National prevention of blindness Programs and Vision 2020 OPHTHALMIC EDUCATION [Archives:2001/29/Health]

July 16 2001

The Right to Sight – PART 7
Dr. Tawfik K. Al-Khatib
Assistant Prof. of Ophthalmology
Faculty of Medicine, Sana’a University.

Q: Are National programs relevant to VISION 2020?
A: A key part of vision 2020 is devolving decision marking and planning to district level – the idea of planning services for units of one million people. Generally when we have tried to plan for larger populations, we have not been successful. This has led some people to question whether national prevention of blindness programs have any role in VISION 2020. Well managed national programs can play a major part in implementing VISION 2020. However, ineffective programs risk becoming irrelevant as the focus of activity will inevitably shift to the districts.
Q: What should National Programs focus on?
A: The main task of a national prevention of blindness programs should be to provide a framework for vision 2020 at the district level. It was successful because it pooled experience and expertise from many sources, and we have all agreed to pursue some clearly defined goals rather than independently pursuing our own priorities. In the same way, at national level, a multitude of isolated, independent programs will not be the most efficient way to eliminate avoidable blindness. A national program can help by providing guidelines in response to a variety of questions – for example:
How should we monitor cataract out comes?
Which districts should have the highest priority for full implementation of SAFE?
What is the minimum standard of equipment and supplies for district eye clinics?
All of these issues are best decided at national level.
Secondly, national programs are vital for human resource development. They must advise the government about the numbers and cadres of eye workers that are needed, how they should be trained, and what they should do. Again, this must be done at national level. It would be unacceptable if ophthalmic assistants were permitted to do cataract surgery in one district, not in another. The program should ensure that eye workers are not only trained, but also empowered – that is:
They are suitably equipped and supplied.
They have a realistic job description.
They have authority to plan their work within the limits of the job description.
They receive continuing medical education.
Finally, national programs should act as channels of communication. They should be constantly sharing good ideas, spreading the message that avoidable blindness can be defeated, encouraging the best programs, and helping the rest to improve. An effective national program will ensure that there is no such thing as an isolated eye worker.
Community Eye Health Vol. 13 No. 36 2000