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

Acknowledgement:Puwat Charukamnoetkanok, MD, Thailand

IntegratingPrimary Eye Care

and Primary Health Care

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

Why?

• Holistic care

• Treating causes of causes

• Wide reach

• Sustainability

What?

WHO

What?

• Horizontal approach

• Team work

• Networking

What?

WHO

How?

• Location

• Areas of Integration

• Stake holders

How?

Khan et al

Global scenario-Thailand

Global scenario-Thailand

Global scenario-Thailand

• 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

Indian scenario – LVPEI

To eliminate avoidable blindness through

integration of Primary eye care with Primary health

care by community Development Initiatives.

Who is a Vision health guardian

•Local village person

•Literate

•Healing touch

•Health worker background

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

Methodology

i. Identification and Training of Village Vision Health Guardians

i. Awareness creation

ii. Service delivery

iii. Community Development Initiatives

Methodology I . Identification and Training of Village Vision Health

Guardians and village vision committee formation

Methodology

II. Awareness creation

Teacher conducting Eye screeningTeachers Training Program

Methodology

III. Service delivery

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

Coverage of One Mandal -54 Villages

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]

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

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

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

Qualitative Impact

Master SaiKumar

Three VHGs – enrolled as Vision technicians

Challenges

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

performance of VHGs • Measuring the Impact

Way forward

• Cost effective Technology Innovations

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

“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

L V Prasad Eye Institutewww.lvpei.org

Thank you!

Excellence

Equity

Efficiency