National Blindness Control

Programme

Presented by :-Sneha .Phalle

Sneha . Gopalkrishnan

NBCP

• It was launched in the year 1976 as a 100% centrally sponsored programme.

• India was the first country in the world to launch a national level blindness control programme.

• The implementation was decentralized in

1994-95 with the formation of district blindness society in each districts of the country.

GOALS• To reduce the prevalence of blindness (1.49% in

1986-89) to less than 0.3%. • To establish an infrastructure and efficiency levels

in the program to be able to cater new cases of blindness each year to prevent future backlog.

OBJECTIVES• To reduce the backlog of blindness through

identification and treatment of blind. • To develop comprehensive eye care facilities in

every district.• To develop human resources for eye care services.• To improve quality of service delivery. • To secure participation of civil society, NGOs, and

private sector in eye care.• To enhance community awareness on eye care.

National Program Management Cell

State Program Cell

District Blindness Control Society

District

District HospitalOpthalmic SurgeonDistrict Mobile Unit

District Health Officer

CHCs

PHCs

Medical Officers

Paramedical Opthalmic Assistants

Organisation StructureNational Level: It is managed by Directorate General

of Heath Service, Min. of Health and Family Welfare, New Delhi.

State Level: State Health Society is formed with

the following members: Chairman : State Mission Director/

Secretary Vice Chairman : Director Health Services Member Secretary : Joint/ Dy. Director (from

the state cadre)

District Level:The District Health Society has max. of 15 members,

consisting of not more than 8 ex-officio and 7 other members as detailed below:

Chairman: District collector/ District Mission Director

Vice- Chairman: Chief Medical & Health Officer

Member Secretary: Officer of the level of Dy. CMO, preferably an opthalmologist

Technical Advisor: Chief Opthalmic Surgeon of District Hospital.

Members: Medical Suprintented/ Civil Surgeon of distict hosp.

District Education Officer Representatives from NGOs District Mass Media/ IEC Officers Prominent Practicing Eye Surgeons

Manpower & Infrastructure (2003)

states population

No:of districts

Eye facilities

Eyebeds

Eye surgeons

Opthalmic assistants

optometrists

Totl opticshops

Chandigarh

900914 ----------

28 135 64 -------------- --------- 0

Delhi 13782976 9 156 1601 592 5 ------ 0

Gujarat 42735439 25 427 4362 562 172 103 779

Goa 13343998 2 19 104 29 5 13 42

Kerala 27953614 14 120 1663 376 147 98 176

Maharashtra

94565379 35 578 4488 1128 611 190 734

Tamil Nadu

53870165 30 267 9673 740 356 233 191

Eleventh Five Year Plan (2007-2012)

Following target has been set for the 11th five year plan:

• Prevention and control and management of Diabetes retinopathy

• Hospital based Screening of Glaucoma and prevention of childhood blindness.

• Improvement in the visual outcome of cataract surgery by performing IOL implantation.

• Development of Pediatric Ophthalmology Units.• Development of fully functional eye bank

networks.• Developing human resource and institutional

capacity.

STRATEGIESThe four pronged strategy of the program is:1. Developing institutional capacity2. Developing human resources for eye care3. Strengthening service delivery4. Promoting outreach activities and public awareness

REVISED STRATEGIES• Strengthening services for other causes of blindness.• To shift from eye camp approach to a fixed facility

surgical approach and from conventional surgery to IOL implantation.

• To expand World Bank projects to the whole country.• To strengthen participation of voluntary organisations• to enhance the coverage of eye care services to

tribal and other under served areas.

ACTIVITIES• Cataract Operations• Involvement of NGOs• Civil works• Training• Commodity Assistant• Information, Education, Communication• Management Information System• Monitoring and Evaluation• School eye screening program• Collection and utilisation of donated eyesOTHER MAJOR ACTIVITIES• Control of vitamin A deficiency• Control of Trachoma• Ophthalmic assistant

FUNDING

• Funds will be released by the GOI to State Health Society based on annual action plan.

• For release of funds, the state society has to submit the following documents:

⁻ Statement on performance and expenditure⁻ Audited statement of accounts⁻ Utilization certificate⁻ State annual action plan for the current year• GOI will release funds into 2 equal installments,

first will equivalent to 50% of planned budget and second will be released on basis of progress made.

• The central government has allocated Rs.1550 crore under the 11th plan for national program which was just Rs.450 crore in 10th plan.

• Though it is a Central Govt program, major service providers are NGOs, non- profit orgs, private, corporate hospitals, philanthropists, volunteers.

• Since almost 75-80% of eye care within the country is provided through non govt. organisations, this resource should be used appropriately.

Funds Released & Expenditure for the Year 2010-11

Particulars Amount (lakhs)

Income

Unspent balance of previous year (08-09) in hand 158.27

Amount received under GIA 1000.00

Amount received (For 5 Medical Colleges) 200

Interest 11.67

Total Funds available (1+2+3) 1169.94

Release & Expenditure

Total Release & Expenditure incurred 707.39

Total Balance available 462.55

Year 2002-032003-042004-052005-062006-072007-082008-09 2009-10 2010-11

Target 240000240000250000250000250000350000450000450000450000

Achievement

224049233870261224274619290973187545376143409601429695

Percentage 93.35 %97.45 %

104.49 %109.85 %116.39 %

92.00%84.00 %91.02 %95.49 %

IOL Percentage

70.00 %

83.00 %

89.26 %

94.50 %

97.00 %

98.00 %

98.00 %

98.47 %

98.72 %

Latest Data For NBCP

KERALA• Cataract is the main cause of blindness in Kerala

state. • There are about 2.5 – 3.0 lakhs blind people in

Kerala.• There are about 25-30,000 corneal blindness

cases.

Vitamin A Prophylaxis Programme

• It is a part of National Program for Control of Blindness (India)

• It was launched by the Ministry of Health and Family Welfare in 1970

• It utilises technology developed by National Institute of Nutrition, Hyderabad

• It has helped to decrease the preventable blindness in the community

• Children between nine months to three years are given six monthly doses of vitamin A.

• The administration of the first two doses is linked with routine immunisation.

Objectives: To decrease the prevalence of vitamin A

deficiency from current 0.6% to less than 0.5%

Strategy:• Health and nutrition education to encourage

colostrum feeding, exclusive breast feeding for first 6 months.

• Adequate intake of Vit A rich foods thereafter.• Early detection and proper treatment of infections.• Prophylactic Vit A as per following dosage

schedule: 100000 IU at 9 mnths with measles immunisation 200000 IU at 16-18 mnths, with DPT booster 200000 IU every mnth upto 5 yrs Thus, a total of 9 mega doses to be given from 9

months upto 5 yrs.

Sick Children

• All children with xerophthalmia are to be treated at health facilities.

• All children having measles to be given 1 dose of Vit A if they have not received it in the previous month.

• All cases of severe malnutrition to be given one additional dose of Vit A.

VISION 2020

• Right to sight. • To eliminate the main

causes of avoidable blindness in India.

Challenges in implementation

*identified by department

5 challenges perceived by VISION 2020 INDIA

1) NGO/ Voluntary sector participation2) Strengthened Public Sector3) Convergence4) Rehabilitation services5) Human resources

Thank you!!!