Review & Development of Actionable National Plan - South East Asia An IAPB-VISION 2020 Workshop

VISION 2020: The Right to Sight the global initiative for elimination of avoidable blindness was jointly launched by World Health Organization (WHO) and International Agency for Prevention of Blindness (IAPB), in Geneva in the year 1999. This has an international membership of NGOs, professional associations, eye care institutions and corporations, each committed to the elimination of avoidable blindness by the year 2020. This resulted in a coordinated effort to plan for eye care delivery systems in the developing countries represented. The member countries of WHO developed their own national VISION 2020 plans to achieve the goal of eliminating avoidable blindness. The eye care efforts of all providers were largely aligned towards these plans.

We are now exactly at the midpoint in this journey towards achieving elimination of avoidable blindness by 2020. The national plans of the countries in the South East Asia Region have had differing degrees of success in implementation. With a decade of experience behind us and with another decade of work ahead of us, it is the right time to pause and take a relook at the national plans.

These plans guide the nation-wide eye care programmes and hence it is imperative that the targets set within the plans are at a level to address the blindness burden in country. While it is a common practice to set small incremental targets, it is clear that such targets are not sufficient to meet all eye care needs of the country. The ultimate targets should be driven by the need in the community while the intermediary milestones should take into account the current realities and the extent to which they can be changed with appropriate strategies and policies. While the target setting exercise is important, in addition the national plan should also delineate what exactly are the issues in service delivery and incorporate the solutions to them in the national plan by way of new strategies and policies.

In order to ensure successful implementation, it is important to incorporate in the plan, the required infrastructure, human resource, working structure and policies to improve the efficiency of the eye care system. The national plan should accommodate all of these support structures. It should also take into considerations the possible hurdles that are likely to be faced during implementation. Based on the lessons learnt over the last decade, the national plans should also address current issues including:

• Issues related to accessibility, affordability, awareness of eye care services
• Referral systems to integrate primary and secondary care
• Resource allocation for eye care in the health budgets of the government and NGOs
• Addressing the availability and mal-distribution of various cadres of ophthalmic personnel
• The need for an effective coordination body at the national level that can monitor the work being done in all areas and also leverage the services of government, private and voluntary sectors in eye care.

This workshop is designed to review the national plan from the following dimensions:

• To see if the target set reflects the magnitude of eye care needs of the country which is estimated as the desired annual workload
• To incorporate strategies that will address issues related to implementation: relating to patients accessing the service, the human resources required for the implementation and the capacity to produce them, and the necessary structures that will support effective implementation

Workshop Outcomes
The workshop aimed to review the existing national plans to:

• Create better alignment of these plans to the actual eye care needs in the community
• Recognise the real issues faced in implementation of these plans and ensuring a solution as part of the plan
• Create an actionable national plan for each of the participating countries from the South-East Asia region.

These discussions helped to draft the action plan to take forward the work being done in the field of eye care in the countries of:

• Bangladesh
• Bhutan
• Nepal
• India
• Sri Lanka