Background
The notion of “universal health coverage” promulgated by WHO is gaining momentum and in many countries, influencing the policy framework that guides health plans. While this plays out differently in different settings, the goal of universal health coverage is to ensure that all people obtain health services they need without suffering financial hardship when paying for them. This requires:

  • a strong, efficient, well-run health system;
  • a system for financing health services;
  • access to essential supplies and technologies;
  • a sufficient capacity of well-trained, motivated health workers

Estimated annual eye care need for a 50,000 population

  • 300-500 Cataract surgeries
    (Targeting a CSR of 6,000 to 10,000)

  • 6000-8000 Spectacles
    (Including children, young adults and those with presbyopia)

  • 500 Glaucoma
    (1% of the population would have glaucoma)

  • 1250 known Diabetics
    (5% of the population is diabetic of which roughly half are diagnosed – they need to be screened each year for Diabetic Retinopathy)

  • 200 Diabetic Retinopathy
    (15% of the known diabetics would have DR)

Universal health care, is more comprehensive and far reaching in its objectives of ensuring accessibility and availability of health care services for the population in need. In eye care too, Vision Centres approach for primary eye care delivery is now becoming a widely accepted model towards ensuring eye care for everyone. Increasingly governments in India and other countries are exploring primary eye care approach through Vision Centres. Universal eye health is a possibility, but only when:

  1. Everyone in need of any form of eye care is able to access and have their needs addressed
  2. Systems enable and are accountable for detection and compliance to follow up for speciality eye services as well as preventive and rehabilitative services.
    Several Vision Centre networks have demonstrated to varying degrees, the potential to achieve universal coverage in its true sense. In addition to becoming the gateway to comprehensive eye care services, Vision Centres could play a role in changing community’s health seeking behaviour and enlarging the patient base.

Emerging opportunities:
Emerging diagnostic technologies and IT systems are opening up possibilities for Vision Centres to become more comprehensive in their service delivery, enhance the effectiveness of tertiary care and also deepen the reach into the community. We need to proactively exploit this. Opportunities emerge from:

  • Better understanding of the population and the community to deepen the reach and thus enhance the footfalls at the Vision Centres
  • New low cost technologies in imaging, refraction and other diagnostics that can help detect and monitor advanced eye problems with a lot more precision
  • Cloud based platforms for better tracking of compliance to treatment advise and referrals – be it further investigations, surgeries or routine follow up, especially for chronic eye problems
  • IT systems that allow for real time monitoring systems of parameters varying from quality of care to community coverage
  • Management tools to improve efficiency of Vision Centre operations – be it supply chain management and resource management

Our recent experiment with several Vision Centres at Aravind has demonstrated that the Vision Centres can enhance compliance to follow-up for chronic conditions like DR and Glaucoma; ensure local availability of specialized eye medication; prevent corneal ulceration through prophylactic intervention; identify those with low vision or blind for rehab services. Thus the Vision Centres seem to have the potential to significantly enhance the efficacy of tertiary care services and its reach.

This consultation:
This two day consultation aims to bring together eye care providers and experts to share experiences, deliberate on strategies and approaches in order to leverage Vision Centres to achieve universal eye health in large scale across communities.

Expected outcomes:
- Develop clarity on leveraging Vision Centre’s potential towards achieving universal coverage and delivering comprehensive eye care services
- Insights on emerging technologies and how they could help us to achieve the true goal of universal coverage
- A monograph on preferred practices for achieving universal coverage.

Methodology:
- Peer learning by way of sharing experiences – successes and challenges faced
- Demonstration of technologies – IT systems as well as emerging ophthalmic technologies

Target group:
Eye hospitals that have vision centres, INGOs, policy makers from the Ministry of Health – Govt. of India as well as various States. Participation from each hospital to include representation from senior leadership and managers of Vision Centres & outreach.

Contact
LEAD FACULTY: Mr. Mohammed Gowth, Faculty Associate, LAICO - Aravind Eye Care System (mohammed@aravind.org).