1 Dedicated to “the promotion of peace through the prevention of blindness” Regional Capacity Building Workshop Program Design for Pediatric Eye Care Interventions The A2Z Child Blindness Program International Eye Foundation Kilimanjaro Centre for Community Ophthalmology April 7-8, 2011 Moshi, Tanzania

2 IEF Founded in Years Improving Ophthalmology “If you restore the sight of one man, you benefit one man. If you teach one man how to restore sight, you benefit many men. And if you teach many men, you benefit mankind.” John Harry King, Jr., MD, Corneal Transplant Pioneer, IEF Founder

Global causes of Blindness th World Health Assembly, 1982 In millions

4 Milestones 1960’s to 1980‘s 1960’s: Short & long-term volunteers to newly independent developing countries with no ophthalmologists of their own. Photo: Dr. Randolph Whitfield, 1972-present MacArthur Foundation Fellow ’s: Established paramedical ophthalmic training programs to help build national eye care services Provided scholarships for ophthalmologists from developing countries Photo: Ophthalmic Medical Assistant Training Program, Ethiopia 1980’s: Focus on disease programs: trachoma, VAD, onchocerciasis IEF is first eye care NGO accepted into “official relations” with WHO (1985) Trachoma Onchocerciasis “river blindness” Vitamin A Deficiency/ Child Survival

5 1990’s IEF’s Paradigm Shift to Sustainability Programming Public health causes of blindness reduced thanks to magic bullet medicines Emerging causes of blindness only treated by ophthalmologists Need sustainable systems, technology, and business approach WHO data supports needed shift – next slide

Global causes of Blindness 2004 Best corrected Visual Acuity < 3/60 (0.05) New WHO data December success against public health causes of blindness

1990’s Management & Sustainability What’s wrong with the system? Unproductive? Few operations? Quality less than optimal? Old, broken and inappropriate equipment? Lack of consumables? No incentives? Qualified staff leave? Patients do not seek government eye care even if it’s free? All patients cannot access private eye care?

1990’s Management & Sustainability Programmatic questions: What percent can afford private eye clinics? Where do middle income people go who can pay a fee or have insurance, but cannot afford private clinics? Can eye clinics serve all economic levels of society and remain financially sustainable?

IEF SightReach® Management Program Social Enterprise Approach IEF developed a hybrid-entrepreneurial approach to eye care delivery combining best of modern clinical eye care practices business planning and management systems Private clinics see paying patients and subsidize poor patients Public hospitals treat the poor and have facilities for private patients who pay a fee Sliding scale pricing structure Revenue generating services

SightReach® Management Improve quality Use paramedicals 4/1 Outreach Earn revenue

21 st Century Technology As ophthalmology has evolved, IEF has evolved from a voluntary organization to one that builds systems capacity focusing on quality, efficiency, financial sustainability and customer satisfaction. Ophthalmic Clinical Officer performs ICCE Dr. Gerald Msukwa performs ECCE with IOL, Small Incision Cataract Surgery and Phaco-emulsification