strategies to operationalise primary eye care boateng wiafe, md, regional director for africa course...
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Strategies to Operationalise Primary Eye Care
Boateng Wiafe, MD, Regional Director for Africa
Course 11, 9GA IAPB
Hyderabad, 18 Sept, 2012
In any community . . . . . .
There are 3 categories of people:1. The healthy group
2. The group at risk of eye diseases or problems
3. The group with certain eye diseases or problems
These can only be identified only when community screening takes place
1.Konyama K: Essential Components of Primary Eye Care: J Comm Eye Health1998;11(26):19-21
Primary Eye Care Services
Should not only be clinical, but equal or more attention is needed for people without the disease.
PEC covers the whole range of eye health care for ALL community members.
There should be something in the package of activities for every member in the community
Situational Analysis
A situational analysis should be the first activity that need to be conducted before deciding to implement any Primary Eye Care programs
information Eye Health of individuals in the community Available system of health / eye health care
• State of PHC in the area• State of secondary level eye care in the area• Available human resources • Health financing
This will help to develop a strategic plan which will guide you in the implementation.
2Strategies for the Prevention of Blindness in National Programmes
Participatory planning
TOGETHER WITH STAKEHOLDERS• Problem Identification• Problem analysis• Strategy development• Action plan formulation
This ensures ownership of the plan and likelihood of it being implemented
Results of the analysis
The results of the analysis can be categorized into the following:• Human Resource available• Common eye conditions in the area• Infrastructure and Equipment• State of the health system• Political will• Resources for eye services• Level of awareness about eye health
advocacy
Advocacy is considered to be the lifeline of any sustainable eye care program, therefore advocacy should be• A planned activity at all levels • All key staff should be trained in
advocacy skills
Human resource management
Human Resources are the most important asset in any eye programme, especially in the developing world
The situational and the Gap Analysis will give us some valuable information.
These are 3 essential aspects of HRM• HRD/ Continuous Professional Development • Teambuilding• Motivation
integration Primary eye care is an integral part of Primary
Health Care and should be managed as such. District Health is PHC
Joint planning sessions are very important here. At the district level this is exactly what happens.
Reports are shared with other departments as well
We put systems in place to ensure that they compliment each other.
Joint Monitoring
Partnerships and networking
It is very important to never underestimate any player in eye health in the community
Take stock of what is already happening and see how it can be improved, up-scaled or realigned
NEVER COMPETE, BUT COMPLEMENT EACH OTHER
AVOID DUPLICATION OF EFFORTS
Awareness Creation
Awareness creation should be an on going activity and should be present in all programs• All appropriate methods should be applied
when creating awareness
IEC Materials should be appropriate and relevant
DELEGATE
•Task shifting and Task sharing are happening in so many other disciplines
•Many of us are scared to delegate for fear of failure
•Once you have trained the staff well you can safely delegate.
Motivation
Remember that Motivation does not equal financial incentives.
Following are some suggested forms of motivation:• Recognition of their contribution• Conducive working environment (Infrastructure
and equipment)• Opportunities for career advancement
Managing Infrastructure and Equipment
These account for up to 70% of the budgets in eye care services and so they should be carefully managed
Appropriate Technology does not mean cheap, low quality equipment
Maintenance culture should be cultivated An up to date inventory should be in place
Improving Quality of Care Improving the quality of Care is a change
process and many of us are afraid to change
Once the quality of care (Clinical and Non Clinical) improves, the uptake of services increases
advocacy
Advocacy is considered to be the lifeline of any sustainable eye care program, therefore advocacy should be• A planned activity at all levels • All key staff should be trained in
advocacy skills
Financial Management
It is important to consider all activities in the Primary Eye Care program along business lines.
Activities undertaken should be cost effective
It is important to know and apply the principles of resource mobilization and cost recovery EVEN AT THE COMMUNITY LEVEL
Monitoring and Evaluation
This is a very important aspect of Management we always overlook. At district level, we have always seen joint monitoring to be the best approach
There should be a program of supportive supervision
In Conclusion
In order to build sustainable primary eye care models we would recommend the following CHECK LIST
How do we build sustainable models?
By developing a plan owned by the program Strategic plan Action plan Indicators
Is there an Advocacy plan?Is there a plan to create awarenessIntegrated in other ongoing programsBy maintaining and continually improving standardsPlan for staff development Monitoring and evaluation planIndicators