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.  2 Strategies 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 awareness  Integrated in other ongoing programs  By maintaining and continually improving standards  Plan for staff development  Monitoring and evaluation plan  Indicators

 Thank you