purpose:  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 Agencies Purpose:  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 - Community Purpose:  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 ( )

CATARACT SURGERIES: World Bank Project Quality: 5% with IOL in 1993 increased to 90% in 2005 Evidence: Funding enhances performance

Tenth Plan ( ): Target Vs. Achievements Activity Target ( ) Achievement (till ) Cataract operations 16,753,00017,366,896 Spectacles to school children 313,500915,120 Eye donations 175,00092,436 Training of ophthalmic Surgeons 1,2001,030 Grants-in-aid to NGOs 8945 Evidence : Have capacity to deliver

Tenth Plan Performance: Budget Allocation & Expenditure Year Allocation ($ Millions) Expenditure ($ Millions) (Total allocation for 10th Plan was $ 110 Millions) Evidence: Have capacity to absorb funding

Major challenges to be addressed  Reaching the underserved population  Providing Comprehensive Eye Care  Enhancing the quality of Services & monitoring outcomes  Human Resource Development - training all cadres  Developing Sustainable Infrastructure through a public-private partnership for service delivery  Remaining Technologically current in Eye Care  Monitoring the impact - epidemiology of Blindness Rationale: What needs to be done?

BUDGET 2007 – 2012 ($ Millions) Activity Total outlay Infrastructure38 HRD21 Disease Control 338 Programme Management 24 TOTAL421 (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 SpeakersTitle 1. Mr R D ThulasirajThe need for Advocacy and its Importance in Promoting Eye Health in India 2. Mr Peter AcklandIAPB’s Advocacy Goals for VISION 2020 and the IAPB Advocacy Training Programme 3. Dr Abdulaziz Al RajhiAdvocacy Strategies and Lessons Learned from EMR’s success in Securing Support for Recent WHA Resolutions 4. Ms Jennifer GersbeckAdvocacy Strategies and Lessons Learnt from Securing Australian Government Support for the Australian Blindness Initiative 5. Mr William FelchThe ICO Advocacy Network 6. PlenaryQ&A session + Secrets of Successful Advocacy based on the Experiences of Audience