Monitoring Primary Eye Care Systems

8/16/2019 Monitoring Primary Eye Care Systems

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Assessing Primary Eye Health DeliveryA Systems Approach

Dr. Sandeep ButtanMS (Ophth), MSC CEH (ICEH, UK)

Program Development Advisor E!e Health "HSS (Asia)

Sightsavers


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What does it mean?

What does it mean to my (your) or!?

#$%#&%$#'&OC $#'&, o*!o

Health Systems " a ne Bu##ord


3/25

Health

+a state o -omplete physical$ mental and social .ell/eing

and not merel! an a/sen-e o disease or inirmit!01

It also in-l2des the a/ilit! to lead a socially andeconomically productive li%e0

Preamble to the Constitution of the World Health Organization as adopted by the

International Health Conference, New Yor, !"#$$ %une, !"&'(


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Health& 'omple Prolem

'ommunity

*amily

+ndividual

3Political system , ill toard health

, development

3Social construct (classes , casts)

3Basic civic amenities (Hygiene ,

sanitation)3*amily , social support

3Economic status , livelihood options

3Education

3Aareness (Health , health careservices)

3-eneral health , ell eing

3rgan speci%ic disease or in%irmityDeterminants o% Health


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Actors$ %unctions and outcomes

People

+nput /anagementH4

Medi-ine

Cons2ma/les

Inormation

e-hnolog!

*inancing4even2e generation

4is* pooling

Allo-ation and

p2r-hasing

5overnmentPoliti-ians

Poli-! ma*ers

ProvidersP2/li-%private

Inormal

Service deliveryP2/li- health

O2trea-h

O2tpatient -ons2ltation

Inpatient -areS2rger!

Other a-torsDonors

65Os

Prote-tion rom

impoverishment

Improve Health

stat2s

-overnance4eg2lation

Poli-ies


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Health Systems approach

)*ll organizations, people and actions whose primary intent is to promote,

restore or maintain Health+


7/257 Sightsavers

Health Systems

'1 Providing services

$1 5enerating the human and physical resources that ma*e

servi-e deliver! possi/le

0. 1aising and pooling the resources 2sed to pa! or health

-are

2. Steardship 8 setting and enor-ing r2les, strategi-

dire-tion

*unctions3 Processes


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Health Systems

-oals

'1 Improved health (level

and e92it!)

$1 4esponsiveness

:1 So-ial and inan-ial ris*

prote-tion

&1 Improved ei-ien-!

Attriutes

'1 A--ess

$1 Coverage

:1 ;2alit!

&1 Saet!


9/257 Sightsavers

Primary eye care

PEC is an integrated, participatory and inclusive approach to the eye

health component of PHC”

“It consists of eye health promotion, prevention, curative and

rehabilitation services.

It is anchored in the community and is delivered by the health

worforce and community members up to and including the front line

health facilities.”


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Primary eye care& a comple

intervention

Health systemHealth inan-ing

Health .or*or-e

treat =%> reer

4e-ord *eeping

Sto-* -ontrol

4 e , e r

r a l s a n d

H M I S

ther health providers

Inormal Health

Pra-titioners Private

se-tor Others e1g1

Opti-ians, pharma-ists

et-1

'ommunity

?elies and attit2des

Health and other prioritiesillingness to pa!

A--ess to servi-es

So-ioe-onomi- development

Health see*ing /ehavio2r

S 2 p e r v

i s i o n,

s 2 p p l i e s

a n d C

P D


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4niversal access to eye health& a gloal

action plan$ 567285679

/ay 5670$ -eneva

:+S+;

A .orld in .hi-h no one is needlessl! vis2all! impaired, .here

those .ith 2navoida/le vision loss -an a-hieve their 2ll

potential and there is 2niversal a--ess to -omprehensive

e!e -are servi-es1


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4niversal 'overage8 main elements

'1 Comprehensive e!e -are servi-es (o-2s on Primar! e!e

-are)

$1 E!e health integrated into health s!stems

:1 Ens2re a--ess or v2lnera/le gro2ps (poor, minorities,

PD, .omen)

&1 Point>o>-are Pa!ment sho2ld not prevent a--ess1


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4niversal coverage8 components


