Integrating Primary Eye Care
and
Primary Health Care
17th Sept 2012
Dr Padmaja Kumari Rani,M.S,FNB (Retina)
Head, Village Vision Complex
International Centre for Advancement of Rural Eye Care (ICARE)
L V Prasad Eye Institute
Hyderabad
PEC PHC
Acknowledgement:Puwat Charukamnoetkanok, MD, Thailand
PEC PHC
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Integrating
Primary Eye Care
and
Primary Health Care
Why
What
How
Global Scenario – Thailand Case Study
Indian Scenario (OEU & LVPEI Case studies)
Challenges
Way forward
PEC PHC
Why?
• Holistic care
• Treating causes of causes
• Wide reach
• Sustainability
PEC PHC
What?
W
H
O
PEC PHC
What?
• Horizontal approach
• Team work
• Networking
PEC PHC
What?
W
H
O
PEC PHC
How?
• Location
• Areas of Integration
• Stake holders
PEC PHC
How?
Khan et al
PEC PHC
Global scenario-Thailand
PEC PHC
Global scenario-Thailand
PEC PHC
PEC PHC
Global scenario-Thailand
PEC PHC
Indian scenario – OEU
Operation Eye Sight Universal – India
• Launched in 1963
• 15 Projects
• 11 Partners
HBCEHP –
USEHP –
OE India -
• 9 States & UT
• 3.4 million - people
covered
• 0.75 million – persons
directly benefited
•Immunization coverage
•ANC/ PNC coverage has
reached 100%
•Increased Awareness levels
PEC PHC
Indian scenario – LVPEI
To eliminate avoidable blindness through
integration of Primary eye care with Primary health
care by community Development Initiatives.
Who is a Vision health guardian
•Local village person
•Literate
•Healing touch
•Health worker background
PEC PHC
LVPEI (2010-2012)
• One tiny Village (5 months) – n-746
• Mandal ( District Subunit) – 54 villages with
(2011-14) n-39,000
• Present Coverage – 70 villages -n-100,000
Methodology
i. Identification and Training of Village Vision
Health Guardians
i. Awareness creation
ii. Service delivery
iii. Community Development Initiatives
Methodology
I . Identification and Training of Village Vision Health
Guardians and village vision committee formation
Methodology
II. Awareness creation
Teachers Training Program
Teacher conducting Eye screening
Methodology
III. Service delivery
Methodology
IV: Community Development Initiatives
JSS trade training program inauguration
JSS trade training program in house wiring and electrical maintenance for
village youth
Vision Garden Inauguration
PEC PHC
Coverage of One Mandal -54 Villages
PEC PHC
Situational Analysis of Study area
Illiteracy in Jainad Mandal
% of population below poverty line
39.45 % - very low in females
>26%
Pattern of agriculture
Dry crops / irrigated dry crops cultivation due to
lack of perennial source of irrigation
Infrastructure
Poor Drainage / Sanitation / Power supply, roads
etc.,
Employment opportunities
Meager, due to lack of industries or arable lands
and low scope for self employment
Type of houses
Gas connection
50% Semi pucca
30%
Individual toilets attached to houses
26%
Average percapita annual income
Rs 29,187/GDP : 8,786 crores [2007-2008]
PEC PHC
Project Survey Data
Slums/Villages surveyed
Houses surveyed
54
9,538
Population covered through door to door survey
38,829
Diabetes high risk [score>60]
Known diabetics identified (2.5%)
Known Hypertension (3.4%)
Identified with High BP > 140/90 by VHG
Identified with disability [All category]
People identified with eye ailments and referred
for eye examination
56
1,006
1106
221
103
2,740
PEC PHC
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Project Survey Interim Data
Blindness (<6/60)-0.4%
Visual Impairment (<6/18)-7.1%
Spectacles prescribed- 664
Spectacles Purchased-354 (53%) children-35
Cataract Identified – 771
Patients visited SC-491
Cataract surgeries done-122
PEC PHC
Project Survey Interim Data
• Eye health and Primary health education
events conducted -363
• n-2,877
• Number of pregnant women in the covered
villages - 408
• Antenatal care-408 , Postnatal care-140
PEC PHC
Qualitative Impact
Master SaiKumar
Three VHGs – enrolled as Vision technicians
PEC PHC
Challenges
• Slow Process
• Linkage with health care providers
• Understanding Motivators/Barriers for
performance of VHGs
• Measuring the Impact
PEC PHC
Way forward
• Cost effective Technology Innovations
• Care of the Community, by the Community
and for the Community
“Thousands of candles can be lit from a single
candle, and the life of the candle will not be
shorter. Happiness never decreases by being
shared.”
The Buddha
Thank you!
L V Prasad Eye Institute
www.lvpei.org
Excellence
Equity
Efficiency
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Dr Padnaja Kumari Rani_ Integrating Primary eye care and primary