Enhancing Eye Care in Africa:

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Enhancing Eye Care in Africa

• Needs, Challenges Opportunities
• Suggestions for a radical shift of paradigm

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Key priority areas

• HRD Related policies
• Essential Equipment Supplies
• Disease Control Expansion Up Scaling
• Advocacy, targeted, for within Africa
• Evaluation, Monitoring, Documenting reporting

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HRD Needs Strategies

• Existing Staff Optimize their performance
• Assess systematically their strengths
  weaknesses, their training/retraining needs
• Address identified weaknesses
• Provide needed support Follow Up
• Promote support the concept of Eye Care Teams
• New Staff More, quickly better trained
• Review Expand current curriculum for more
  relevance to local needs
• Train all members of the Eye Care Team, not just
  ophthalmologists or ophthalmic nurses, but also
  optometrists, Low Vision technicians, etc!

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EYE CARE TEAMS CURRENTLY AVAILABLE - IN COUNTRY
e.g., MOZAMBIQUE
e.g., DEM. REP. CONGO
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e.g., GUINEA CONAKRY
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SEVERE SHORTAGES OF STAFF
CAR
CONGO BRAZZA
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HRD Needs Strategies, contd

• Sync HRD with Essential Equipment needed
• Plan anticipate these needs from the time
  training of staff is being planned, NOT AFTER.
• Ensure availability by the time the trainees
  return from training (this is still not
  happening)
• Ensure better and more effective Coordination
  among All HRD Sponsors Stakeholders
• Make (help) all those involved in training
  (sponsors, national coordinators, training
  institutions, etc,) work together better
  coordinate their inputs, as real partners

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HRD Needs Strategies

• For All Staff Address in a sustainable way
  issues related to HRD Policies
• Recruitment of ophthalmic personnel
• Deployment of eye care teams
• Retention motivation/remuneration of ophthalmic
  personnel
• CME

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2. Equipment Priority Needs

• Comprehensive Inventory of Country Needs
• Assess priority needs re essential equipment
  supplies in each country, province by province
• Assess identify gaps in the procurement and
  distribution of the above in each country
• Identify/Assess procurement opportunities
  options within countries within each sub-region
• Coordination Facilitation of Procurement
  Delivery of all essential supplies between MOH,
  NGDO/Missions/Central Medical Stores
• Coordinate Facilitate, as appropriate

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3. Disease Control Priority Needs

• Cataract Do a lot More a lot Better
• More surgeries on more people in most parts of
  each country, not just in a few high volume
  centers
• Using better and affordable techniques, e.g.,
  SICS monitoring visual outcomes (not just the
  numbers!)
• Get serious with other V2020 Priorities
• Childhood/Pediatric Ophthalmology services in
  each country aim for at least one in each
  country
• Refractive Services, for school children
  (priority ) for core adult professions
  medical staff, teachers, pastors, women in small
  businesses, etc, needing good vision to read,
  place IV drips, knit or sew

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3. Dis. Control Priority Needs, Contd

• Start getting ready now, for the next big ones
• Glaucoma develop national strategies/guidelines
  a few fully equipped centres in each country
  define minimum standards of care
• Diabetic retinopathy same as above
• Provide specific support closer follow up to
• Promising or potentially successful projects to
• Carefully selected NGDO, MOH, Foundations
  projects already doing well but still with
  potential to do even better
• Document and report and share each success story

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4. Advocacy

• Getting the message across more effectively, more
  clearly more widely
• Let more Africans friends of Africa, know get
  concerned/enthused about the many real life
  challenges of poor eye health and limited access
  to comprehensive eye care among their fellow
  citizens
• Let them know especially how they can get
  involved how those with means can contribute
• Help develop country sub-regional country
  strategies (some good ideas already available in
  IAPB Africas Business Plan)
• Stop improvising. Use involve experts, for
  specific campaigns or on an ad-hoc basis

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4. Advocacy, contd

• Target specific groups for political financial
  support, e.g.
• Senior Officials, MOH, Ministry of Finance with
  decision making power
• Corporations Companies Local Businesses.
• Document document documentAnd report
  report report And share each success story
  across the continent, to inspire encourage
  others

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5. Monitoring Documenting

• A lot more is taking place than is currently
  being reported or documented, even in Africa!
• A good data collection (HMIS) system already
  exists, could be perfected, but is still largely
  underutilized for lack of support staff.
• Countries programmes should be helped in the
  documentation reporting of their own successes.
  
• Clear strategies are needed to better document
  ongoing progress
• Such strategies should include helping countries
  own as much as feasible, the documenting process.

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Underlying paradigm shift

• From prevention of blindness to eye health, from
  disease control to promotive, preventive
  curative services
• From selective eye care to a few, to
  comprehensive eye care to most
• From doing well even a lot, to doing enough to
  make a lasting impact, especially where the needs
  are the greatest
• From providers centered services, to patients
  centered community-wide services