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7 Sightsavers

Assessing Health Systems

3 Monitoring o programme inp2ts, pro-esses and res2lts, re92ired or the

management o health s!stem investments@

3 Health s!stems perorman-e assessment, as the *e! or de-ision>

ma*ing pro-esses@ and

3 Eval2ating the res2lts o health reorm investments and identi!ing .hi-h

approa-hes .or* /est1

+n%ormation is needed to trac! ho health systems respond to

increased inputs and improved processes$ and the impact they have

on improved health indicators

Purpose


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7 Sightsavers

Assessment /atri

Inp2ts "Pro-ess O2tp2ts O2t-omes Impa-t

+mproved Health8

Supply

chain

+n%ormation


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7 Sightsavers

4>++@A>+;

A**1DAB++>

SE1:+'E DE+:E1

A''ESS+B++>

+/P1:ED EE HEA>HSA>+S*A'>+;

AWA1E;ESS

DE/A;D

PE'8 +denti%y ey attriutes

EE 'A1E ;EED


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7 Sightsavers

/apping o% components

'//4;+>

>E1>+A1

evel

SE';DA1

evel

Primary 'are

EADE1SH+P3 -:E1;A;'E

1ES41'ES(+;*1AS14'>41E)

+;*1/A>+;

SS>E/

SE1:+'E DE+:E1

HEA>H

W1*1'E

*+;A;'+;-

Access

'overage


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7 Sightsavers

Data collection , Analysis

3 M2ltiple so2r-es

3 ?oth 92antitative " 92alitative data (Primar! data)

3 A--essing availa/le data so2r-es (Se-ondar! data)

3 Setting I s!stems or ro2tine -olle-tion o relevant

inormation

/ied methodology


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Data 'ollection

/anagement3

Policy /a!ers

ocal'oordinators

PA>+E;>S

'//4;+>

SE1:+'E

P1:+DE1S

+;>E1:+EW

*-D

*-D

EC+>

+;>E1:+EW

S41:E

P+'

D'4/E;>S

*A'++>

:+S+>

*A'++>1EP1>S

('+;+'A 3

*+;A;'+A /+S)

1-A;+@A>+;

SE1:+'E

4;+>

BE;+*+'+A1+ES

P1+/A1 DA>ASE';DA1

DA>A


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7.-:E1;A;'E

'1 ision " poli-ies

$1 Strategi- planning

:1 Operational planning

5. H4/A;1ES41'E

'1 4e-r2itment -riteria

$1 raining

:1 In-entive " motivation

2. *+;A;'E

'1 So2r-e o 2nds

$1 Cost -ons-io2sness

. SE1:+'EDE+:E1

'1 Servi-e -omponents

$1 Coverage

:1 Comm2nit!engagement

&1 Integration .ith healths!stems

0. HEA>H+;*1/A>+;

'1 Data -olle-tion

$1 4evie. " anal!sis:1 e-hnolog!

E**E'>+:E;ESS

'1 A--ess ordisadvantaged gro2ps

$1 Aorda/ilit!

E

'1 A--essi/ilit!

$1 Availa/ilit! " -ontin2it!

:1 Health see*ing

&1 Satisa-tion

E**+'+E;'

'1 Cost re-over! "s2staina/ilit!

HEA>H SS>E/S *4;'>+;S

4>P4>S

Systems +ndicators , Analysis


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7 Sightsavers

Assessment /aps

-overnance

Health Wor!%orce

/edicines and >echnology

Health *inancing

+n%ormation

Service delivery

6

6

766


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'hallenges in measuring systems

strengthening

3 6ot pres-riptive

3 O/Be-tive, eviden-e>/ased and

tailored to the -ontet

3 Indire-t lin* /et.een HSS and health

o2t-omes Attri/2tion dii-2lt

3 Donor -oordination

3 term pro-ess


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All PEC initiatives are -ontet spe-ii-

3 Dierent approa-hes in dierent settings

3 Dierent priorities

3 Dierent roles pla!ed /! 5overnments, 65Os and Private

se-tor

3 Dierent so-io>politi-al environment

3 Dierent levels o interventions (Individ2al, Instit2tion,

so-iet!, poli-!)


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Systems thin!ing

Every intervention$ %rom the simplest to the most comple$

has an e%%ect on the overall system$ and the overall

systemhas an e%%ect on every intervention


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If you can!t plan it, "ou can!t do it

If you can!t measure it, you can!t

manage it

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Monitoring Primary Eye Care Systems